Overdose Death Rates in the U.S…..by County

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I read this great journal article about overdoses in the U.S., and since it had a map, I must include it in my blog. The actual article is of course interesting, and free to the public at this web address: http://www.ajpmonline.org/article/S0749-3797(13)00490-X/fulltext

I love maps. In a glance, a map can tell a story.

This article deals with drug overdose deaths, which are now the most common cause of injury death in the U.S. Most people know drug overdose deaths, fueled by the increased availability of prescription opioid medications, have increased over 300% in the U.S. over the past thirty years.

We’ve had data at state levels about rates of drug overdose deaths, but this article was unusual because it reported death rates from drug overdoses by county in each state in the U.S. Overdose death rates by county can be misleading, because the data deal with smaller sample sizes. Several overdoses can skew the data significantly, making the data unstable. This study used statistical techniques to reduce this problem. Because some age groups have higher overdose death rates than others, this study also controlled for age in their calculation of overdose deaths.

Several things struck me as I looked at the article. Even though I know the Western part of the U.S. has had increasing problems with overdoses, the map drove that home. Vast expanses of red cover large parts of large states. This shows it isn’t just Appalachia dealing with overdoses.

I was also struck by New York State’s relatively lower rates of overdose than its surrounding states. I wonder if their lower rates of drug overdose deaths have anything to do with better acceptance of opioid treatment programs in that state.

After all, methadone treatment for heroin addiction started in New York City, at Rockefeller University, by Drs. Dole, Nyswander, and Kreek in 1964. Dr. Dole even won the Lasker Award in Medicine for this life-saving treatment innovation. At the AATOD (American Association for the Treatment of Opioid Addiction) conference earlier this month, I was honored to hear a lecture by Dr. Kreek, who still works at Rockefeller University, about the last fifty years of opioid addiction treatment with methadone.

New York’s prescription monitoring program has been operating since 1983, considerably earlier than the majority of states in the U.S. New York’s Medicaid program covers opioid addiction treatment with methadone and buprenorphine. New York has some of the most prestigious medical schools and teaching hospitals in the U.S. Overall, New York is usually considered more progressive than, say….. a state like Tennessee.

And of course I’m going to take my usual poke at Tennessee’s Department of Mental Health. Just last summer, a certificate of need for an opioid-addiction treatment program for Eastern Tennessee was rejected by this department. State officials said there was no need for additional treatment for opioid addiction in this area.

Take a look at the map. Tennessee is a red state in more ways than one. Once again, objective data indicates Tennessee’s opinions are not fact-based. The addicts of Tennessee continue to pay the ultimate price for this close-minded approach.

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One response to this post.

  1. Look at all that DARK RED in upper-eastern Tennessee… Where the Tennessee Health Services & Development Agency just recently DENIED a Certificate of NEED for a proposed Opioid Treatment Program. The entire state of Tennessee, for that matter, is dark red… A state that only has TWELVE opioid treatment programs in the entire state (compared to Georgia’s 50+ and North Carolina’s 40+). It’s a shame.

    Thanks for this entry.

    Zac Talbott
    NAMA-R TN
    http://www.tnmethadone.org

    Reply

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