142nd APHA Annual Meeting and Exposition

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315203
Unintentional drug poisoning deaths in New York City (NYC), opioid analgesic and heroin trends, 20002012

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:10 PM - 3:30 PM

Ellenie Tuazon, MPH , Bureau of Alcohol, Drug Use, Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, NY
Denise Paone, EdD , Bureau of Alcohol, Drug Use, Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, NY
Michelle Nolan, MPH , Bureau of Alcohol, Drug Use, Prevention, Care and Treatment, New York City Department of Health and Mental Hygiene, Long Island City, NY
Background: Recent increases in the annual number of persons in the United States who used heroin for the first time have raised concerns about transitioning from opioid analgesics to heroin.

Methods: We linked death certificates and files from the Office of the Chief Medical Examiner to conduct a retrospective review of unintentional opioid poisonings in NYC 2000-2012. Joinpoint regression modeling was used to measure annual percent change in mortality rates and to detect significant linear trends between years.

Results: During 2000­–2012, there were 9,085 unintentional drug overdose deaths in NYC. Seven in ten deaths involved an opioid; of those, 50% involved heroin and 18% involved an opioid analgesic; 7% involved both heroin and opioid analgesics. The rate of unintentional drug overdose deaths increased from 2000–2006 and 2010–2012 by 2.4% (p=0.08) and 17.4% (p=0.11) respectively; the rate decreased annually by 11% from 2006­–2010 (p=0.02). The rate for deaths involving opioids showed similar trends from 2000–2012, with notable decreases from 2006­–2010, 9.9% annually, (p<0.05). From 2000–2012 the rate for deaths involving opioid analgesics (without heroin) increased annually by 10% (p<0.05). In contrast, rates for deaths involving heroin (without opioid analgesics) decreased annually by 5.3% (p<0.05) from 2000–2012.

Conclusions: Despite decreases in heroin-associated mortality from 2000-2012, rates of opioid analgesic involved deaths steadily trended upwards. Ongoing surveillance and analysis of trends by demographic and geographic characteristics can inform public health initiatives that can prevent overdose death.

Learning Areas:

Epidemiology
Public health or related research

Learning Objectives:
Describe heroin and opioid analgesic overdose trends in New York City for the years 2000-2012 and identify overdose prevention strategies.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist with the New York City Department of Health and Mental Hygiene; I work on real-time analyses of unintentional drug poisoning (overdose) data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.