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!
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology