Trends in Drug Overdose Mortality Rates in Kentucky, 2019-2020.
Ontology highlight
ABSTRACT:
SUBMITTER: Slavova S
PROVIDER: S-EPMC8278264 | biostudies-literature | 2021 Jul
REPOSITORIES: biostudies-literature
Publications
Trends in Drug Overdose Mortality Rates in Kentucky, 2019-2020.
Slavova Svetla S Quesinberry Dana D Hargrove Sarah S Rock Peter P Brancato Candace C Freeman Patricia R PR Walsh Sharon L SL
JAMA network open 20210701 7
Similar Datasets
Project description: Not available
| S-EPMC9856503 | biostudies-literature
Project description: Not available
| S-EPMC9166618 | biostudies-literature
Project description:BackgroundDrug overdose deaths in the USA have increased rapidly in the past 20 years, and understanding patterns and trends in mortality is essential to develop policy responses. This study aimed to determine whether cohort patterns in mortality due to drug overdose have changed in the past two decades and assess these patterns by race and sex.MethodsThe national records of accidental drug overdose death were extracted from Centers for Disease Control and Prevention, National Center for Health Statistics Mortality Data for 2000-2020. Age-period-cohort analysis was performed to examine independent effects of age, period and birth cohort on accidental drug overdose mortality.FindingsThe number of accidental drug overdose deaths increased by 622% between 2000 and 2020, and age-standardized mortality rates increased nearly four-fold in both men and women. Age-period-cohort decomposition found rapid increases in mortality since 2012 in men and women, with higher mortality risk in cohorts born after 1990. The fastest increase occurred in Black Americans since 2012, and Americans of all races born after 1975 had significantly higher mortality risk, with mortality risk increasing rapidly in more recent cohorts. The peak of mortality has shifted from the 40-59 age group to the 30-40 year age group in the past decade.InterpretationThe burden of drug overdose mortality has shifted to younger Americans, and a new generation of Americans are at significantly higher and rapidly increasing risk of overdose death. Urgent action is needed to prevent an entire generation of young people being consigned to decades of preventable mortality.FundingNone.
| S-EPMC10359729 | biostudies-literature
Project description:IntroductionPsychotropic drug-implicated (PDI) mortality-deaths in which psychotropic drugs were a contributing but not underlying cause of death-increased over two decades, with circulatory mortality as the primary cause leading to such deaths. Trends in PDI circulatory mortality over a 22-year period and its patterning in U.S. deaths are described.MethodsDeaths extracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research Multiple Causes of Death database from 1999 to 2020 were analyzed to generate annual counts and rates for drug-implicated deaths due to diseases of the circulatory system, including by specific drug, sex, race/ethnicity, age, and state.ResultsDuring a period when overall age-adjusted circulatory mortality rates declined, PDI circulatory mortality more than doubled, from 0.22 per 100,000 in 1999 to 0.57 per 100,000 by 2020, now representing 1 in 444 circulatory deaths. Although PDI deaths from ischemic heart diseases are proportionally aligned with overall circulatory deaths (50.0% vs 48.5%), PDI deaths from hypertensive diseases represent a larger proportion (19.8% vs 8.0%). Psychostimulants generated the greatest escalation for PDI circulatory deaths (0.029-0.332 per 100,000). The sex gap in PDI mortality rates widened (0.291 females, 0.861 males). PDI circulatory mortality is particularly notable for Black Americans and midlife Americans, with considerable geographic variability.ConclusionsCirculatory mortality with psychotropic drugs as a contributing cause escalated over 2 decades. Trends in PDI mortality are not evenly distributed across the population. Greater engagement with patients about their substance use is needed to intervene in cardiovascular deaths. Prevention and clinical intervention could contribute to reinvigorating previous trends of declining cardiovascular mortality.
