Nhung T H Trinh1, Parvati Singh2, Magdalena Cerdá3, Tim A Bruckner4. 1. Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France; IQVIA France, Courbevoie, France. Electronic address: nhung.trinh@inserm.fr. 2. Program in Public Health, University of California, Irvine, CA, USA. Electronic address: parvatis@uci.edu. 3. Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, NY, USA. Electronic address: magdalena.cerda@nyulangone.org. 4. Program in Public Health, University of California, Irvine, CA, USA; Center for Population, Inequality, and Policy, University of California, Irvine, USA. Electronic address: tim.bruckner@uci.edu.
Abstract
BACKGROUND: The rise in opioid-related mortality and opioid-related emergency department (ED) visits has stimulated research on whether broader economic declines, such as the Great Recession, affect opioid-related morbidity. We examine in New York City whether one measure of morbidity-opioid-related ED visits-responded acutely to the large negative "shock" of the Great Recession. METHODS: Data comprise outpatient "treat and release" opioid-related ED visits in New York City for the 72 months spanning January 2006 to December 2011, taken from the Statewide Emergency Department Database (n = 150,246). We modeled the monthly incidence of opioid-related ED visits using Autoregressive, Integrated, Moving Average (ARIMA) time-series methods to control for patterning in ED visits before examining its potential association with the economic shock of the Great Recession. RESULTS: New York City shows a mean of 1761 outpatient ED visits per month for opioid dependence and abuse. Unexpectedly large drops in employment coincide with fewer than expected opioid dependence and abuse ED visits in that same month. The result (coefficient = 0.046, 95% Confidence Interval [CI]: 0.002, 0.090) represents a 0.8% drop in overall incidence of opioid dependence and abuse ED visits during the Great Recession. We, however, observe no association between the Great Recession and ED visits for prescription opioid overdose or heroin overdose, or with inpatient ED visits for opioid dependence and abuse. CONCLUSIONS: Findings, if replicated, indicate distinct short-term reductions in opioid-related morbidity following the Great Recession. This result diverges from previous findings of increased opioid use following extended economic downturns.
BACKGROUND: The rise in opioid-related mortality and opioid-related emergency department (ED) visits has stimulated research on whether broader economic declines, such as the Great Recession, affect opioid-related morbidity. We examine in New York City whether one measure of morbidity-opioid-related ED visits-responded acutely to the large negative "shock" of the Great Recession. METHODS: Data comprise outpatient "treat and release" opioid-related ED visits in New York City for the 72 months spanning January 2006 to December 2011, taken from the Statewide Emergency Department Database (n = 150,246). We modeled the monthly incidence of opioid-related ED visits using Autoregressive, Integrated, Moving Average (ARIMA) time-series methods to control for patterning in ED visits before examining its potential association with the economic shock of the Great Recession. RESULTS: New York City shows a mean of 1761 outpatient ED visits per month for opioid dependence and abuse. Unexpectedly large drops in employment coincide with fewer than expected opioid dependence and abuse ED visits in that same month. The result (coefficient = 0.046, 95% Confidence Interval [CI]: 0.002, 0.090) represents a 0.8% drop in overall incidence of opioid dependence and abuse ED visits during the Great Recession. We, however, observe no association between the Great Recession and ED visits for prescription opioid overdose or heroin overdose, or with inpatient ED visits for opioid dependence and abuse. CONCLUSIONS: Findings, if replicated, indicate distinct short-term reductions in opioid-related morbidity following the Great Recession. This result diverges from previous findings of increased opioid use following extended economic downturns.
Authors: Ralph Catalano; Sidra Goldman-Mellor; Katherine Saxton; Claire Margerison-Zilko; Meenakshi Subbaraman; Kaja LeWinn; Elizabeth Anderson Journal: Annu Rev Public Health Date: 2011 Impact factor: 21.981