An Analysis of State-Level Policies and Opioid Overdose Deaths

2020 ◽  
Vol 42 (7) ◽  
pp. 535-542
Author(s):  
Nicole Adams ◽  
Ellen Gundlach ◽  
Ching-Wei Cheng
Keyword(s):  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Interrupted Time Series ◽  
Opioid Overdose ◽  
Interrupted Time Series Analysis ◽  
Community Members ◽  
Minimal Impact ◽  
Regulatory Changes ◽  
Overdose Deaths

Many legislative and regulatory changes have occurred at the state level in response to the opioid crisis in an attempt to decrease overdose deaths. We conducted a negative binomial, regression-based, interrupted time series analysis to evaluate the effects of policies on opioid overdose death counts for 2008–2017 in five Midwestern states: Illinois, Indiana, Kentucky, Michigan, and Ohio. Except for the Good Samaritan laws in Illinois, no single policy change was statistically significant in decreasing overdose deaths. Governmental involvement as a whole was significantly associated with an increase in overdose deaths in Indiana. Policies created to address opioid overdose mortality have had minimal impact in these five Midwestern states. Most of the legislation and regulation that have been created lack educational components for prescribers and community members, which may explain why these policies have not had the intended effect.

Drug overdose deaths at work, 2011–2016

2019 ◽  
Vol 25 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Hope M Tiesman ◽  
Srinivas Konda ◽  
Lauren Cimineri ◽  
Dawn N Castillo
Keyword(s):  
Drug Overdose ◽  
Negative Binomial ◽  
Occupational Injuries ◽  
Negative Binomial Regression ◽  
Opioid Overdose ◽  
Full Time ◽  
Demographic Groups ◽  
Drug Overdoses ◽  
The Impact ◽  
Overdose Deaths

Drug overdose fatalities have risen sharply and the impact on US workplaces has not been described. This paper describes US workplace overdose deaths between 2011 and 2016. Drug overdose deaths were identified from the Census of Fatal Occupational Injuries and fatality rates calculated using denominators from the Current Population Survey. Fatality rates were compared among demographic groups and industries. Negative binomial regression was used to analyse trends. Between 2011 and 2016, 760 workplace drug overdoses occurred for a fatality rate of 0.9 per 1 000 000 full-time equivalents (FTEs). Workplace overdose fatality rates significantly increased 24% annually. Workplace overdose fatality rates were highest in transportation and mining industries (3.0 and 2.6 per 1 000 000 FTEs, respectively). One-third of workplace overdose fatalities occurred in workplaces with fewer than 10 employees. Heroin was the single most frequent drug documented in workplace overdose deaths (17%). Workplace overdose deaths were low, but increased considerably over the six-year period. Workplaces are impacted by the national opioid overdose epidemic.

scholarly journals Association between the COVID-19 pandemic and pertussis in France using multiple nationwide data sources

2021 ◽  
Author(s):  
Soraya Matczak ◽  
Corinne Levy ◽  
Camille Fortas ◽  
Jeremie F. Cohen ◽  
Stephane Bechet ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Interrupted Time Series ◽  
Mitigation Strategies ◽  
Data Sources ◽  
Mitigation Measures ◽  
Interrupted Time Series Analysis ◽  
National Network ◽  
Vaccination Recommendations ◽  
Quasi Experimental

Background: Interventions to mitigate coronavirus disease 19 (COVID-19) pandemic may impact other respiratory diseases such as pertussis. We aimed to study the course of pertussis in France over an 8-year period and its association with COVID-19 mitigation strategies, using multiple nationwide data sources. Methods: We analyzed the number of French pertussis cases between 2013 and 2020, using the PCR test results from nationwide outpatient laboratories (Source 1) and the pediatric network of 41 hospitals (Source 2), and using the reports of an office-based pediatric national network (Source 3). We conducted a quasi-experimental interrupted time-series analysis, relying on negative binomial regression models. The models accounted for seasonality, longterm cycles, and secular trend, and included a binary variable for the first national lockdown (ordered on March 16, 2021). Results: We identified 19,039 cases of pertussis from the three data sources during the study period. There was a significant decrease of pertussis cases following the implementation of mitigation measures, with adjusted incidence rate ratios of 0.102 (95% CI 0.040-0.256) and 0.216 (95% CI 0.071-0.656) for Source 1 and Source 2, respectively. The association was confirmed in Source 3 (median of 1 [IQR 0-2] vs. 0 [IQR 0-0] pertussis cases per month before and after lockdown, respectively, p=0.0048). Conclusion: The drastic reduction of outpatient and hospitalized cases of pertussis strongly suggests an impact of COVID-19 mitigation measures and their consequences on pertussis epidemiology. Pertussis vaccination recommendations should be carefully followed, and disease monitoring should be continued to detect any resurgence after relaxation of mitigation measures.

