Geopersonality of Preventable Death in the United States: Anger-Prone States and Opioid Deaths

Background: Opioid overdoses have reached epidemic levels in the United States and have clustered in Northeastern and “Rust Belt” states. Five Factor Model (FFM) personality traits also vary at the state level, with anger-prone traits clustered in the Northeast region. This study tested the hypothesis that state-level anger proneness would be associated with a greater increase in rates of opioid overdose death. Methods: This was a secondary analysis of state-level data on FFM traits, opioid overdose deaths, and other classes of preventable death. Robust mixed models tested whether change in rates of opioid overdose death from 2008 to 2016 was moderated by state-level anger proneness. Results: State-level anger proneness was significantly associated with greater increases in rates of opioid overdose deaths (B = 1.01, standard error = 0.19, P < .001, 95% confidence interval: 0.63-1.39). The slope of increase in opioid overdose death rates was 380% greater in anger-prone states and held after adjustment for potential confounders such as state-level prevalence of major depressive disorder, number of mental health facilities, and historical patterns of manufacturing decline. A similar pattern was observed between state-level anger proneness and benzodiazepine overdose deaths but was not significant for the latter after adjustment for potential confounders. Conclusion: These findings suggest that states characterized as more anger prone have experienced greater increases in opioid overdose deaths.

Download Full-text

Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011–2015

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-018-1594-y ◽

2018 ◽

Vol 54 (1) ◽

pp. 131-134 ◽

Cited By ~ 1

Author(s):

Madeline Foley ◽

Laura M. Schwab-Reese

Keyword(s):

United States ◽

State Level ◽

The United States ◽

Opioid Overdose

Download Full-text

Change in Five-Factor Model Personality Traits During the Acute Phase of the Coronavirus Pandemic

10.31234/osf.io/ja7b5 ◽

2020 ◽

Cited By ~ 1

Author(s):

Angelina Sutin ◽

Martina Luchetti ◽

Damaris Aschwanden ◽

Ji Hyun Lee ◽

Amanda A Sesker ◽

...

Keyword(s):

United States ◽

Personality Traits ◽

Acute Phase ◽

Factor Model ◽

Five Factor Model ◽

The United States ◽

Anxiety And Depression ◽

Psychological Function ◽

Rapid Spread

The rapid spread of the coronavirus and the strategies to slow it have disrupted just about every aspect of our lives. Such disruption may be reflected in changes in psychological function. The present study used a pre-posttest design to test whether Five Factor Model personality traits changed with the coronavirus outbreak in the United States. Participants (N=2,137) were tested in early February 2020 and again during the President’s 15 Days to Slow the Spread guidelines. In contrast to the preregistered hypotheses, Neuroticism decreased across these six weeks, particularly the facets of Anxiety and Depression, and Conscientiousness did not change. Exploratory analyses indicated that quarantine/isolation status moderated change such that Neuroticism only decreased for those not in quarantine, whereas Openness, Agreeableness, and Conscientiousness declined for participants in quarantine. The present research suggests modest changes in personality traits across the acute phase of the coronavirus outbreak.

Download Full-text

Emerging and Continuing Trends in Opioid Overdose Decedent Characteristics during COVID-19

10.1101/2021.07.28.21261276 ◽

2021 ◽

Author(s):

Gian-Gabriel P. Garcia ◽

Erin Stringfellow ◽

Catherine DiGennaro ◽

Nicole Poellinger ◽

Jaden Wood ◽

...

Keyword(s):

North Carolina ◽

Rhode Island ◽

Race And Ethnicity ◽

The United States ◽

Vital Statistics ◽

Opioid Overdose ◽

Cross Sectional ◽

Death Rates ◽

Overdose Death ◽

Overdose Deaths

Background: Since COVID-19 erupted in the United States, little is known about how state-level opioid overdose trends and decedent characteristics have varied throughout the country. Objective: Investigate changes in annual overdose death rates, substances involved, and decedent demographics in opioid overdose deaths across nine states; assess whether 2019-2020 trends were emerging (i.e., change from 2019-2020 was non-existent from 2018-2019) or continuing (i.e., change from 2019-2020 existed from 2018-2019). Design: Cross-sectional study using vital statistics data to conduct a retrospective analysis comparing 2020 to 2019 and 2019 to 2018 across nine states. Setting: Alaska, Colorado, Connecticut, Indiana, Massachusetts, North Carolina, Rhode Island, Utah, and Wyoming. Participants: Opioid-related overdose deaths in 2018, 2019, and 2020. Measurements: Annual overdose death rate, proportion of overdose deaths involving specific substances, and decedent demographics (age, sex, race, and ethnicity). Results: We find emerging increases in annual opioid-related overdose death rates in Alaska (55.3% [P=0.020]), Colorado (80.2% [P<0.001]), Indiana (40.1% [P=0.038]), North Carolina (30.5% [P<0.001]), and Rhode Island (29.6% [P=0.011]). Decreased heroin-involved overdose deaths were emerging in Alaska (-49.5% [P=0.001]) and Indiana (-58.8% [P<0.001]), and continuing in Colorado (-33.3% [P<0.001]), Connecticut (-48.2% [P<0.001]), Massachusetts (39.9% [P<0.001]), and North Carolina (-34.8% [P<0.001]). Increases in synthetic opioid presence were emerging in Alaska (136.5% [P=0.019]) and Indiana (27.6% [P<0.001]), and continuing in Colorado (44.4% [P<0.001]), Connecticut (3.6% [P<0.05]), and North Carolina (14.6% [P<0.001]). We find emerging increases in the proportion of male decedents in Colorado (15.2% [P=0.008]) and Indiana (12.0% [P=0.013]). Limitations: Delays from state-specific death certification processes resulted in varying analysis periods across states. Conclusion: These findings highlight emerging changes in opioid overdose dynamics across different states, which can inform state-specific public health interventions.

