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Tag: overdose rates

  • Cities Now Outpace Rural Towns In Overdose Deaths

    Cities Now Outpace Rural Towns In Overdose Deaths

    In 2017, there were a reported 22 overdose deaths per 100,000 people in urban areas, officially surpassing the 20 deaths per 100,000 in rural areas by a slim margin.

    Rural areas have been hardest hit by the opioid crisis, but overdoses in cities are now on the rise.

    As it developed, coverage of the opioid crisis seemed to center on rural white Americans. Now, overdose rates in urban areas of the United States has overtaken rural rates.

    This shift began happening in 2015 and, according to experts like Dr. Daniel Ciccarone, is due to a change in the dynamic of opioid addiction. The exact nature of this shift isn’t precisely known.

    One argument is that the crisis initially began because prescription opioid painkillers were available to virtually anyone in the United States at the discretion of a doctor. This allowed opioid addiction to grip Midwestern and Appalachian areas in a way other drugs could not. 

    Theories

    As awareness of opioids grew, prescription pills became harder to come by. This pushed people who were already hooked to look for heroin and fentanyl–drugs more easily found in urban areas where illicit markets are already in place.

    An alternative theory is that the epidemic has simply expanded to the point where it’s started to affect black and Hispanic populations who tend to live in more urban areas.

    “Early on, this was seen as an epidemic affecting whites more than other groups,” said Dr. Ciccarone. “Increasingly, deaths in urban areas are starting to look brown and black.”

    In 2017, there were a reported 22 overdose deaths per 100,000 people in urban areas, officially surpassing the 20 deaths per 100,000 in rural areas by a narrow margin.

    Overdoses continue to be an epidemic, killing about 68,000 Americans last year. According to data from the Centers for Disease Control (CDC), overdoses in urban areas are affecting mostly men and are caused mostly by fentanyl and heroin. However, overdoses are killing more women in rural areas. These rural deaths are mostly caused by meth and opioid painkillers.

    This epidemic doesn’t discriminate, not only between race and geography, but wealth and fame as well. Most recently, Saoirse Kennedy Hill, the granddaughter of Robert F. Kennedy, was found dead of an overdose on Thursday at just 22 years old. Other prominent people who lost their lives to overdose include the actor Philip Seymour Hoffman, the legendary musician Prince, and rapper Mac Miller.

    View the original article at thefix.com

  • Opioid Addiction Isn't Just A Rural Problem

    Opioid Addiction Isn't Just A Rural Problem

    While the epidemic has been framed as one that mostly affects rural America, new research shows that overdose rates are actually higher in urban areas.

    The common narrative of the national opioid crisis has been that this “disease of despair” has affected rural areas the most.

    However, a new working paper argues that economic depression and access to opioids are the biggest determinants of overdose rates in both rural and urban areas. 

    “I really do want to push back against this cliche that addiction does not discriminate,” Shannon Monnat, the paper’s author and a sociologist at Syracuse University, told Pacific Standard. “The physiological processes that underlie addiction themselves may not discriminate, but the factors that put people in communities at higher risk are are not spatially random.”

    Looking at non-Hispanic whites and controlling for demographics, Monnat found that overdose rates were highest in urban areas. The rate decreased the further one moved from cities, a trend that held true for all racial groups. Overall, urban counties had an average of 6.2 more deaths per 100,000 people than rural counties. 

    Interestingly, supply and demand interacted differently in rural and urban settings. In the city, supply of drugs seemed to have the biggest effect on overdose rates. In rural areas, economic distress was the stronger predictor of overdose rates.

    “A lot of what’s going on here are regional effects,” she said. “You get regional levels of despair and distress that seemed to reinforce and exacerbate the problem.”

    Monnat did find that some of the things associated with rural living were connected with an increased risk for overdose. For example, areas with an economy heavily dependent on mining or the service industries had higher rates of overdose. Controlling for how many drugs were supplied to an area, places with higher economic distress had higher overdose rates. 

    “What that means is that drug mortality rates aren’t higher in economically distressed places simply because they’ve had a greater supply of opioid prescribing there,” she said. “There’s something about economic distress in and of itself that helps to explain the variation that we’re seeing across the country and the magnitude of the drug crisis.”

    Places hardest hit by the crisis, like West Virginia, had both economic vulnerabilities and an excessive supply of opioids, Monnat said.

    “It’s no coincidence that widespread opioid prescribing first started in the most economically vulnerable places of the country—there was vulnerability there. These places had been primed to be vulnerable to opioids, which are drugs that numb both physical and mental pain, through decades of economic and social decline.”

    View the original article at thefix.com

  • Drug-Related Deaths Plunge In Ohio: How They Did It

    Drug-Related Deaths Plunge In Ohio: How They Did It

    The fading presence of carfentanil may have played a major role in the decline of drug-related deaths in some parts of Ohio.

    Overdose deaths in Montgomery County—in Dayton, Ohio—have dramatically decreased in 2018. The county has seen an incredible 54% decline in overdose deaths: there were 548 by November 30 last year; this year there have been 250.

    Dayton is an economically-challenged city, deserted of jobs after manufacturers left in droves. Some speculate that this is part of the reason why Dayton had the highest opioid overdose death rates in the nation in 2017.

    The overdose deaths were so rapid and unrelenting that according to Wral.com, the coroner’s office continuously ran out of space, and ended up renting refrigerated trailers. So what has changed?

    The New York Times did extensive research and reporting on the ground to look into the positive changes in Dayton. Dayton Mayor Nan Whaley believes the largest impact on the rate of overdose deaths came from Gov. John Kasich’s decision to expand Medicaid in 2015. This expansion allowed almost 700,000 low-income adults access to free addiction and mental health treatment.

    In addition to the treatments being free for low-income residents, the expansion of Medicaid pulled in more than a dozen new treatment providers within a year. Some of these providers are residential programs and outpatient clinics that utilize methadone, buprenorphine and naltrexone for their patients. These are the three FDA-approved medications to treat opioid addiction.

    “It’s the basis — the basis — for everything we’ve built regarding treatment,” NYT reported Mayor Whaley said at City Hall. “If you’re a state that does not have Medicaid expansion, you can’t build a system for addressing this disease.”

    Dayton’s East Held holds a bimonthly event called Conversations for Change, which lays out the available addiction treatment options. Food is served, and anyone attending can meet treatment providers. The New York Times reported the evening they attended there were more than a dozen tables of providers.

    Significant to a large degree is the fading presence on the streets of Dayton of carfentanil, an analog of the synthetic opioid fentanyl. Carfentanil is described by the CDC as 10,000 times more powerful than morphine.

    In recent years carfentanil was very present in Ohio street drugs, for unknown reasons. Mid-2017 carfentanil’s hold began to loosen, possibly because drug traffickers realized they were losing money due to the large upsurge in overdose deaths, said Timothy Plancon, a DEA special agent in charge of Ohio.

    A crucial decision was made by Richard Biehl, Dayton police chief, in 2014. Chief Biehl ordered all officers to carry naloxone, directly contrary to some of his peers in other Ohio cities. Naloxone, or Narcan, is the well-known medication that reverses opioid overdoses if administered in a timely manner.

    Police in Ohio and others elsewhere oppose harm reduction tools like naloxone due to a belief that they simply enable drug use. Still, the evidence is overwhelming that they save lives.

    View the original article at thefix.com