Drug Poisoning Mortality, by State and Race and Ethnicity: United States, 2019

Provides information on drug overdose mortality by state and race and ethnicity.

Place, poverty and prescriptions: a cross-sectional study using Area Deprivation Index to assess opioid use and drug-poisoning mortality in the USA from 2012 to 2017

ObjectiveTo identify the relationships between county-level area deprivation and patterns of both opioid prescriptions and drug-poisoning mortality.Design, setting and participantsFor this retrospective cross-sectional study, we used the IQVIA Xponent data to capture opioid prescriptions and Centres for Disease Control and Prevention National Vital Statistics System to assess drug-poisoning mortality. The Area Deprivation Index (ADI) is a composite measure of social determinants of health comprised of 17 US census indicators, spanning four socioeconomic domains. For all US counties with available opioid prescription (2712 counties) and drug-poisoning mortality (3133 counties) data between 2012 and 2017, we used negative binomial regression to examine the association between quintiles of county-level ADI and the rates of opioid prescriptions and drug-poisoning mortality adjusted for year, age, race and sex.Primary outcome measuresCounty-level opioid prescription fills and drug-poisoning mortality.ResultsBetween 2012 and 2017, overall rates of opioid prescriptions decreased from 96.6 to 72.2 per 100 people, while the rates of drug-poisoning mortality increased from 14.3 to 22.8 per 100 000 people. Opioid prescription and drug-poisoning mortality rates were consistently higher with greater levels of deprivation. The risk of filling an opioid prescription was 72% higher, and the risk of drug-poisoning mortality was 36% higher, for most deprived compared with the least deprived counties (both p<0.001).DiscussionCounties with greater area-level deprivation have higher rates of filled opioid prescriptions and drug-poisoning mortality. Although opioid prescription rates declined across all ADI quintiles, the rates of drug-poisoning mortality continued to rise proportionately in each ADI quintile. This underscores the need for individualised and targeted interventions that consider the deprivation of communities where people live.

Drug Poisoning Mortality Trends in the Scandinavian Countries 1961–1973

Poisoning mortality rates have increased considerably in Denmark and Sweden, slightly in Norway, and remained essentially the same in Finland, during the period 1961 to 1973. In the present study, fatal poisoning included cases of intoxication by solid or liquid substances classified as suicidal, accidental (alcohol poisonings excepted) or of undetermined intent. From 1961 to 1973 poisoning mortality rates increased in Sweden by about 200%, in Denmark by about 100%, and in Norway by about 50%. In males, the age-standardized mortality rates were: in Denmark and Sweden, about 130; in Finland, about 70, and in Norway, about 30 cases per one million of population in 1972. The corresponding figures for females were 125, 75, 40 and 20. Despite this overall rise, rates of suicidal poisoning mortality and mortality from accidental poisoning have decreased in Sweden since 1969. From this year onwards, the classification category ‘undetermined poisoning’ has been used and the decreases in other categories are compensated by an increase in this group. On the basis of the scanty data available, the substances most frequently responsible for fatal poisoning are drugs (in particular barbiturates), other soporifics, and tranquillizers. There is some evidence that poisoning mortality is correlated with the prevalence of drug use and could consequently be reduced by drug control.