Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113580

Angela Bucciarelli, MPH¹, Kyle Bernstine, PhD ScM², Tinka Markham Piper, MPH, CSW³, Sandro Galea, MD, MPH¹, Kenneth J. Tardiff, MD, MPH⁴, and David Vlahov, PhD³. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212.419.3583, abucciarellli@nyam.org, (2) Department of Emergency Medicine, New York University School of Medicine, 462 First Ave, New York, NY 10016, (3) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 55 West 125th Street, 13th Floor, New York, NY 10027, (4) Department of Psychiatry, New York Presbyterian Hosptial, 525 East 68th Street Box 140, New York, NY 10021

In New York City (NYC), the annual mortality rate is higher for accidental drug overdoses than for homicides; cocaine and opiates are the drugs most frequently associated with drug overdose deaths. We were interested in assessing trends and correlates of cocaine- and opiate-related overdose deaths in NYC during 1990-2000. Data were collected from the NYC Office of the Chief Medical Examiner (OCME) on all fatal drug overdoses that occurred between 1990-2000 (n=9,149). Overall, cocaine was present in 5949 (65.0%) and opiates were present in 6382 (69.8%) decedents among decedents ages 15-64. Among overdose deaths, 2392 (26.1%) were attributed only to cocaine and 2825 (30.9%) were attributed only to opiates. The percentage of drug overdose deaths attributed exclusively to cocaine fell from 27.4% to 22.0% while the percentage of overdose deaths attributed to exclusively opiates rose from 28.7% to 37.5% during the interval. In multivariable logistic regression models men were significantly less likely than women to have a cocaine-only overdose (OR=0.79) but more likely to have an opiate-only overdose (OR=1.29); blacks and Hispanics were more likely than whites (OR=3.35 and 1.41 respectively) to have a cocaine-only death but less likely (OR=0.39, 0.80) to have an opiate-only death. Persons over the age of 25 were more likely to have a cocaine-only death while those under 25 were more likely to have an opiate-only death. Detection of changing trends in drug overdose and their determinants, both socio-demographic and contextual, is essential for successful intervention and risk reduction efforts.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Discuss individual-level factors associated with fatal drug overdose, but also compare and contrast variation in these factors observed in New York City.
• Assess the importance of analyzing both individual- and contextual-factors when identifying risk of fatal drug overdose.

Keywords: Drug Use Review, Urban Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.