The Increasing Prevalence of Fentanyl: A Urinalysis‐Based Study Among Individuals With Opioid Use Disorder in New York City

Abstract Background Along with a growing opioid epidemic nationwide, opioid users often have an increased risk of severe infectious diseases including endocarditis, osteomyelitis, and central nervous system (CNS) abscess. As the largest city in the United States, New York City (NYC) may serve as a study model for opioid use and infectious diseases. We investigated the association between opioid use and hospitalizations for endocarditis, osteomyelitis, and CNS abscess in NYC. Methods Data for NYC residents aged ≥18 years discharged from New York State hospitals during 2001–2014 were analyzed using a hospital discharge dataset. We defined a hospitalization for endocarditis, osteomyelitis, and CNS abscess as one with a principal or secondary diagnosis for these conditions within the discharge record. We identified opioid users by examining principal or secondary diagnoses for opioid use within the discharge record at the time of hospitalization for endocarditis, osteomyelitis, and CNS abscess. Log-binomial model was applied among all hospitalized patients using endocarditis, osteomyelitis, and CNS abscess as the outcome, adjusting for age, sex, race, and borough. Results During 2001–2014, there were 139,392 hospitalizations in total for endocarditis, osteomyelitis, or CNS abscess, of which 8,823 (6.3%) were among opioid users. There was an increased risk of hospitalization for endocarditis [RR: 2.6 (95% CI: 2.5–2.7)], osteomyelitis [RR: 1.1 (95% CI: 1.1–1.1)], and CNS abscesses [RR: 1.9 (95% CI: 1.8–2.1)] among hospitalized opioid users compared with hospitalized nonopioid users, adjusted by age, sex, race, and borough. Hospitalized opioid users had four times the risk for endocarditis hospitalization compared with hospitalized nonopioid users in the 18–44 year age group (RR: 4.2 [95% CI: 3.9–4.5]) (Table 1). Conclusion These results provide further evidence that opioid use is associated with an increased risk of endocarditis, osteomyelitis, and CNS abscess. Efforts to combat the opioid epidemic might lower the overall incidence of endocarditis, osteomyelitis, and CNS abscess. Disclosures All authors: No reported disclosures.

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Opioid Use Initiation, Progression, and Motivations Among OEF/OIF/OND-Era Veterans in New York City: An Age-Period-Cohort Analysis

Military Behavioral Health ◽

10.1080/21635781.2017.1343163 ◽

2017 ◽

Vol 6 (1) ◽

pp. 75-81 ◽

Cited By ~ 5

Author(s):

Luther Elliott ◽

Andrew Golub ◽

Alexander Bennett

Keyword(s):

New York ◽

New York City ◽

York City ◽

Cohort Analysis ◽

Opioid Use

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Hepatitis C Virus Incidence in a Cohort in Medication-Assisted Treatment for Opioid Use Disorder in New York City

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz659 ◽

2020 ◽

Vol 222 (Supplement_5) ◽

pp. S322-S334

Author(s):

Ashly E Jordan ◽

Charles M Cleland ◽

Katarzyna Wyka ◽

Bruce R Schackman ◽

David C Perlman ◽

...

Keyword(s):

New York ◽

New York City ◽

Hepatitis C Virus ◽

Hepatitis C ◽

York City ◽

Antibody Test ◽

Female Gender ◽

Drug Injection ◽

Opioid Use ◽

Medication Assisted Treatment

Abstract Background Hepatitis C virus (HCV) incidence has increased in the worsening opioid epidemic. We examined the HCV preventive efficacy of medication-assisted treatment (MAT), and geographic variation in HCV community viral load (CVL) and its association with HCV incidence. Methods HCV incidence was directly measured in an open cohort of patients in a MAT program in New York City between 1 January 2013 and 31 December 2016. Area-level HCV CVL was calculated. Associations of individual-level factors, and of HCV CVL, with HCV incidence were examined in separate analyses. Results Among 8352 patients, HCV prevalence was 48.7%. Among 2535 patients seronegative at first antibody test, HCV incidence was 2.25/100 person-years of observation (PYO). Incidence was 6.70/100 PYO among those reporting main drug use by injection. Female gender, drug injection, and lower MAT retention were significantly associated with higher incidence rate ratios. Female gender, drug injection, and methadone doses <60 mg were independently associated with shorter time to HCV seroconversion. HCV CVLs varied significantly by geographic area. Conclusions HCV incidence was higher among those with lower MAT retention and was lower among those receiving higher methadone doses, suggesting the need to ensure high MAT retention, adequate doses, and increased HCV prevention and treatment engagement. HCV CVLs vary geographically and merit further study as predictors of HCV incidence.

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