The rate of drug overdose from prescription opioids increased seven-fold in New York City over a 16-year period and was concentrated especially among white residents of the city, according to latest research at Columbia University's Mailman School of Public Health. The study is one of the earliest and most comprehensive analyses of how the opioid epidemic has affected an urban area.
The findings are published in Drug and Alcohol Dependence.
There are two classes of prescription opioids: analgesics, or painkillers like Oxycontin (oxycodone), and methadone, which is used to treat heroin addiction but which carries a risk of overdose. Using data from the city's Office of the Chief Medical Examiner for the period 1990-2006, the researchers examined the factors associated with death from prescription opioids versus heroin, which historically has been the most common type of opioid fatality in urban areas.
They found that the increase in the rate of drug overdose was driven entirely by analgesic overdoses, which were 2.7 per 100,000 persons in 2006 or seven times higher than in 1990. Meanwhile, methadone overdoses remained stable, and heroin overdoses declined.
Whites were much more likely to overdose on analgesics than blacks or Hispanics. By 2006, the fatality rate among white males was almost two times higher than the rate among Latinos and three times higher than the rate among blacks.
Deaths were mostly concentrated in neighborhoods with high-income inequality but lower-than-average rates of poverty.
"A possible reason for the concentration of fatalities among whites is that this group is more likely to have access to a doctor who can write prescriptions," says Magdalena Cerdá, DrPH, assistant professor of epidemiology at Columbia's Mailman School of Public Health and the lead author on the study. "However, more often than not, those who get addicted have begun using the drug through illicit channels rather than through a prescription."
Price may also play a role, since heroin costs less than analgesics. Additionally, users of prescription opioids may perceive they are safer than other drugs.
Although methadone overdose rates did not increase overall, fatalities among whites increased almost nine-fold while among blacks decreased by 2%. This shift may reflect a change in the nature of methadone use, from a treatment for heroin addiction to a treatment for chronic non-cancer pain.
The study suggests that the profile of a recreational prescription opioid user is very different from the heroin consumer, with less involvement in street-based forms of drug-trafficking and use of other drugs such as cocaine. Because of the different demographics between heroin and prescription opioid users, a different public health approach is needed to target the latter group, say the authors. "It's a different type of drug with a different profile, and we need a different type of response to it," said Dr. Cerdá.
Over the last 20 years, prescription drug overdoses have risen dramatically in the U. S. By 2006, overdose fatalities exceeded the number of suicides, and by 2009, they exceeded the number of motor vehicle deaths.
Most studies on recreational opioid use have focused on rural areas, which have been hit the hardest by the epidemic, but this study suggests that urban areas are contending with a growing health burden from opioid use.
The authors recommend regulating the aggressive marketing of potent drugs like Oxycontin, controlling over-prescribing of analgesics, and taking stricter measures to regulate sales. They also say there should be more law enforcement measures to identify illicit networks of distribution of these drugs and education outreach for physicians and patients.
About Columbia University's Mailman School of Public Health
Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu
Stephanie Berger | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy