title: Area-level socioeconomic status in relation to outcomes in gamma-hydroxybutyrate intoxication.
abstract: 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.
authors.affiliation: Department of Clinical Pharmacy, California Poison Control System, San Francisco Division, University of California, San Francisco, CA 94143-1369, USA. iba@calpoison.org
authors.forename: Ilene B
authors.initials: IB
authors.lastname: Anderson
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Kim-Katz
authors.forename: Jo Ellen
authors.initials: JE
authors.lastname: Dyer
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Earnest
authors.forename: John P
authors.initials: JP
authors.lastname: Lamb
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: 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
chemical_list: D013287:Illicit Drugs; D012978:Sodium Oxybate
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