| S-EPMC10440260 | biostudies-literature
Project description:Previous research has demonstrated increasing diversity in causes of mortality among high-income nations in recent decades, associated with improvements in health and increasing life expectancies. Health outcomes are known to vary widely between communities within these countries and inequalities between sexes and other subpopulations are key in understanding the health of populations. Despite this, little is known about variation in the diversity of mortality causes between these subpopulations. Diversification in mortality causes indicates an increase in the pool of potential causes of mortality an individual is likely to face. This poses challenges for the public health and medical sectors by increasing diagnostic uncertainty and broadening the range of causes to be addressed by public health and medical interventions. Here we examine trends over time in the diversity in causes of mortality in Scotland by sex and area-level deprivation, also examining deaths among those younger than 75 years and those 75 years and older separately. We find that diversity in causes of mortality has increased across subpopulations; that it has risen more quickly in men than women; that the rate of increase has been similar across age categories; and that there is no clear ranking in the trends by deprivation quintile, despite slower improvements in mortality rates among the most deprived. Increasing diversity in mortality causes suggests that a greater public health focus on reducing death rates from a broader range of causes is likely to be required, and this may be especially important for men who face a faster rate of diversification.
| S-EPMC9418986 | biostudies-literature
Project description:Background Breast cancer (BC) and prostate cancer (PC) mortality rates in Lithuania remain comparatively high despite the ongoing BC and PC screening programmes established in 2006. The aim of this study was to investigate time trends in BC and PC mortality rates in Lithuania evaluating the effects of age, calendar period of death, and birth-cohort over a 35-year time span. Methods We obtained death certification data for BC in women and PC in men for Lithuania during the period 1986–2020 from the World Health Organisation database. Age-standardised mortality rates were analysed using Joinpoint regression. Age-period-cohort models were used to assess the independent age, period and cohort effects on the observed mortality trends. Results Joinpoint regression analysis indicated that BC mortality increased by 1.6% annually until 1996, and decreased by − 1.2% annually thereafter. The age-period-cohort analysis suggests that temporal trends in BC mortality rates could be attributed mainly to cohort effects. The cohort effect curvature showed the risk of BC death increased in women born prior to 1921, remained stable in cohorts born around 1921–1951 then decreased; however, trend reversed in more recent generations. The period effect curvature displayed a continuous decrease in BC mortality since 1991–1995. For PC mortality, after a sharp increase by 3.0%, rates declined from 2007 by − 1.7% annually. The period effect was predominant in PC mortality, the curvature displaying a sharp increase until 2001–2005, then decrease. Conclusions Modestly declining recent trends in BC and PC mortality are consistent with the introduction of widespread mammography and PSA testing, respectively, lagging up to 10 years. The study did not show that screening programme introduction played a key role in BC mortality trends in Lithuania. Screening may have contributed to favourable recent changes in PC mortality rates in Lithuania, however the effect was moderate and limited to age groups < 65 years. Further improvements in early detection methods followed by timely appropriate treatment are essential for decreasing mortality from BC and PC. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14207-4.
