Benjamin Levy1, Bridget Spelke2, Leonard J Paulozzi3, Jeneita M Bell4, Kurt B Nolte5, Sarah Lathrop6, David E Sugerman7, Michael Landen8. 1. Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway MS-F62, Chamblee, GA 30341, United States. Electronic address: benalevy@hotmail.com. 2. Women and Infants' Hospital of Rhode Island, Warrren Alpert Medical School at Brown University, United States. Electronic address: mspelke@wihri.org. 3. Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, 601 Sunland Park Dr. Suite 200, El Paso, TX 79912, United States. Electronic address: lbp4@cdc.gov. 4. Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway MS-F62, Chamblee, GA 30341, United States. Electronic address: hqp8@cdc.gov. 5. The University of New Mexico, 1101 Camino de Salud NE, Albuquerque, NM 87102, United States. Electronic address: knolte@salud.unm.edu. 6. The University of New Mexico, Albuquerque, NM 87131, United States. Electronic address: slathrop@salud.unm.edu. 7. Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329-4018, United States. Electronic address: ggi4@cdc.gov. 8. New Mexico Department of Health, 1190 S. St. Francis Drive, Santa Fe, NM 87505, United States. Electronic address: Michael.Landen@state.nm.us.
Abstract
PURPOSE: Drug overdose deaths are epidemic in the U.S. Prescription opioid pain relievers (OPR) and heroin account for the majority of drug overdoses. Preventing death after an opioid overdose by naloxone administration requires the rapid identification of the overdose by witnesses. This study used a state medical examiner database to characterize fatal overdoses, evaluate witness-reported signs of overdose, and identify opportunities for intervention. METHODS: We reviewed all unintentional drug overdose deaths that occurred in New Mexico during 2012. Data were abstracted from medical examiner records at the New Mexico Office of the Medical Investigator. We compared mutually exclusive groups of OPR and heroin-related deaths. RESULTS: Of the 489 overdose deaths reviewed, 49.3% involved OPR, 21.7% involved heroin, 4.7% involved a mixture of OPR and heroin, and 24.3% involved only non-opioid substances. The majority of OPR-related deaths occurred in non-Hispanic whites (57.3%), men (58.5%), persons aged 40-59 years (55.2%), and those with chronic medical conditions (89.2%). Most overdose deaths occurred in the home (68.7%) and in the presence of bystanders (67.7%). OPR and heroin deaths did not differ with respect to paramedic dispatch and CPR delivery, however, heroin overdoses received naloxone twice as often (20.8% heroin vs. 10.0% OPR; p<0.01). CONCLUSION: OPR overdose deaths differed by age, health status, and the presence of bystanders, yet received naloxone less often when compared to heroin overdose deaths. These findings suggest that naloxone education and distribution should be targeted in future prevention efforts.
PURPOSE:Drug overdose deaths are epidemic in the U.S. Prescription opioid pain relievers (OPR) and heroin account for the majority of drug overdoses. Preventing death after an opioid overdose by naloxone administration requires the rapid identification of the overdose by witnesses. This study used a state medical examiner database to characterize fatal overdoses, evaluate witness-reported signs of overdose, and identify opportunities for intervention. METHODS: We reviewed all unintentional drug overdose deaths that occurred in New Mexico during 2012. Data were abstracted from medical examiner records at the New Mexico Office of the Medical Investigator. We compared mutually exclusive groups of OPR and heroin-related deaths. RESULTS: Of the 489 overdose deaths reviewed, 49.3% involved OPR, 21.7% involved heroin, 4.7% involved a mixture of OPR and heroin, and 24.3% involved only non-opioid substances. The majority of OPR-related deaths occurred in non-Hispanic whites (57.3%), men (58.5%), persons aged 40-59 years (55.2%), and those with chronic medical conditions (89.2%). Most overdose deaths occurred in the home (68.7%) and in the presence of bystanders (67.7%). OPR and heroindeaths did not differ with respect to paramedic dispatch and CPR delivery, however, heroinoverdoses received naloxone twice as often (20.8% heroin vs. 10.0% OPR; p<0.01). CONCLUSION:OPRoverdose deaths differed by age, health status, and the presence of bystanders, yet received naloxone less often when compared to heroinoverdose deaths. These findings suggest that naloxone education and distribution should be targeted in future prevention efforts.
Authors: Steven Allan Sumner; Melissa C Mercado-Crespo; M Bridget Spelke; Leonard Paulozzi; David E Sugerman; Susan D Hillis; Christina Stanley Journal: Prehosp Emerg Care Date: 2015-09-18 Impact factor: 3.077
Authors: David Wang; Andrew A Somogyi; Brendon J Yee; Keith K Wong; Jasminder Kaur; Paul J Wrigley; Ronald R Grunstein Journal: Respir Physiol Neurobiol Date: 2012-12-01 Impact factor: 1.931
Authors: Jon E Zibbell; Alice K Asher; Rajiv C Patel; Ben Kupronis; Kashif Iqbal; John W Ward; Deborah Holtzman Journal: Am J Public Health Date: 2017-12-21 Impact factor: 9.308