Prescription opioid mortality trends in New York City, 1990-2006: examining the emergence of an epidemic.
BACKGROUND
The drug overdose mortality rate tripled between 1990 and 2006; prescription opioids have driven this epidemic. We examined the period 1990-2006 to inform our understanding of how the current prescription opioid overdose epidemic emerged in urban areas.


METHODS
We used data from the Office of the Chief Medical Examiner to examine changes in demographic and spatial patterns in overdose fatalities induced by prescription opioids (i.e., analgesics and methadone) in New York City (NYC) in 1990-2006, and what factors were associated with death from prescription opioids vs. heroin, historically the most prevalent form of opioid overdose in urban areas.


RESULTS
Analgesic-induced overdose fatalities were the only types of overdose fatalities to increase in 1990-2006 in NYC; the fatality rate increased sevenfold from 0.39 in 1990 to 2.7 per 100,000 persons in 2006. Whites and Latinos were the only racial/ethnic groups to exhibit an increase in overdose-related mortality. Relative to heroin overdose decedents, analgesic and methadone overdose decedents were more likely to be female and to concurrently use psychotherapeutic drugs, but less likely to concurrently use alcohol or cocaine. Analgesic overdose decedents were less likely to be Black or Hispanic, while methadone overdose decedents were more likely to be Black or Hispanic in contrast to heroin overdose decedents.


CONCLUSIONS
The distinct epidemiologic profiles exhibited by analgesic and methadone overdose fatalities highlight the need to define drug-specific public health prevention efforts.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA. mc3226@columbia.edu
Magdalena
M
Cerdá
Yusuf
Y
Ransome
Katherine M
KM
Keyes
Karestan C
KC
Koenen
Melissa
M
Tracy
Kenneth J
KJ
Tardiff
David
D
Vlahov
Sandro
S
Galea
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000506:poisoning; D003627:Data Interpretation, Statistical; D062787:Drug Overdose / Q000401:mortality*; D058872:Epidemics; D005006:Ethnicity; D005260:Female; D006556:Heroin Dependence / Q000401:mortality; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning; D008297:Male; D008691:Methadone / Q000506:poisoning; D008875:Middle Aged; D009294:Narcotics / Q000506:poisoning; D009519:New York City / Q000453:epidemiology; D055553:Prescription Drugs / Q000506:poisoning*; D011619:Psychotropic Drugs / Q000506:poisoning; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000401:mortality; D055815:Young Adult
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009294:Narcotics; D055553:Prescription Drugs; D011619:Psychotropic Drugs; D008691:Methadone
Epidemiology; Methadone; Mortality; Opioid analgesics; Overdose; Prescription drugs; Urban health