The epidemiology of opioid overdose in Flint and Genesee County, Michigan: Implications for public health practice and intervention.

As the opioid epidemic continues to worsen throughout the United States, researchers and practitioners require additional tools to help in efforts to address use and prevent overdose. Although opioids are increasingly of concern to all racial and socioeconomic groups, specific geographic regions and sub-populations remain more burdened by overdoses than others. The example of Flint, Michigan, is used to contextualize the landscape of opioid overdose death and understand geographic and demographic variation in risk. Kernel density analysis and spatial joins in ArcGIS were used to map opioid overdose death clusters, treatment availability, and neighborhood-level conditions to uncover factors related to overdose death. Spatial analysis revealed three geographic clusters in opioid overdose death in Flint. These neighborhoods tended to be somewhat poorer but also significantly Whiter than the average Flint neighborhood. Alternatively, opioid overdose death clusters did not occur in predominately African-American neighborhoods. As well, treatment sites were not coincident with the location of overdose death clusters, suggesting a potential need for geographically-targeted interventions. Of the 47 treatment sites, only 29 offered medication-assisted treatment, and expansion of these programs may therefore be warranted. This work is of great importance to ongoing prevention and treatment efforts in Flint, but also to other communities with a need for better tools to monitor and intervene in the opioid epidemic.