Opioid poisoning rates on Long Island, especially in Nassau and Suffolk counties, increased between 2010 and 2016, according to research published in the American Journal of Preventive Medicine. Study results support the importance of community-level opioid use interventions and the utility of data analytics tools to identify patient populations and regions requiring interventions.
Researchers conducted a retrospective cohort study to analyze the geographic, temporal, and sociodemographic differences in patients with opioid poisoning and related hospital visits in New York state. Patient-level data were collected from the New York Statewide Planning and Research Cooperative System, in combination with 2010 Census data and American Community Survey Long Island 5-digit ZIP code level data. The total study population included 3,426,563 patients from Nassau and Suffolk counties in Long Island, New York (1,636,758 patients from Nassau and 1,789,805 patients from Suffolk).
Between 2010 and 2016, the number and rates of opioid poisoning-related inpatient and outpatient visits significantly increased for New York state, Nassau, and Suffolk counties (2.7-fold for both New York state and Nassau counties and 2.5-fold for Suffolk County). Rates for Suffolk county remained higher than those for New York state over the course of the evaluation period. Between 2015 and 2016, opioid poisoning rates for each county and for New York state almost doubled.
During the study period, 8615 New York state residents presented multiple times with opioid poisoning (14.8%, rate of 4.45 per 10,000 population). Nassau county percentages were lower and Suffolk county percentages were higher than New York state (12.4% and 16.8%, respectively).
Crude opioid poisoning rates ranged from 0 to 588.24 per 10,000 population, with higher quartile ranges in Suffolk county. One Nassau county ZIP code had the highest overall crude rate compared with Suffolk county (588.24 vs 529.80 per 10,000 population).
ZIP codes were divided into 4 quartiles. Quartile 4 ZIP codes in both counties were home to communities with the lowest median home values, highest percentage of residents who completed high school, and the lowest percentage of residents who were educated beyond the college level. Patients in quartile 4 who experienced opioid poisoning were significantly younger and more often self-identified as white (P ≤.001). Patients in Nassau quartile 4 were significantly more frequently men and were more likely to pay with Medicaid (P =.006 and P <.001, respectively), while those from Suffolk were significantly more likely to self-pay (P <.001). Linear trends between 2010 and 2016 were observed for both counties and for New York state, with decreases in percentage of white patients and self-pay.
Limitations of the study included the exclusion of patients who were treated or died outside of a healthcare facility, resulting in possible underreporting of opioid poisoning. Additional limitations included the lack of granularity and lack of information on opioid source or reason for use.
“The methods of this study can be applied to other regional data to help understand and intervene in this crisis,” the researchers of the study concluded. “The strength of multidisciplinary collaborations and the role of data analytics methods provide a collaborative approach to planning and action to address a crisis affecting [Long Island] and with applicability to other US communities.”
Schoenfeld ER, Leibowitz GS, Wang Y, et al. Geographic, temporal, and sociodemographic differences in opioid poisoning [published online June 18, 2019]. Am J Prev Med. doi:10.1016/j.amepre.2019.03.020