| S-EPMC9508783 | biostudies-literature
Project description:ImportanceDrug overdoses from opioids like fentanyl and heroin and stimulant drugs such as methamphetamine and cocaine are a major cause of mortality in the United States, with potential sex differences across the lifespan.ObjectiveTo determine overdose mortality for specific drug categories across the lifespan of males and females, using a nationally representative state-level sample.DesignState-level analyses of nationally representative epidemiological data on overdose mortality for specific drug categories, across 10-year age bins (age range: 15-74).SettingPopulation-based study of Multiple Cause of Death 2020-2021 data from the Centers of Disease Control and Prevention (CDC WONDER platform).ParticipantsDecedents in the United States in 2020-2021.Main outcome measuresThe main outcome measure was sex-specific rates of overdose death (per 100,000) for: synthetic opioids excluding methadone (ICD-10 code: T40.4; predominantly fentanyl), heroin (T40.1), psychostimulants with potential for misuse, excluding cocaine (T43.6, predominantly methamphetamine; labeled "psychostimulants" hereafter), and cocaine (T40.5). Multiple regression analyses were used to control for ethnic-cultural background, household net worth, and sex-specific rate of misuse of the relevant substances (from the National Survey on Drug Use and Health, 2018-2019).ResultsFor each of the drug categories assessed, males had greater overall overdose mortality than females, after controlling for rates of drug misuse. The mean male/female sex ratio of mortality rate for the separate drug categories was relatively stable across jurisdictions: synthetic opioids (2.5 [95%CI, 2.4-2.7]), heroin, (2.9 [95%CI, 2.7-3.1], psychostimulants (2.4 [95%CI, 2.3-2.5]), and cocaine (2.8 [95%CI, 2.6-2.9]). With data stratified in 10-year age bins, the sex difference generally survived adjustment for state-level ethnic-cultural and economic variables, and for sex-specific misuse of each drug type (especially for bins in the 25-64 age range). For synthetic opioids, the sex difference survived adjustment across the lifespan (i.e., 10-year age bins ranging from 15-74), including adolescence, adulthood and late adulthood.Conclusions and relevanceThe robustly greater overdose mortality in males versus females for synthetic opioids (predominantly fentanyl), heroin, and stimulant drugs including methamphetamine and cocaine indicate that males who misuse these drugs are significantly more vulnerable to overdose deaths. These results call for research into diverse biological, behavioral, and social factors that underlie sex differences in human vulnerability to drug overdose.Key pointsQuestion: What are the current national trends in overdose mortality from opioids (synthetic opioids such as fentanyl, and heroin) and stimulant drugs (psychostimulants such as methamphetamine and cocaine) for males and females, over the lifespan (overall range 15-74 years)?Findings: State-level analyses of data from CDC for 2020-2021 indicate that after controlling for rates of drug misuse, males had significantly greater (2-3 fold) overdose mortality rates than females for synthetic opioids, heroin, psychostimulants and cocaine. These findings were generally consistent across the lifespan, studied as 10-year age bins (especially in the 25-64 age range).Meaning: These data indicate that males who misuse opioids and stimulant drugs are considerably more vulnerable to overdose mortality, compared to females. This finding calls for research on the underlying biological, behavioral, and social factors.
| S-EPMC9882660 | biostudies-literature
Project description:BackgroundThe availability and use of broadband internet play an increasingly important role in health care and public health.ObjectiveThis study examined the associations between broadband internet availability and use with drug overdose deaths in the United States.MethodsWe linked 2019 county-level drug overdose death data in restricted-access multiple causes of death files from the National Vital Statistics System at the US Centers for Disease Control and Prevention with the 2019 county-level broadband internet rollout data from the Federal Communications Commission and the 2019 county-level broadband usage data available from Microsoft's Airband Initiative. Cross-sectional analysis was performed with the fixed-effects regression method to assess the association of broadband internet availability and usage with opioid overdose deaths. Our model also controlled for county-level socioeconomic characteristics and county-level health policy variables.ResultsOverall, a 1% increase in broadband internet use was linked with a 1.2% increase in overall drug overdose deaths. No significant association was observed for broadband internet availability. Although similar positive associations were found for both male and female populations, the association varied across different age subgroups. The positive association on overall drug overdose deaths was the greatest among Hispanic and Non-Hispanic White populations.ConclusionsBroadband internet use was positively associated with increased drug overdose deaths among the overall US population and some subpopulations, even after controlling for broadband availability, sociodemographic characteristics, unemployment, and median household income.
