The association between community social vulnerability and prescription opioid availability with individual opioid overdose.

Autor: El Ibrahimi S; Division of Research and Evaluation, Comagine Health, Portland, OR, United States; School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, United States. Electronic address: selibrahimi@comagine.org., Hendricks MA; General Medical Sciences division, Washington University School of Medicine, St. Luis, MO, United States., Little K; Division of Research and Evaluation, Comagine Health, Portland, OR, United States., Ritter GA; Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States., Flores D; Division of Research and Evaluation, Comagine Health, Portland, OR, United States., Loy B; Injury and Violence Prevention Program - Public Health Division - Oregon Health Authority, Portland, OR, United States., Wright D; Injury and Violence Prevention Program - Public Health Division - Oregon Health Authority, Portland, OR, United States., Weiner SG; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2023 Nov 01; Vol. 252, pp. 110991. Date of Electronic Publication: 2023 Oct 12.
DOI: 10.1016/j.drugalcdep.2023.110991
Abstrakt: Background: This study aims to assess the association of community social vulnerability and community prescription opioid availability with individual non-fatal or fatal opioid overdose.
Methods: We identified patients 12 years of age or older from the Oregon All Payer Claims database (APCD) linked to other public health datasets. Community-level characteristics were captured in an exposure period (EP) (1/1/2018-12/31/2018) and included: census tract-level social vulnerability domains (socio-economic status, household composition, racial and ethnic minority status, and housing type and transportation), census tract-level prescriptions and community-level opioid use disorder (OUD) diagnoses per 100 capita binned into quartiles or quintiles. We employed Cox models to estimate the risk of fatal and non-fatal opioid overdoses events in the 12 months following the EP.
Main Findings: We identified 1,548,252 individuals. Patients were mostly female (54%), White (61%), commercially insured (54%), and lived in metropolitan areas (81%). Of the total sample, 2485 (0.2%) experienced a non-fatal opioid overdose and 297 died of opioid overdose. There was higher hazard for non-fatal overdose in communities with greater OUD per 100 capita. We also found higher non-fatal and fatal hazards for opioid overdose among patients in communities with higher housing type and transportation-related vulnerability compared to the lowest quintile. Conversely, patients were at less risk of opioid overdose when living in communities with greater prevalence of the young or the elderly, the disabled, single parent families or low English proficiency.
Conclusion: These findings underscore the importance of the environmental context when considering public health policies to reduce opioid harms.
Competing Interests: Declaration of Competing Interest None declared.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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