Rural‐Urban Trends in Opioid Overdose Discharges in Missouri Emergency Departments, 2012‐2016

Coffey, Whitney; Hunter, Andrew; Mobley, Evan; Vivolo-Kantor, Alana M.

doi:10.1111/jrh.12368

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…On the other hand, use of coal as a source of heating is more common in rural regions. These correlations are in line with existing research that has suggested that in recent years opioid epidemic has been expanding from rural regions to urban regions [23], [33]. Higher levels of education have been associated with healthier populations [34].…”

Section: Resultssupporting

confidence: 89%

Understanding the factors driving the opioid epidemic using machine learning

Gavali¹,

Chen²,

Cowart³

et al. 2021

Preprint

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In recent years, the US has experienced an opioid epidemic with an unprecedented number of drugs overdose deaths. Research finds such overdose deaths are linked to neighborhood-level traits, thus providing opportunity to identify effective interventions. Typically, techniques such as Ordinary Least Squares (OLS) or Maximum Likelihood Estimation (MLE) are used to document neighborhood-level factors significant in explaining such adverse outcomes. These techniques are, however, less equipped to ascertain non-linear relationships between confounding factors. Hence, in this study we apply machine learning based techniques to identify opioid risks of neighborhoods in Delaware and explore the correlation of these factors using Shapley Additive explanations (SHAP). We discovered that the factors related to neighborhoods' environment, followed by education and then crime, were highly correlated with higher opioid risk. We also explored the change in these correlations over the years to understand the changing dynamics of the epidemic. Furthermore, we discovered that, as the epidemic has shifted from legal (i.e., prescription opioids) to illegal (e.g., heroin and fentanyl) drugs in recent years, the correlation of environment, crime and health related variables with the opioid risk has increased significantly while the correlation of economic and socio-demographic variables has decreased. The correlation of education related factors has been higher from the start and has increased slightly in recent years suggesting a need for increased awareness about the opioid epidemic.

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Section: Resultssupporting

confidence: 89%

Understanding the factors driving the opioid epidemic using machine learning

Gavali¹,

Chen²,

Cowart³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, 1 in 10 reported a rural residence. Rural and micropolitan counties have fewer resources such as infectious diseases and/or addiction providers and rehabilitation facilities, which necessitates a long commute to more urban medical centers [ 32 ]. These counties often lack robust emergency medical services to distribute life-saving interventions, such as naloxone [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rural and micropolitan counties have fewer resources such as infectious diseases and/or addiction providers and rehabilitation facilities, which necessitates a long commute to more urban medical centers [ 32 ]. These counties often lack robust emergency medical services to distribute life-saving interventions, such as naloxone [ 32 ]. Due to a lack of Medicaid expansion in Alabama, hospitals face financial hurdles when trying to care for their inpatients and safely transition them to outpatient settings [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Methamphetamines and Serious Injection-Related Infections: Opioid Use Care Continuum and Opportunities to End Alabama's Drug Crisis

Levy

Bassler

Gagnon

et al. 2022

Open Forum Infectious Diseases

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Background Increasingly, injection opioid use and opioid use disorder (OUD) are complicated by methamphetamine use, but the impact of stimulant use on the care of people who inject drugs (PWID) with serious injection related infections (SIRI) is unknown. The objective of this study is to explore hospital outcomes as well as post-discharge trends for a cohort of hospitalized PWID to identify opportunities for intervention. Methods We queried the electronic medical record for patients hospitalized at the University of Alabama at Birmingham with injection drug-use related infections between 1/11/2016 and 4/24/2021. Patients were categorized as having OUD only (OUD), OUD plus methamphetamine use (OUD/meth), or injection of other substance(s) (other). We utilized statistical analyses to assess group differences across hospital outcomes and post-discharge trends. We determined the OUD continuum of care for those with OUD, with and without methamphetamine use. Results A total of 370 patients met inclusion criteria- many with readmissions (98%) and high mortality (8%). The majority were White, male, and uninsured, with a median age of 38. One in four resided outside of a metropolitan area. There were significant differences according to substance use in terms of sociodemographics and hospital outcomes: patients with OUD/meth were more likely to leave via patient directed discharge, but those with OUD only had the greatest mortality. Comorbid methamphetamine use did not significantly impact the OUD care continuum. Conclusions The current drug crisis in AL will require targeted interventions to engage a young, uninsured population with SIRI in evidence-based addiction and infection services.

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