| S-EPMC11237777 | biostudies-literature
Project description:ImportanceOpioid-involved overdose mortality has been on the rise for 2 decades in the US, exacerbated by an unregulated drug supply that is unpredictable and has increasingly contained highly potent fentanyl analogs starting a decade ago.ObjectiveTo determine whether there is a geospatial association between law enforcement drug seizures and opioid-involved overdose mortality in San Francisco.Design, setting, and participantsThis cross-sectional study used location- and time-stamped overdose mortality data from the Office of the Chief Medical Examiner and publicly available crime data from the San Francisco Police Department between 2020 and 2023 to assess whether location and time of law enforcement drug seizures were associated with subsequent opioid-involved overdose mortality. Data were analyzed from January 2020 to September 2023.ExposuresTime-stamped locations of law enforcement drug seizures involving a drug distribution charge.Main outcomes and measuresThe primary outcomes were the time and location of (1) overdose mortality involving any opioid and (2) overdose mortality involving fentanyl or any fentanyl analog. The relative risk (RR) and 95% CIs for endemic and epidemic factors were calculated.ResultsThere were 2653 drug seizure crime events that involved any drug distribution charge and 1833 overdose deaths that tested positive for any opioid or synthetic opioid, including heroin and fentanyl analogs. Within the surrounding 100 meters, law enforcement drug seizures were associated with increase risk of fatal opioid-involved overdoses the day following the drug seizure event (RR, 1.74; 95% CI, 1.06-2.83; P = .03) and elevated risk persisted for 7 days (2 days: RR, 1.55; 95% CI, 1.09-2.21; P = .02; 3 days: RR, 1.45; 95% CI, 1.08-1.93; P = .01; 7 days: RR, 1.27; 95% CI, 1.11-1.46; P = .001). Similar statistically significant spatiotemporal patterns were observed in the 250- and 500-meter spatial bandwidths. Within each space-time kernel, the strength of the association, all of which were statistically significant, dissipated the further away in time and distance from the law enforcement drug seizure event.Conclusions and relevanceThe findings of this cross-sectional study suggest that the enforcement of drug distribution laws to increase public safety for residents in San Francisco may be having an unintended negative consequence of increasing opioid overdose mortality. To reduce overdose mortality, it may be better to focus on evidence-based health policies and interventions.
| S-EPMC11923703 | biostudies-literature
Project description:IntroductionOpioid and sedative/hypnotic drug overdoses are major causes of morbidity in the U.S. This study compares 12-month incidence of fatal unintentional drug overdose, suicide, and other mortality among emergency department patients presenting with nonfatal opioid or sedative/hypnotic overdose.MethodsThis is a retrospective cohort study using statewide, longitudinally linked emergency department patient record and mortality data from California. Participants comprised all residents presenting to a licensed emergency department at least once in 2009-2011 with nonfatal unintentional opioid overdose, sedative/hypnotic overdose, or neither (a 5% random sample). Participants were followed for 1 year after index emergency department presentation to assess death from unintentional overdose, suicide, or other causes, ascertained using ICD-10 codes. Absolute death rates per 100,000 person years and standardized mortality ratios relative to the general population were calculated. Data were analyzed February-August 2019.ResultsFollowing the index emergency department visit, unintentional overdose death rates per 100,000 person years were 1,863 following opioid overdose, 342 following sedative/hypnotic overdose, and 31 for reference patients without an index overdose (respective standardized mortality ratios of 106.1, 95% CI=95.2, 116.9; 24.5, 95% CI=21.3, 27.6; and 2.6, 95% CI=2.2, 3.0). Suicide mortality rates per 100,000 were 319, 174, and 32 following opioid overdose, sedative/hypnotic overdose, and reference visits, respectively. Natural causes mortality rates per 100,000 were 8,058 (opioid overdose patients), 17,301 (sedative/hypnotic overdose patients), and 3,097 (reference patients).ConclusionsEmergency department patients with nonfatal opioid or sedative/hypnotic drug overdose have exceptionally high risks of death from unintentional overdose, suicide, and other causes. Emergency department-based interventions offer potential for reducing these patients' overdose and other mortality risks.
| S-EPMC7311279 | biostudies-literature