Download Full-text

Mortality among Adults Ages 25-44 in the United States During the COVID-19 Pandemic

10.1101/2020.10.21.20217174 ◽

2020 ◽

Author(s):

Jeremy Samuel Faust ◽

Harlan M. Krumholz ◽

Katherine L. Dickerson ◽

Zhenqiu Lin ◽

Cleavon Gilman ◽

...

Keyword(s):

United States ◽

New York ◽

The United States ◽

Relative Increase ◽

Opioid Overdose ◽

Public Data ◽

Control And Prevention ◽

Incident Rate ◽

Opioid Deaths ◽

Overdose Deaths

AbstractIntroductionCoronavirus disease-19 (COVID-19) has caused a marked increase in all-cause deaths in the United States, mostly among adults aged 65 and older. Because younger adults have far lower infection fatality rates, less attention has been focused on the mortality burden of COVID-19 in this demographic.MethodsWe performed an observational cohort study using public data from the National Center for Health Statistics at the United States Centers for Disease Control and Prevention, and CDC Wonder. We analyzed all-cause mortality among adults ages 25-44 during the COVID-19 pandemic in the United States. Further, we compared COVID-19-related deaths in this age group during the pandemic period to all drug overdose deaths and opioid-specific overdose deaths in each of the ten Health and Human Services (HHS) regions during the corresponding period of 2018, the most recent year for which data are available.ResultsAs of September 6, 2020, 74,027 all-cause deaths occurred among persons ages 25-44 years during the period from March 1st to July 31st, 2020, 14,155 more than during the same period of 2019, a 23% relative increase (incident rate ratio 1.23; 95% CI 1.21–1.24), with a peak of 30% occurring in May (IRR 1.30; 95% CI 1.27-1.33). In HHS Region 2 (New York, New Jersey), HHS Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas), and HHS Region 9 (Arizona, California, Hawaii, Nevada), COVID-19 deaths exceeded 2018 unintentional opioid overdose deaths during at least one month. Combined, 2,450 COVID-19 deaths were recorded in these three regions during the pandemic period, compared to 2,445 opioid deaths during the same period of 2018.MeaningWe find that COVID-19 has likely become the leading cause of death—surpassing unintentional overdoses—among young adults aged 25-44 in some areas of the United States during substantial COVID-19 outbreaks.NoteThe data presented here have since been updated. As a result, an additional 1,902 all-cause deaths occurring among US adults ages 25-44 during the period of interest are not accounted for in this manuscript.

Download Full-text

Pandemic meets epidemic: Co-location of COVID-19 and drug overdose deaths in the United States

Journal of Community Safety and Well-Being ◽

10.35502/jcswb.216 ◽

2021 ◽

Vol 6 (4) ◽

pp. 174-178

Author(s):

Navya Tripathi ◽

Nancy Hardt

Keyword(s):

United States ◽

Spatial Correlation ◽

Drug Overdose ◽

Hot Spot ◽

State Level ◽

The United States ◽

Time Step ◽

Access To Treatment ◽

Control And Prevention ◽

Overdose Deaths

Drug overdose deaths (DOD) in the last two decades have increased over 300 percent. In 2019 alone, 71,000 deaths represented a 7% increase from the previous year. According to recent data released by the Center for Disease Control and Prevention (CDC), 81,230 overdose deaths occurred in the United States from June 2019 to May 2020, the highest number of DOD recorded in a 12-month period. Early 2020 saw the spread of the COVID-19 pandemic in the United States, which CDC suggests has amplified the previously alarming rise in drug-related mortalities. A hot spot analysis of COVID-19 and DOD rates, as well as a spatial correlation between the two datasets at the state level on a monthly time step, showed a significant increase in DOD during the COVID-19 pandemic. This study, conducted for the period of March through July 2021, showed a spatial correlation between the two types of mortalities in the initial months of 2020. Furthermore, the hot spots for both types of mortalities were concentrated in the northeastern states. The COVID-19 mortalities shifted southeast in July 2020, but DOD data was unavailable for further analysis. Since DOD are a leading contributor to preventable deaths, the results of the study may help focus the efforts of effective and innovative programs to reduce substance use disorder and related mortality through increased access to treatment. During the pandemic, access to such facilities was reduced.

