Trends in Hospitalization for Opioid Overdose among Rural Compared to Urban Residents of the United States, 2007‐2014

Mosher, Hilary J.; Zhou, Yunshu; Thurman, Andrew L.; Vaughan-Sarrazin, Mary; Ohl, Michael

doi:10.12788/jhm.2793

Cited by 26 publications

(23 citation statements)

References 13 publications

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“…Previous studies have shown that certain state or county-level characteristics such as rurality, poverty, educational attainment, health care access, and racial demographics, are associated with higher opioid use. [2][3][4] An earlier study observed similarities between geographic variation of opioid use and Republican voters at the county level. 5 Rather than being directly causal, this association is likely driven by external factors shared by both opioid users and voters for the Republican candidate in the 2016 election.…”

Section: Introductionmentioning

confidence: 93%

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: A Cross-Sectional Study in New York State at Census Tract Level

Xiang

Rashidian

Hou³

et al. 2020

Preprint

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Background: Opioid overdose related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD). Objective: We aimed to discover geospatial patterns in problematic opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State. Methods: This cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one opioid use disorder (OUD) diagnosis between 2010 and 2016, and 36,004 patients with at least one opioid poisoning (OP) diagnosis between 2012 and 2016. A logistic regression model was used to determine the associations between patient level characteristics (sex, age group, race, and payment type) and OUD and OP patient rates at census tract level. Results: Several areas shared similar patterns of OUD rates and Republican vote: census tracts in Western New York, Central New York, and Suffolk County. The Spearman rank correlation between OUD rates and the Republican vote was 0.38 (P < 0.0001). A multiple regression model of census tract level demographic and socioeconomic factors explains 29% of the variance in OUD rates, with disability and republican vote the biggest predictors. Conclusions: At the census tract level, opioid use disorder rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic features explain a large portion of the association between the Republican vote and opioid use disorder. Together, these findings underscore the importance of socioeconomic interventions in combatting the opioid epidemic.

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Section: Introductionmentioning

confidence: 93%

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: A Cross-Sectional Study in New York State at Census Tract Level

Xiang

Rashidian

Hou³

et al. 2020

Preprint

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“…The recent opioid crisis is characterized by greater increase in rural opioid use disorder and related mortality rates when compared with urban samples . Nationally, nonsuicide drug poisoning mortality rates increased 51% between 1999 and 2004 in metropolitan counties as compared with 159% in nonmetropolitan counties, and this was driven primarily by deaths involving prescription drugs, especially opioids .…”

Section: Purposementioning

confidence: 99%

Community Treatment for Opioid Use Disorders in Urban and Rural Veterans

Turvey

Lund

Jones

et al. 2019

The Journal of Rural Health

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Purpose The recent opioid crisis is characterized by a relatively greater increase in opioid use disorder and related mortality in rural populations when compared with urban populations.1‐5 As almost a quarter of our nation's veterans reside in rural settings, the United States Veterans Health Administration (VHA) is interested in the impact of this epidemic on rural veterans. This study aims to develop a comprehensive understanding of the trends in substance use disorders (SUD) in veterans seeking treatment from community, non‐VHA providers. Methods Using Substance Abuse and Mental Health Services Administration (SAMHSA)’s Treatment Episode Data Set (TEDS), this study presents the prevalence of treatment for veterans seeking initial admission into publicly funded non‐VHA SUD treatment centers for years 2011‐2016. Comparisons were made for all SUD types. Multivariate trend analysis based on annual data from 2011 to 2016 compared urban and rural veterans for opioid use disorder treatment. Findings Both urban and rural veterans had comparable rates of treatment for SUD, though rural veterans had slightly higher rates of injectable (11.2% vs 8.7%; P < .001) and opiate drug use disorder admissions (20.7% vs 18.1%; P = .014). Both urban and rural showed an increase in admissions for opioid, heroin, and injectable drug use disorders between 2011 and 2016 (P < .001). Conclusions Comprehensive understanding of veteran SUD and treatment should include national‐level data on community non‐VHA treatment. SAMHSA's TEDS for years 2011‐2016 provides clinical information for more than 90,000 veterans and indicates continued increase in treatment seeking for opioid use disorders, particularly for rural veterans.

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“…Rural patients have also been shown to be at higher risk for opioid misuse due to socioeconomic factors and prior illicit drug use [6 7]. In fact, it has been estimated that patients living in rural areas are 20-30% more likely to fatally overdose on opioid narcotics than patients living in an urban setting partially due to demographic factors, but also because of di culties in access to emergency care facilities and services [8]. Prescribing providers have to balance the pain management needs of their patients living in rural areas and their access to care with the high potential for misuse.…”

Section: Introductionmentioning

confidence: 99%

Opioid Prescribing Practices Among Surgical Providers: The Relationship with Patient-Level Factors: Rural Residency or Cancer Diagnosis

Thiesset¹,

Huang²,

Schliep³

et al. 2020

Preprint

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Background Patients living in rural communities and patients with a cancer diagnosis are two areas potentially overlooked in opioid prescribing clinical decision making that may relate to the amount of overprescribed opioids in the postsurgical environment.Methods A 35-item questionnaire was administered to surgeons, residents/ fellows (trainees), and advanced practice clinicians (APCs). Descriptive statistics were generated.Results Surgeons, trainees, and APCs self-reported that they give the same amount of opioids to rural patients as other patients. APCs were more likely to agree that it is easy to e-prescribe (56%) than surgeons (41%) and trainees (35%), so rural patients do not need different consideration. Surgeons (50%) and trainees (50%) agreed compared to APCs (0%) that it is easier to give more opioids so a patient does not have get refills if needed for pain. Compared to APCs (5%), 21% of surgeons and 45% of trainees acknowledged giving more opioid narcotics to patients with cancer than patients without a cancer diagnosis.Conclusions While both groups of prescribing providers reported that they gave the same amount of opioids to rural patients, they differed in their knowledge about e-prescribing and what healthcare access disparities may exist for the rural patient. No differences were reported between provider groups for cancer patients. Responses indicate an opportunity to work with providers to identify potential solutions for improving opioid prescribing practices in rural and cancer patients.

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Trends in Hospitalization for Opioid Overdose among Rural Compared to Urban Residents of the United States, 2007‐2014

Cited by 26 publications

References 13 publications

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: A Cross-Sectional Study in New York State at Census Tract Level

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: A Cross-Sectional Study in New York State at Census Tract Level

Community Treatment for Opioid Use Disorders in Urban and Rural Veterans

Opioid Prescribing Practices Among Surgical Providers: The Relationship with Patient-Level Factors: Rural Residency or Cancer Diagnosis

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