Exploration of the STOP Act and Opioid Deaths in North Carolina, 2010–2018

2020 ◽  
Vol 110 (10) ◽  
pp. 1573-1577
Author(s):  
Phillip Hughes ◽  
Sheri Denslow ◽  
Bayla Ostrach ◽  
Carriedelle Fusco ◽  
Casey Tak
Keyword(s):  
North Carolina ◽  
Interrupted Time Series ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Interrupted Time Series Analysis ◽  
Opioid Use ◽  
The North ◽  
Opioid Deaths ◽  
The Impact ◽  
Overdose Deaths

Objectives. To examine the impact of North Carolina’s 2017 Strengthening Opioid Misuse Prevention (STOP) Act on opioid overdose deaths. Methods. We used quarterly data from the North Carolina Opioid Dashboard to conduct an interrupted time series analysis ranging from 2010 to 2018. Results were stratified by heroin–fentanyl deaths and other opioid deaths. Results. After the STOP Act, there was an initial rate increase of 0.60 opioid deaths per 100 000 population (95% confidence interval [CI] = 0.04, 1.15) and a decrease of 0.42 (95% CI = −0.56, −0.29) every quarter thereafter. Results differed by stratification. Conclusions. Our results suggest that North Carolina’s STOP Act was associated with a reduction in opioid deaths in the year following enactment. The changes in opioid overdose death trends coinciding with the STOP Act were similar to outcomes seen with previous opioid policies. Public Health Implications. Future policies designed to reduce the availability of opioids may benefit from encouraging and increasing the availability of evidence-based treatment of opioid use disorder.

scholarly journals Population-level impact of infant 10-valent pneumococcal conjugate vaccination on adult pneumonia hospitalisations in Finland

Thorax ◽  
2017 ◽  
Vol 73 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Omar Okasha ◽  
Hanna Rinta-Kokko ◽  
Arto A Palmu ◽  
Esa Ruokokoski ◽  
Jukka Jokinen ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Population Level ◽  
Interrupted Time Series ◽  
The Elderly ◽  
Negative Binomial Regression Model ◽  
Interrupted Time Series Analysis ◽  
Entire Study ◽  
Before And After ◽  
International Statistical Classification

IntroductionLimited data are available on population-level herd effects of infant 10-valent pneumococcal conjugate vaccine (PCV10) programmes on pneumonia. We assessed national trends in pneumococcal and all-cause pneumonia hospitalisations in adults aged ≥18 years, before and after infant PCV10 introduction in 2010.MethodsMonthly hospitalisation rates of International Statistical Classification of Diseases, 10th revision (ICD-10)-coded primary discharge diagnoses compatible with pneumonia from 2004–2005 to 2014–2015 were calculated with population denominators from the population register. Trends in pneumonia before and after PCV10 introduction were assessed with interrupted time-series analysis. Rates during the PCV10 period were estimated from adjusted negative binomial regression model and compared with those projected as continuation of the pre-PCV10 trend. All-cause hospitalisations were assessed for control purposes.ResultsBefore PCV10, the all-cause pneumonia rate in adults aged ≥18 years increased annually by 2.4%, followed by a 4.7% annual decline during the PCV10 period. In 2014–2015, the overall all-cause pneumonia hospitalisation rate was 109.3/100 000 (95% CI 96.5 to 121.9) or 15.4% lower than the expected rate. A significant 6.7% decline was seen in persons aged ≥65 years (131.5/100 000), which translates to 1456 fewer pneumonia hospitalisations annually. In comparison, hospitalisations other than pneumonia decreased by 3.5% annually throughout the entire study period.ConclusionThese national data suggest that herd protection from infant PCV10 programme has reversed the increasing trend and substantially decreased all-cause pneumonia hospitalisations in adults, particularly the elderly.

scholarly journals Psychiatric consequences of a father’s leave policy by nativity: a quasi-experimental study in Sweden