Download Full-text

Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic

January 2018 - Pain Physician ◽

10.36076/ppj.2018.4.309 ◽

2018 ◽

Vol 1 (21;1) ◽

pp. 309-326 ◽

Cited By ~ 42

Author(s):

Laxmaiah Manchikanti

Keyword(s):

United States ◽

The United States ◽

Opioid Overdose ◽

Prescription Opioids ◽

Opioid Epidemic ◽

Synthetic Opioids ◽

Opioid Crisis ◽

Electronic Reporting ◽

Number Of Patients ◽

Overdose Deaths

The opioid epidemic has been called the “most consequential preventable public health problem in the United States.” Though there is wide recognition of the role of prescription opioids in the epidemic, evidence has shown that heroin and synthetic opioids contribute to the majority of opioid overdose deaths. It is essential to reframe the preventive strategies in place against the opioid crisis with attention to factors surrounding the illicit use of fentanyl and heroin. Data on opioid overdose deaths shows 42,000 deaths in 2016. Of these, synthetic opioids other than methadone were responsible for over 20,000, heroin for over 15,000, and natural and semisynthetic opioids other than methadone responsible for over 14,000. Fentanyl deaths increased 520% from 2009 to 2016 (increased by 87.7% annually between 2013 and 2016), and heroin deaths increased 533% from 2000 to 2016. Prescription opioid deaths increased by 18% overall between 2009 and 2016. The Drug Enforcement Administration (DEA) mandated reductions in opioid production by 25% in 2017 and 20% in 2018. The number of prescriptions for opioids declined significantly from 252 million in 2013 to 196 million in 2017 (9% annual decline over this period), falling below the number of prescriptions in 2006. In addition, data from 2017 shows significant reductions in the milligram equivalence of morphine by 12.2% and in the number of patients receiving high dose opioids by 16.1%. This manuscript describes the escalation of opioid use in the United States, discussing the roles played by drug manufacturers and distributors, liberalization by the DEA, the Food and Drug Administration (FDA), licensure boards and legislatures, poor science, and misuse of evidencebased medicine. Moreover, we describe how the influence of pharma, improper advocacy by physician groups, and the promotion of literature considered peer-reviewed led to the explosive use of illicit drugs arising from the issues surrounding prescription opioids. This manuscript describes a 3-tier approach presented to Congress. Tier 1 includes an aggressive education campaign geared toward the public, physicians, and patients. Tier 2 includes facilitation of easier access to non-opioid techniques and the establishment of a National All Schedules Prescription Electronic Reporting Act (NASPER). Finally, Tier 3 focuses on making buprenorphine more available for chronic pain management as well as for medication-assisted treatment. Key words: Opioid epidemic, fentanyl and heroin epidemic, prescription opioids, National All Schedules Prescription Electronic Reporting Act (NASPER), Prescription Drug Monitoring Programs (PDMPs)

Download Full-text

Using Geographic Information System Analysis to Understand West Virginia’s Growing Opioid-Overdose Epidemic - What Are We Missing?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19001249 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s53-s53

Author(s):

Sasha Rihter ◽

Nathan Menke

Keyword(s):

Information System ◽

Geographic Information System ◽

The United States ◽

Geographic Information ◽

The State ◽

Opioid Overdose ◽

Death Rates ◽

Overdose Death ◽

The Impact ◽

Overdose Deaths

Introduction:The opioid epidemic is overwhelming communities across the United States. West Virginia (WV) has been devastated, heralding a 86% increase in deaths from 2012-2016, and over 1,000 deaths last year as per WV Health Statistics Center. Treatment centers and providers have emerged throughout the state to provide medication-assisted treatment (MAT). The impact of these clinics on the opioid abusing population is not yet fully understood.Aim:Utilizing Geographic Information System (GIS), a comparison of MAT provider locations versus regions of historical overdoses can indicate areas of deficiency. If no providers emerge in underserved counties, overdose deaths in those areas will continue to rise.Methods:Maps were created using current DEA-X licenses in WV registered through Substance Abuse and Mental Health Services Administration (SAHMSA). Overdose death rates were taken from WV Public Health Records from 2010-2017. Two maps and corresponding data were compared for overlap or lack thereof.Results:Of the 338 locations of DEA-X licenses registered, 17.5% are in Cabell County, which led the state in overdose deaths in 2017. Only 2.5% of the total providers are currently in Wayne County, which had the second highest overdose death rate. Berkeley County, which was 3rd highest, has a mere 6.5% of total providers. Comparatively, Kanawah County, home to the state’s capital, has over twice this number of providers despite consistently having at or below the state average of overdose rates. Resources are pulled towards population-dense areas or university centers, where the epidemic is present but misses counties with higher overdose rates.Discussion:Results show a lack of MAT providers in many of WV’s devastated counties. Treatment centers exist throughout the state but are concentrated in regions with large cities or academic centers. This distribution limits accessibility to a marginalized patient population, making improvements unlikely in WV’s future opioid-overdose death rates.

Download Full-text