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Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017

BACKGROUND: Opioid-overdose deaths and opioid prescriptions have increased substantially within the past decade, leading to examinations of urban-rural differences for these opioid-related outcomes, and whether annual trends differ by urban-rural status. Most investigations have examined differences...

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Autores principales: Lister, Jamey J., Ellis, Jennifer D., Yoon, Miyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244930/
https://www.ncbi.nlm.nih.gov/pubmed/32467830
http://dx.doi.org/10.1016/j.abrep.2019.100234
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author Lister, Jamey J.
Ellis, Jennifer D.
Yoon, Miyoung
author_facet Lister, Jamey J.
Ellis, Jennifer D.
Yoon, Miyoung
author_sort Lister, Jamey J.
collection PubMed
description BACKGROUND: Opioid-overdose deaths and opioid prescriptions have increased substantially within the past decade, leading to examinations of urban-rural differences for these opioid-related outcomes, and whether annual trends differ by urban-rural status. Most investigations have examined differences using national data, whereas few studies have identified patterns in hard-hit regions. Therefore, we examined urban-rural differences for opioid-related outcomes in Michigan, a state with overdose death and prescribing rates above the national average. METHODS: This study used county-level public data on opioid prescribing and opioid-overdose death rates in Michigan. Bivariate and joinpoint regression analyses tested for annual differences and annual changes in opioid-related outcomes across 2013–2017. Rural Urban Continuum Codes classified urban-rural county status. RESULTS: Bivariate analyses demonstrated that urban counties had consistently higher opioid-overdose death rates than rural, whereas rural counties had consistently higher opioid prescribing rates than urban. Joinpoint regression (2013–2017) revealed opioid-overdose death rates increased in urban (Annual Percent Change = 25.0%, p = .001) and rural counties (Annual Percent Change = 21.7%, p = .002), though no changes for opioid prescribing rates were observed among urban or rural counties. CONCLUSIONS: Our study highlights nuanced urban-rural patterns in Michigan, a hard-hit state, compared to trends in national data. Both urban and rural counties experienced rising rates of opioid-overdose deaths, and rural counties experienced higher opioid prescribing rates than urban. Though urban counties experienced higher opioid-overdose death rates than rural, the rise in both county types was similar. Future research directions, implications for public health, and healthcare policy recommendations are discussed.
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spelling pubmed-72449302020-05-27 Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017 Lister, Jamey J. Ellis, Jennifer D. Yoon, Miyoung Addict Behav Rep Research paper BACKGROUND: Opioid-overdose deaths and opioid prescriptions have increased substantially within the past decade, leading to examinations of urban-rural differences for these opioid-related outcomes, and whether annual trends differ by urban-rural status. Most investigations have examined differences using national data, whereas few studies have identified patterns in hard-hit regions. Therefore, we examined urban-rural differences for opioid-related outcomes in Michigan, a state with overdose death and prescribing rates above the national average. METHODS: This study used county-level public data on opioid prescribing and opioid-overdose death rates in Michigan. Bivariate and joinpoint regression analyses tested for annual differences and annual changes in opioid-related outcomes across 2013–2017. Rural Urban Continuum Codes classified urban-rural county status. RESULTS: Bivariate analyses demonstrated that urban counties had consistently higher opioid-overdose death rates than rural, whereas rural counties had consistently higher opioid prescribing rates than urban. Joinpoint regression (2013–2017) revealed opioid-overdose death rates increased in urban (Annual Percent Change = 25.0%, p = .001) and rural counties (Annual Percent Change = 21.7%, p = .002), though no changes for opioid prescribing rates were observed among urban or rural counties. CONCLUSIONS: Our study highlights nuanced urban-rural patterns in Michigan, a hard-hit state, compared to trends in national data. Both urban and rural counties experienced rising rates of opioid-overdose deaths, and rural counties experienced higher opioid prescribing rates than urban. Though urban counties experienced higher opioid-overdose death rates than rural, the rise in both county types was similar. Future research directions, implications for public health, and healthcare policy recommendations are discussed. Elsevier 2019-11-15 /pmc/articles/PMC7244930/ /pubmed/32467830 http://dx.doi.org/10.1016/j.abrep.2019.100234 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research paper
Lister, Jamey J.
Ellis, Jennifer D.
Yoon, Miyoung
Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title_full Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title_fullStr Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title_full_unstemmed Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title_short Opioid prescribing and opioid-overdose deaths in Michigan: Urban-rural comparisons and changes across 2013–2017
title_sort opioid prescribing and opioid-overdose deaths in michigan: urban-rural comparisons and changes across 2013–2017
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244930/
https://www.ncbi.nlm.nih.gov/pubmed/32467830
http://dx.doi.org/10.1016/j.abrep.2019.100234
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