2021 ◽  
pp. jech-2021-217980
Author(s):  
Helena Honkaniemi ◽  
Srinivasa Vittal Katikireddi ◽  
Mikael Rostila ◽  
Sol P Juárez
Keyword(s):  
Mental Health ◽  
Negative Binomial ◽  
Parental Leave ◽  
Negative Binomial Regression ◽  
Interrupted Time Series ◽  
Well Being ◽  
Migrant Health ◽  
Interrupted Time Series Analysis ◽  
Psychiatric Hospitalisation ◽  
Leave Policy

BackgroundParental leave use has been found to promote maternal and child health, with limited evidence of mental health impacts on fathers. How these effects vary for minority populations with poorer mental health and lower leave uptake, such as migrants, remains under-investigated. This study assessed the effects of a Swedish policy to encourage fathers’ leave, the 1995 Father’s quota, on Swedish-born and migrant fathers’ psychiatric hospitalisations.MethodsWe conducted an interrupted time series analysis using Swedish total population register data for first-time fathers of children born before (1992–1994) and after (1995–1997) the reform (n=198 589). Swedish-born and migrant fathers’ 3-year psychiatric hospitalisation rates were modelled using segmented negative binomial regression, adjusting for seasonality and autocorrelation, with stratified analyses by region of origin, duration of residence, and partners’ nativity.ResultsFrom immediately pre-reform to post-reform, the proportion of fathers using parental leave increased from 63.6% to 86.4% of native-born and 37.1% to 51.2% of migrants. Swedish-born fathers exhibited no changes in psychiatric hospitalisation rates post-reform, whereas migrants showed 36% decreased rates (incidence rate ratio (IRR) 0.64, 95% CI 0.47 to 0.86). Migrants from regions not predominantly consisting of Organisation for Economic Cooperation and Development countries (IRR 0.50, 95% CI 0.19 to 1.33), and those with migrant partners (IRR 0.23, 95% CI 0.14 to 0.38), experienced the greatest decreases in psychiatric hospitalisation rates.ConclusionThe findings of this study suggest that policies oriented towards promoting father’s use of parental leave may help to reduce native–migrant health inequalities, with broader benefits for family well-being and child development.

scholarly journals The Economic Underpinnings of the Drug Epidemic

2019 ◽  
Author(s):  
Nathan Seltzer
Keyword(s):  
Labor Market ◽  
Labor Markets ◽  
Drug Overdose ◽  
Manufacturing Sector ◽  
State Level ◽  
Opioid Overdose ◽  
Transformative Change ◽  
Drug Deaths ◽  
Overdose Deaths ◽  
The U.S

U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999-2017 that comprise over 700,000 drug deaths, I test two questions. First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be accounted for by manufacturing decline? The findings provide strong evidence that restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 77,000 overdose deaths for men and up to 40,000 overdose deaths for women are attributable to the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time, including the supply of prescription opioids. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.

scholarly journals Temporal Trends in Opioid Prescribing Patterns Among Oncologists in the Medicare Population

2020 ◽  
Author(s):  
Vikram Jairam ◽  
Daniel X Yang ◽  
Saamir Pasha ◽  
Pamela R Soulos ◽  
Cary P Gross ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Temporal Trends ◽  
State Level ◽  
Negative Binomial Regression ◽  
Time Frame ◽  
Prescribing Patterns ◽  
Annual Number ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Opioid Prescribing

Abstract Background In the wake of the US opioid epidemic, there have been efforts to curb opioid prescribing. However, it is unknown whether these efforts have affected prescribing among oncologists, whose patients often require opioids for symptom management. We investigated temporal patterns in opioid prescribing for Medicare beneficiaries among oncologists and nononcologists. Methods We queried the Centers for Medicare and Medicaid Services Part D prescriber dataset for all physicians between January 1, 2013, and December 31, 2017. We used population-averaged multivariable negative binomial regression to estimate the association between time and per-provider opioid and gabapentinoid prescribing rate, defined as the annual number of drug claims (original prescriptions and refills) per beneficiary, among oncologists and nononcologists on a national and state level. Results From 2013 to 2017, the national opioid-prescribing rate declined by 20.7% (P < .001) among oncologists and 22.8% (P < .001) among non oncologists. During this time frame, prescribing of gabapentin increased by 5.9% (P < .001) and 23.1% (P < .001) among oncologists and nononcologists, respectively. Among palliative care providers, opioid prescribe increased by 15.3% (P < .001). During the 5-year period, 43 states experienced a decrease (P < .05) in opioid prescribing among oncologists, and in 5 states, opioid prescribing decreased more among oncologists than nononcologists (P < .05). Conclusions Between 2013 and 2017, the opioid-prescribing rate statistically significantly decreased nationwide among oncologists and nononcologists, respectively. Given similar declines in opioid prescribing among oncologists and nononcologists, there is concern that opioid-prescribing guidelines intended for the noncancer population are being applied inappropriately to patients with cancer and cancer survivors.

