The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70743

Robert Heimer, PhD¹, Mark Kinzly¹, Anthony Givens¹, Marcella Sorg, PhD², and Margaret Greenwald, MD³. (1) Epidemiology and Public Health, Yale University, 60 College St., P.O Box 208034, New Haven, CT 06511, (2) ITHCRA Project, MCSC University of Maine, 11 Glenwood St., Coburn Hall, Orono, ME 04469, 207-581-2596, marcella_sorg@umit.maine.edu, (3) Medical Examiner's Office, State of Maine, #37 State House Station, Augusta, ME 04333

Aims: To investigate the fatal opiate overdoses in two New England states, determine overdose rates, ascertain differences in the opiates involved, and identify possible causes for the differences. Methods: Overdose deaths from the state medical examiner’s offices in Connecticut and Maine for 1997-2001 attributed to opiates were compiled and analyzed. Drug use data were collected from active opiate users in the two states. Results: In Connecticut, the annual rate of opiate-related overdoses was constant at about 1.76 per 100,000 inhabitants over the five year study period. The majority of opiate-related overdoses were attributed to heroin alone (32.1%) or in combination with alcohol and/or cocaine (30.4%). Fewer overdoses were associated either with methadone alone (4.2%) or combination with other drugs (7.1%) or with oxycodone alone (4.6%) or in combination with other drugs (2.1%). In Maine, overdoses per 100,000 inhabitants increased from 2.66 in 1997, to 5.16 in 1999, and to 7.04 in 2001. Decedent toxicologies about equally included methadone (23.5%) and heroin (22.7%), with oxycodone a strong third (16.8%). Maine has recently experienced waves of increases in opiate misuse – first oxycodone, followed by heroin and methadone. Opiate misuse in Connecticut, in contrast, has remained largely one of heroin. Conclusions: Differences in drug use patterns between Maine and Connecticut combined with a widespread increase in opiate misuse in Maine were reflected in the fatal overdoses patterns in the two states. Different intervention strategies to prevent overdoses will need to be developed for these two states.

Learning Objectives:

• List key causes of fatal opiate overdoses in Connecticut and Maine;
• Recognize that the causes of overdoses in the two states are very different;
• Describe the higher rates of opiate overdoses Maine; and
• Explain the possible causes of these differences.

Keywords: Drug Abuse, Death

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.