Racial/ethnic differences in opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States, 1999-2017. | LitMetric
Milkin Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052, United States; Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900 Calverton, MD 20705, United States. Electronic address:
Published: July 2020
AI Article Synopsis
Article Abstract
Background: From 1999 to 2017, more than 400,000 Americans died from a drug overdose death involving an opioid. Early surveillance studies have observed large variations in opioid-involved overdose deaths among different geographic regions and racial/ethnic groups. The purpose of this study was to characterize trends in racial/ethnic opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States from 1999 to 2017.
Methods: The analysis used National Vital Statistics System data from 1999 to 2017 that were accessed through the CDC WONDER online database. Drug overdose deaths involving any opioid were identified using the International Classification of Diseases, Tenth Revision, codes and were represented as age-adjusted rates per 100,000 population. Joinpoint regression was used to examine trends in opioid-involved overdose deaths among racial/ethnic groups (non-Hispanic white, non-Hispanic black, Hispanic, non-Hispanic other) by metropolitan and non-metropolitan status (large metropolitan areas, medium-small metropolitan areas, and non-metropolitan areas).
Results: The annual age-adjusted death rates for drug overdose deaths that involved any opioid significantly increased for all racial/ethnic groups in metropolitan and non-metropolitan areas from 1999 to 2017. The largest average annual increases in rates occurred among non-Hispanic whites in non-metropolitan areas (13.6% increase per year) and medium-small metropolitan areas (12.3% increase per year), followed by non-Hispanic blacks in medium-small metropolitan areas (11.3% increase per year).
Conclusions: The variations in opioid-involved overdose deaths among different racial/ethnic groups across geographic regions support the existence of multiple sub-epidemics in the current opioid overdose crisis and provide directions for targeted intervention efforts.
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For over 40 years, ivermectin has served as an effective anti-parasitic drug used in human and veterinary medicine. In laboratory animal facilities it is used prophylactically or therapeutically to maintain the health status of the colony or experimentally in studies. Although ivermectin is generally safe to use, there are reports of neurotoxicity associated with ivermectin crossing the blood-brain barrier due to overdosing or blood-brain barrier dysfunction.
Objectives: Yearly rolling aggregate trends or rates are commonly used to analyze trends in overdose deaths, but focusing on long-term trends can obscure short-term fluctuations (eg, daily spikes). We analyzed data on spikes in daily fatal overdoses and how various spike detection thresholds influence the identification of spikes.
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Purpose: Most drug-related deaths in the United States (US) in 2022 involved opioids. However, methodological challenges in overdose surveillance may contribute to underestimation of opioid involvement in the overdose crisis. This scoping review aimed to synthesize existing literature to examine the breadth and contributing sources of misclassification of opioid-related overdose deaths.