scholarly journals Retracted: Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Associations With Intimate Partner Homicide

2017 ◽  
Vol 187 (7) ◽  
pp. 1449-1455 ◽  
Author(s):  
April M Zeoli ◽  
Alexander McCourt ◽  
Shani Buggs ◽  
Shannon Frattaroli ◽  
David Lilley ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Fixed Effects ◽  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Intimate Partner ◽  
Restraining Order ◽  
Level Data ◽  
Binomial Regression ◽  
Firearms Restrictions

Abstract In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs) on the basis of the strength of the policies. We posit that the association of firearm laws with IPHs depends on the following characteristics of the laws: 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from persons prohibited from having firearms; and 3) systems of accountability that prevent those prohibited from doing so from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust, negative binomial regression models with state fixed effects, domestic violence restraining order firearm-prohibition laws are associated with 10% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (−11%) and ex parte orders (−12%). Laws prohibiting access to those convicted of nonspecific violent misdemeanors were associated with a 24% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against IPH.

scholarly journals The association between alcohol restriction policies and vehicle-related mortality in Cali, Colombia, 1998-2008

2014 ◽  
Vol 3 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Jorge Mena ◽  
Álvaro I. Sánchez ◽  
María Isabel Gutiérrez ◽  
Juan-Carlos Puyana ◽  
Brian Suffoleto
Keyword(s):  
Negative Binomial ◽  
Drug Research ◽  
Road Traffic ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Control Policies ◽  
Alcohol Availability ◽  
Alcohol Control ◽  
Traffic Mortality ◽  
Related Mortality

Mena, J., Sánchez, Á., Gutiérrez, M., Puyana, J., & Suffoleto, B. (2014). The association between alcohol restriction policies and vehicle-related mortality in Cali, Colombia, 1998-2008. The International Journal Of Alcohol And Drug Research, 3(2), 149-158. doi:http://dx.doi.org/10.7895/ijadr.v3i2.157Aims: To determine whether the implementation of alcohol control policies was associated with changes in the incidence of road traffic deaths.Design: Ecologic study conducted using an interrupted time series analysis. Full restrictive polices banned alcohol between 6 p.m. and 6 a.m. Most restrictive polices prohibited alcohol between 1 a.m. and 10 a.m. Restrictive policies prohibited alcohol between 2 a.m. and 10 a.m. Moderately restrictive policies banned alcohol between 3 a.m. and 10 a.m. Lax policies prohibited alcohol between 4 a.m. and 10 a.m.Setting: We used data of road traffic mortality in the population of Cali, Colombia from 1998 to 2008.Participants: The population of Cali in 2008 was 2,184,753 inhabitants; 47% were male.Measures: Aggregated daily counts of road traffic deaths. Restrictive policies were compared with lax policies to estimate the effect of reducing hours of alcohol availability using multiple negative binomial regressions.Findings: There was a decreased risk of road traffic mortality in periods when moderately restrictive policies were in effect (IRR = 0.84, 95% CI 0.72–0.97, p = 0.019). There was an even lower risk of road traffic deaths in periods when most restrictive policies were in effect (IRR = 0.70, 95% CI 0.58–0.85, p < 0.001). In motorcyclists, most restrictive (IRR 0.55, 95% CI 0.38–0.81, p = 0.002) and full restrictive policies (IRR 0.52, 95% CI 0.29–0.94, p = 0.032) were associated with decreased risk of mortality.Conclusions: Our findings support more restrictive alcohol control policies to reduce road traffic mortality. Specifically, reducing the time of alcohol availability was associated with a decrease in road traffic death rates.

scholarly journals Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

2019 ◽  
Author(s):  
Toby Bonvoisin ◽  
Leah Utyasheva ◽  
Duleeka Knipe ◽  
David Gunnell ◽  
Michael Eddleston
Keyword(s):  
Negative Binomial ◽  
Public Health Problem ◽  
State Level ◽  
Negative Binomial Regression ◽  
World Health ◽  
State Governments ◽  
Suicide Rates ◽  
Level Data ◽  
Agricultural Yield ◽  
Health Organization

Abstract Background Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

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