The 130th Annual Meeting of APHA

3287.0: Monday, November 11, 2002 - Board 7

Abstract #44436

Poly-drug use and fatal overdose in New York City, 1990-1998

Sandro Galea, MD, MPH1, Jennifer Ahern, MPH1, Kenneth J Tardiff, MD, MPH2, Phillip O Coffin, MIA1, Andrew C Leon, PhD3, and David Vlahov, PhD1. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 5th Avenue, New York, NY 10029, 212-822-7378,, (2) Department of Psychiatry, New York Presbyterian Hosptial, 525 East 68th Street Box 140, New York, NY 10021, (3) New York Presbyterian Hospital, 525 East 68th Street, Box 140, New York, NY 10021

BACKGROUND Drug overdose fatalities have long contributed to the high mortality rate among drug users, yet efforts to understand and prevent overdoses and resultant fatalities are rare. Knowledge of the characteristics of drug use preceding overdose fatality can contribute to the development of preventive programs. METHODS Using records from the Office of the Chief Medical examiner we analyzed records on all fatal accidental drug overdoses in New York City (NYC) between 1990-1998. We examined decedents' positive toxicology for cocaine, opiates, alcohol, and cannabis and calculated annual rates of accidental drug overdose standardized to the 1990 NYC population. RESULTS Among 7,560 fatal overdoses over the 9 year period, 79.4% of decedents were male. Overall, 36.5% were African-american, 32.8% were white, and 29.9% were hispanic. 75.3% of all deaths happened inside a personal residence. Drugs were detected in 94.4% of all deaths; cocaine was present in 68.8% of all deaths, opiates in 73.2%, alcohol in 41.9% and cannabis in 7.5%. Most (67.8%) decedents were positive for multiple drug toxicology. Cocaine and opiates were present in 26.7% of all deaths and cocaine and alcohol were present in 21.9%. African-americans decedents were more likely to be positive for only one drug than other racial/ethnic groups. Overall, there were consistently 2-2.5 times more deaths from poly-drug overdose than from single-drug overdose during the time period of study. CONCLUSIONS Multiple drug use was consistently more common among accidental overdose decedents in NYC during the 1990s. Public health interventions might address the hazards of poly-drug use.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Poly-Drug Use: Multiple Problems, Multiple Challenges Poster Session

The 130th Annual Meeting of APHA