The rate of drug overdose from prescription opioids increased seven-fold in New York City over a 16-year period and was concentrated especially among white residents of the city, according to the latest research at the Columbia University Mailman School of Public Health. The study is one of the earliest and most comprehensive analyses of how the opioid epidemic has affected an urban area.
There are two classes of prescription opioids: analgesics, or painkillers like Oxycontin (oxycodone), and methadone, which is used to treat heroin addiction but carries a risk of overdose. Using data from the city’s Office of the Chief Medical Examiner for the period 1990-2006, the researchers examined the factors associated with death from prescription opioids versus heroin, which historically has been the most common type of opioid fatality in urban areas.
They found that the increase in the rate of drug overdose was driven entirely by analgesic overdoses, which were 2.7 per 100,000 persons in 2006 or seven times higher than in 1990. Meanwhile, methadone overdoses remained stable, and heroin overdoses declined. Whites were much more likely to overdose on analgesics than blacks or Hispanics. By 2006, the fatality rate among white males was almost two times higher than the rate among Latinos and three times higher than the rate among blacks. Deaths were mostly concentrated in neighborhoods with high-income inequality but lower-than-average rates of poverty.
“A possible reason for the concentration of fatalities among whites is that this group is more likely to have access to a doctor who can write prescriptions,” says Dr. Magdalena Cerdá, assistant professor of epidemiology at the School of Public Health and the lead author on the study. “However, more often than not, those who get addicted have begun using the drug through illicit channels rather than through a prescription.”
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[Photo: Dr. Magdalena Cerdá]