Understanding Regional Patterns of Overdose Deaths Related to Opioids and Psychostimulants.

Autor:	Segel JE; Department of Health Policy and Administration, Penn State University, University Park, Pennsylvania, USA.; Penn State Cancer Institute, Hershey, Pennsylvania, USA.; Consortium on Substance Use and Addiction, Penn State University, University Park, Pennsylvania, USA., Shearer RD; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA., Jones AA; Consortium on Substance Use and Addiction, Penn State University, University Park, Pennsylvania, USA.; Department of Human Development and Family Studies, Penn State University, University Park, Pennsylvania, USA., Khatri UG; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Howell BA; SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, Connecticut, USA., Crowley DM; Department of Human Development and Family Studies, Penn State University, University Park, Pennsylvania, USA.; Evidence-to-Impact Collaborative, Penn State University, University Park, Pennsylvania, USA., Sterner G; Consortium on Substance Use and Addiction, Penn State University, University Park, Pennsylvania, USA.; Department of Criminal Justice, Penn State Abington, Abington, Pennsylvania, USA., Vest N; Stanford University School of Medicine, Stanford, California, USA., Teixeira da Silva D; National Clinician Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Department of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Winkelman TNA; Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA.; Health, Homelessness, and Criminal Justice Laboratory, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	Substance use & misuse [Subst Use Misuse] 2024; Vol. 59 (4), pp. 558-566. Date of Electronic Publication: 2024 Feb 08.
DOI:	10.1080/10826084.2023.2287220
Abstrakt:	Background: As overdose rates increase for multiple substances, policymakers need to identify geographic patterns of substance-specific deaths. In this study, we describe county-level opioid and psychostimulant overdose patterns and how they correlate with county-level social vulnerability measures. Methods: A cross-sectional observational study, we used nationwide 2016-2018 restricted access Centers for Disease Prevention and Control county-level mortality files for 1,024 counties. We estimated quartiles of opioid and psychostimulant overdose mortality and provided estimates of their association with county-level Social Vulnerability Index (SVI) percentile. Results: There was high opioid and psychostimulant overdose mortality in the Middle Atlantic, South Atlantic, East North Central, and Mountain regions. The Central US had the lowest opioid and psychostimulant overdose mortality rates. Counties with higher SVI scores (i.e. higher social vulnerability) were significantly more likely to experience high opioid and high psychostimulant overdose (high-high) mortality. A 10-percentile increase in SVI score was associated with a 3.1 percentage point increase in the likelihood of being a high-high county (p < 0.001) in unadjusted models and a 1.5 percentage point increase (p < 0.05) in models adjusting for region. Conclusion: Our results illustrated the heterogenous geographic distribution of the growing concurrent opioid and psychostimulant overdose crisis. The substantial regional variation we identified highlights the need for local data to guide policymaking and treatment planning. The association of opioid-psychostimulant overdose mortality with social vulnerability demonstrates the critical need in impacted counties for tailored treatment that addresses the complex medical and social needs of people who use both opioids and psychostimulants.
Databáze:	MEDLINE
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