Xiao Zang1, Alexandria Macmadu1, Maxwell S Krieger1, Czarina N Behrends2, Traci C Green3, Jake R Morgan4, Sean M Murphy2, Shayla Nolen1, Alexander Y Walley5, Bruce R Schackman2, Brandon Dl Marshall6. 1. Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, United States. 2. Department of Healthcare Policy and Research, Weill Cornell Medical College, New York City, New York, United States. 3. Institute for Behavioral Health, School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States. 4. Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, United States. 5. Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, United States. 6. Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, United States. Electronic address: brandon_marshall@brown.edu.
Abstract
BACKGROUND: Rates of fatal opioid overdose in Massachusetts (MA) and Rhode Island (RI) far exceed the national average. Community-based opioid education and naloxone distribution (OEND) programs are effective public health interventions to prevent overdose deaths. We compared naloxone distribution and opioid overdose death rates in MA and RI to identify priority communities for expanded OEND. METHODS: We compared spatial patterns of opioid overdose fatalities and naloxone distribution through OEND programs in MA and RI during 2016 to 2019 using public health department data. The county-level ratio of naloxone kits distributed through OEND programs per opioid overdose death was estimated and mapped to identify potential gaps in naloxone availability across geographic regions and over time. RESULTS: From 2016 to 2019, the statewide community-based naloxone distribution to opioid overdose death ratio improved in both states, although more rapidly in RI (from 11.8 in 2016 to 35.6 in 2019) than in MA (from 12.3 to 17.2), driven primarily by elevated and increasing rates of naloxone distribution in RI. We identified some urban/non-urban differences, with higher naloxone distribution relative to opioid overdose deaths in more urban counties, and we observed some counties with high rates of overdose deaths but low rates of naloxone kits distributed through OEND programs. CONCLUSIONS: We identified variations in spatial patterns of opioid overdose fatalities and naloxone availability, and these disparities appeared to be widening in some areas over time. Data on the spatial distribution of naloxone distribution and opioid overdose deaths can inform targeted, community-based naloxone distribution strategies that optimize resources to prevent opioid overdose fatalities.
BACKGROUND: Rates of fatal opioid overdose in Massachusetts (MA) and Rhode Island (RI) far exceed the national average. Community-based opioid education and naloxone distribution (OEND) programs are effective public health interventions to prevent overdose deaths. We compared naloxone distribution and opioid overdose death rates in MA and RI to identify priority communities for expanded OEND. METHODS: We compared spatial patterns of opioid overdose fatalities and naloxone distribution through OEND programs in MA and RI during 2016 to 2019 using public health department data. The county-level ratio of naloxone kits distributed through OEND programs per opioid overdose death was estimated and mapped to identify potential gaps in naloxone availability across geographic regions and over time. RESULTS: From 2016 to 2019, the statewide community-based naloxone distribution to opioid overdose death ratio improved in both states, although more rapidly in RI (from 11.8 in 2016 to 35.6 in 2019) than in MA (from 12.3 to 17.2), driven primarily by elevated and increasing rates of naloxone distribution in RI. We identified some urban/non-urban differences, with higher naloxone distribution relative to opioid overdose deaths in more urban counties, and we observed some counties with high rates of overdose deaths but low rates of naloxone kits distributed through OEND programs. CONCLUSIONS: We identified variations in spatial patterns of opioid overdose fatalities and naloxone availability, and these disparities appeared to be widening in some areas over time. Data on the spatial distribution of naloxone distribution and opioid overdose deaths can inform targeted, community-based naloxone distribution strategies that optimize resources to prevent opioid overdose fatalities.
Authors: Hawre Jalal; Jeanine M Buchanich; Mark S Roberts; Lauren C Balmert; Kun Zhang; Donald S Burke Journal: Science Date: 2018-09-21 Impact factor: 47.728
Authors: Joshua A Barocas; Laura F White; Jianing Wang; Alexander Y Walley; Marc R LaRochelle; Dana Bernson; Thomas Land; Jake R Morgan; Jeffrey H Samet; Benjamin P Linas Journal: Am J Public Health Date: 2018-10-25 Impact factor: 11.561
Authors: Benjamin P Linas; Alexandra Savinkina; R W M A Madushani; Jianing Wang; Golnaz Eftekhari Yazdi; Avik Chatterjee; Alexander Y Walley; Jake R Morgan; Rachel L Epstein; Sabrina A Assoumou; Sean M Murphy; Bruce R Schackman; Stavroula A Chrysanthopoulou; Laura F White; Joshua A Barocas Journal: JAMA Netw Open Date: 2021-02-01
Authors: Shayla Nolen; Xiao Zang; Avik Chatterjee; Czarina N Behrends; Traci C Green; Aranshi Kumar; Benjamin P Linas; Jake R Morgan; Sean M Murphy; Alexander Y Walley; Shapei Yan; Bruce R Schackman; Brandon D L Marshall Journal: Addiction Date: 2021-12-05 Impact factor: 7.256
Authors: Erin J Stringfellow; Tse Yang Lim; Keith Humphreys; Catherine DiGennaro; Celia Stafford; Elizabeth Beaulieu; Jack Homer; Wayne Wakeland; Benjamin Bearnot; R Kathryn McHugh; John Kelly; Lukas Glos; Sara L Eggers; Reza Kazemi; Mohammad S Jalali Journal: Sci Adv Date: 2022-06-24 Impact factor: 14.957