Area-level socioeconomic status in relation to outcomes in gamma-hydroxybutyrate intoxication.
BACKGROUND
Area-level socioeconomic status (SES) may play an important role in drug abuse patterns, including related health outcomes. This may be particularly relevant for gamma-hydroxybutyrate (GHB), which is prototypical of "party" drug abuse.


METHODS
We retrospectively reviewed GHB-related cases reported to the California Poison Control System (CPCS; January 1, 1999 through June 30, 2007). We limited analysis to CPCS calls containing a residential zip code (ZC). The CPCS data were extracted for key case characteristics, including the residential ZC. We linked cases to corresponding 2000 U.S. Census data for area-level measures of SES and demographics. We used multiple logistic regression analysis to test the associations between area-level SES and GHB case severity, taking into account area-level demographics and individual-level GHB high-risk behaviors.


RESULTS
We analyzed 210 cases. Taking into account area-level demographics (age and racial mix; urbanicity) and GHB-related high-risk behaviors (use of GHB congeners; GHB-dependence; co-ingestion of other agents), we associated higher area-level SES with greater GHB case severity. There was 40% increased likelihood of major GHB adverse health outcomes for every $100,000 incremental increase in median home values (OR 1.41; 95% CI 1.1-1.8). For median annual household income (per $10,000), the association was similar (OR 1.39; 95% CI 1.0-1.9).


CONCLUSIONS
Higher area-level SES is associated with greater GHB-related case severity. This study may serve as a model using a geographic information system (GIS) approach to study the population-based correlates of drugs of abuse reported through poison control surveillance.
Anderson
Ilene B
IB
Department of Clinical Pharmacy, California Poison Control System, San Francisco Division, University of California, San Francisco, CA 94143-1369, USA. iba@calpoison.org
Kim-Katz
Susan Y
SY
Dyer
Jo Ellen
JE
Earnest
Gillian E
GE
Lamb
John P
JP
Blanc
Paul D
PD
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D019352:Censuses; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning*; D008297:Male; D011039:Poison Control Centers; D011041:Poisoning / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D012978:Sodium Oxybate / Q000506:poisoning*; D055815:Young Adult
D013287:Illicit Drugs; D012978:Sodium Oxybate
Drug Alcohol Depend. 2005 Sep 1;79(3):311-20
16102375
Clin Toxicol (Phila). 2007;45(2):144-51
17364631
Am J Public Health. 2003 May;93(5):699; author reply 699-700
12721119
J Psychopharmacol. 2005 Mar;19(2):195-204
15871147
Drug Alcohol Depend. 2006 Sep 1;84(1):102-13
16483730
Subst Use Misuse. 2007;42(11):1723-43
17934992
J Toxicol Clin Toxicol. 2002;40(6):767-73
12475189
Soc Sci Med. 2007 Dec;65(12):2458-63
17761378
Am J Drug Alcohol Abuse. 2007;33(3):429-38
17613970
J Anal Toxicol. 2005 Jul-Aug;29(5):398-400
16105269
Drug Alcohol Depend. 2007 Sep 6;90(1):64-71
17386981
N Engl J Med. 2001 Jan 11;344(2):87-94
11150358
Ann Emerg Med. 2006 Feb;47(2):177-83
16431231
Int J Health Geogr. 2006 Dec 13;5:58
17166283
Pediatrics. 2006 Nov;118(5):2094-100
17079583
Am J Prev Med. 2007 Jun;32(6 Suppl):S203-10
17543712
Med J Aust. 2008 Jan 7;188(1):54-5
18021061
Eur Respir J. 2006 Jan;27(1):85-94
16387940
Drug Alcohol Depend. 2007 Jul 10;89(2-3):153-60
17267140
J Gen Intern Med. 2007 Sep;22(9):1239-45
17594131
Am Heart J. 2007 Aug;154(2):385-90
17643593
J Interpers Violence. 2008 Jan;23(1):3-20
18087029
Am J Public Health. 2002 Jul;92(7):1100-2
12084688
Int J Health Geogr. 2007 Dec 19;6:56
18093323
J Toxicol Environ Health A. 2003 Oct 24;66(20):1905-8
14514432
Lakartidningen. 2005 Nov 7-13;102(45):3294-6, 3299
16342543
Am J Emerg Med. 2005 Sep;23(5):589-666
16140178
J Toxicol Clin Toxicol. 2002;40(7):855-60
12507054
J Toxicol Environ Health A. 2005 May 28;68(10):755-61
16020174
J Psychoactive Drugs. 2007 Jun;39(2):115-29
17703706
J Psychoactive Drugs. 2007 Sep;39(3):293-6
18159783
J Psychoactive Drugs. 2004 Sep;36(3):397-9
15559686