Accidental Fatal Drug Overdoses in New York City: 1990–1992

Tardiff, Kenneth; Marzuk, Peter M.; Leon, Andrew C.; Portera, Laura; Hartwell, Nancy; Hirsch, Charles S.; Stajíc, Marina

doi:10.3109/00952999609001650

Cited by 41 publications

(18 citation statements)

References 19 publications

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“…In the multiple logistic regression models, female decedents were more likely to have a cocaine only overdose and male decedents an opiate only overdose. This finding is contrary to other studies [25,42] and particularly interesting since it has been shown that males with a fatal cocaine overdose were more likely to have contributory coronary disease[25]. The higher risk of cocaine only overdose among women seen in our analysis may reflect unique characteristics of the drug economy and drug use patterns in the United States or in NYC and bears further study.…”

Section: Discussioncontrasting

confidence: 99%

Cocaine- and opiate-related fatal overdose in New York City, 1990–2000

et al. 2007

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BackgroundIn New York City (NYC), the annual mortality rate is higher for accidental drug overdoses than for homicides; cocaine and opiates are the drugs most frequently associated with drug overdose deaths. We assessed trends and correlates of cocaine- and opiate-related overdose deaths in NYC during 1990–2000.MethodsData were collected from the NYC Office of the Chief Medical Examiner (OCME) on all fatal drug overdoses involving cocaine and/or opiates that occurred between 1990–2000 (n = 8,774) and classified into three mutually exclusive groups (cocaine only; opiates-only; cocaine and opiates). Risk factors for accidental overdose were examined in the three groups and compared using multinomial logistic regression.ResultsOverall, among decedents ages 15–64, 2,392 (27.3%) were attributed to cocaine only and 2,825 (32.2%) were attributed to opiates-only. During the interval studied, the percentage of drug overdose deaths attributed to cocaine only fell from 29.2% to 23.6% while the percentage of overdose deaths attributed to opiates-only rose from 30.6% to 40.1%. Compared to New Yorkers who fatally overdosed from opiates-only, fatal overdose attributed to cocaine-only was associated with being male (OR = 0.71, 95% CI 0.62–0.82), Black (OR = 4.73, 95% CI 4.08–5.49) or Hispanic (OR = 1.51, 95% CI 1.29–1.76), an overdose outside of a residence or building (OR = 1.34, 95% CI 1.06–1.68), having alcohol detected at autopsy (OR = 0.50, 95% CI 0.44–0.56) and older age (55–64) (OR = 2.53 95% CI 1.70–3.75)).ConclusionAs interventions to prevent fatal overdose become more targeted and drug specific, understanding the different populations at risk for different drug-related overdoses will become more critical.

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Section: Discussioncontrasting

confidence: 99%

Cocaine- and opiate-related fatal overdose in New York City, 1990–2000

et al. 2007

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“…The OCME applies uniform guidelines to its reporting of cases to ensure that causes of death are consistently determined. 91 This indicates that the mortality data we used were a valid representation of the causes of death in New York City. We also believe that our data represent a complete count of unintentional mortality cases, given the expectation that all unexpected deaths are reported to the OCME.…”

Section: Discussionmentioning

confidence: 98%

Revisiting the Role of the Urban Environment in Substance Use: The Case of Analgesic Overdose Fatalities

et al. 2013

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Objectives We examined whether neighborhood social characteristics (income distribution and family fragmentation) and physical characteristics (clean sidewalks and dilapidated housing) were associated with the risk of fatalities caused by analgesic overdose. Methods In a case-control study, we compared 447 unintentional analgesic opioid overdose fatalities (cases) with 3436 unintentional nonoverdose fatalities and 2530 heroin overdose fatalities (controls) occurring in 59 New York City neighborhoods between 2000 and 2006. Results Analgesic overdose fatalities were less likely than nonoverdose unintentional fatalities to have occurred in higher-income neighborhoods (odds ratio [OR] = 0.82; 95% confidence interval [CI] = 0.70, 0.96) and more likely to have occurred in fragmented neighborhoods (OR = 1.35; 95% CI = 1.05, 1.72). They were more likely than heroin overdose fatalities to have occurred in higher-income (OR = 1.31; 95% CI = 1.12, 1.54) and less fragmented (OR = 0.71; 95% CI = 0.55, 0.92) neighborhoods. Conclusions Analgesic overdose fatalities exhibit spatial patterns that are distinct from those of heroin and nonoverdose unintentional fatalities. Whereas analgesic fatalities typically occur in lower-income, more fragmented neighborhoods than nonoverdose fatalities, they tend to occur in higher-income, less unequal, and less fragmented neighborhoods than heroin fatalities.

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“…Overdose death rates have varied significantly by drug type (Centers for Disease Control and Prevention, 2004). Cocaine and heroin were historically considered leading causes of overdose death in the US (Tardiff et al, 1996; Harlow, 1990; Mittleman and Wetli, 1984). Methamphetamine use increased in the last decade, and thus may have contributed to an increase in related overdose deaths (Substance Abuse and Mental Health Services Administration, 2005; Substance Abuse and Mental Health Services Administration, 2007).…”

Section: Introductionmentioning

confidence: 99%

National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999–2009

Calcaterra

Glanz

Binswanger

2013

Drug and Alcohol Dependence

306

238

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Background: Pharmaceutical opioid related deaths have increased. This study aimed to place pharmaceutical opioid overdose deaths within the context of heroin, cocaine, psychostimulants, and pharmaceutical sedative hypnotics, examine demographic trends, and describe common combinations of substances involved in opioid related deaths. Methods: We reviewed deaths among 15-64 year olds in the US from 1999-2009 using death certificate data available through the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Database. We identified International Classification of Disease-10 codes describing accidental overdose deaths, including poisonings related to stimulants, pharmaceutical drugs, and heroin. We used crude and age adjusted death rates (deaths/100,000 person years [p-y] and 95% confidence interval [CI] and multivariable Poisson regression models, yielding incident rate ratios (IRRs), for analysis. Results: The age adjusted death rate related to pharmaceutical opioids increased almost 4-fold from 1999 to 2009 (1.54/100,000 p-y [95% CI 1.49-1.60] to 6.05/100,000 p-y [95% CI 5.95-6.16; p<0.001). From 1999 to 2009, pharmaceutical opioids were responsible for the highest relative increase in overdose death rates (IRR 4.22, 95% CI 3.03-5.87) followed by sedative hypnotics (IRR 3.53, 95% CI 2.11-5.90). Heroin related overdose death rates increased from 2007 to 2009 (1.05/100,000 persons [95% CI 1.00-1.09] to 1.43/100,000 persons [95% CI 1.38-1.48; p<0.001). From 2005-2009 the combination of pharmaceutical opioids and benzodiazepines was the most common cause of polysubstance overdose deaths (1.27/100,000 p-y (95% CI 1.25-1.30). Conclusion: Strategies, such as wider implementation of naloxone, expanded access to treatment, and development of new interventions are needed to curb the pharmaceutical opioid overdose epidemic.

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Accidental Fatal Drug Overdoses in New York City: 1990–1992

Cited by 41 publications

References 19 publications

Cocaine- and opiate-related fatal overdose in New York City, 1990–2000

Cocaine- and opiate-related fatal overdose in New York City, 1990–2000

Revisiting the Role of the Urban Environment in Substance Use: The Case of Analgesic Overdose Fatalities

National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999–2009

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