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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4173.0: Tuesday, December 13, 2005 - Board 9

Abstract #113528

Public heath disparities in rural areas: High rates of prescription opioid abuse?

Richard Dart, MD, PhD and Alice Hughes, MSPH. Rocky Mountatin Poison & Drug Center, 777 Bannock St, Mail Code 0180, Denver, CO 80204, 303-739-1229, Alice.Hughes@rmpdc.org

Background: Prescription drug abuse is an emerging important public health concern. Allegedly, rural areas have higher rates of prescription drug abuse. We measured the frequency of intentional exposure calls to 8 poison centers (PC) as indicators of misuse and abuse of prescription opioids. Methods: Intentional exposure calls from 11/03/02 through 9/30/03 that involved fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone (excluding OxyContin®) or OxyContin® alone were defined as cases of misuse or abuse. Data were grouped by three-digit zip code into 11 population categories. Results: A 5 fold difference in call rate was found (*per 100,000 total population of 3 digit zip code, population in thousands).

Population:   100- 200- 300- 400- 500- 600- 700- 800- 900-  
  <100 200 300 400 500 600 700 800 900 1,000 >1,000
Call Rate*: 15.25 10.12 7.37 5.56 6.04 8.41 8.71 5.26 9.62 4.51 3.25

ANOVA testing indicates a higher prevalence of intentional exposure calls from lower population areas (p<0.01). Calls involving hydrocodone were most common; fentanyl and hydromorphone were least common. Similar trends in call rates by population area were present for all 7 opioids studied and will be presented. The call rate was greater from low population areas despite lower overall call penetration in these areas. Conclusion: Among several possible reasons for increased PC call rates are higher incidence of prescription drug use/misuse per capita, lack of local medical resources, or increased willingness to call PC in rural areas. Poison centers offer another perspective on rural health disparities.

Learning Objectives:

Keywords: Rural Populations, Prescription Drug Use Patterns

Presenting author's disclosure statement:

Not Answered

Patterns of Substance Use Among Adults Poster Session

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA