Overdose in rural and urban areas will rise sharply, new study reveals geographic breakdown — ScienceDaily

But the coming wave will not distinguish between rural and urban areas, the findings suggest. Deaths are projected to increase dramatically. According to the study’s authors, the reason opioid overdoses have reached record highs is because synthetic opioids were combined with stimulants such as cocaine and methamphetamine.

“I am sounding alarm bells as we see for the first time convergence and escalation of accelerated rates in rural and urban counties of all types,” said corresponding author Lori Post, director of the Buehler Center for Health Policy and Economics. . Northwestern University Feinberg School of Medicine. “Not only is the death rate from opioids at an all-time high, but the acceleration in that mortality rate already marks an explosive exponential growth even greater than the historical highs.”

The study will be published on July 28th. JAMA network open..

This study explores geographic trends in opioid-related overdose deaths from 1999 to 2020 and explores whether geography played a role in the three waves of the American opioid crisis and a theoretical fourth wave. I decided what The authors used data recorded for 3,147 counties recorded in the U.S. Centers for Disease Control and Prevention’s WONDER database and county equivalents classified on a 6-point urban scale (most urban to most rural).

First study to systematically examine acceleration rates by geography

Although some investigators have examined the rate of acceleration from one year to the next, the authors of the study, to their knowledge, have systematically determined the rate of acceleration of opioid-related overdose mortality geographically each year. He said no one had actually investigated.

Post used the method she developed to assess where COVID-19 outbreaks are occurring and applied it to opioid misuse.

Near the end of available data in 2020, the study found that overdose deaths in rural areas were escalating faster than in urban areas. Visualization of data between 2019 and 2020 show that opioid-related overdose mortality converged and escalated for the first time in six rural and urban counties.

“This fourth wave will be worse than ever, with the highest rate of infection in the United States for the first time,” Post said. “It would mean mass death.”

lethal combination

The study authors examined toxicology reports that people used fentanyl (a synthetic opioid 50 to 100 times more potent than morphine) and carfentanil (a synthetic opioid about 100 times more potent than fentanyl) in combination with methamphetamine and cocaine. I discovered that The result is a powerful, lethal cocktail that can even escape the help of overdose-controlling drugs like naloxone.

“The more potent the drug, the more difficult it is to resuscitate,” said study co-author Alexander Lundberg, assistant professor of emergency medicine at Feinberg University. “The use of polysubstances complicates an already dire situation.”

“People who died from opioid overdoses appeared to be pretending to be pharmacists and trying to control their own dosages,” Post said. This is a bigger issue because there are people who are, so they need to be treated for two things at once, and fentanyl is terribly volatile.”

What can i do?

“Nobody wants to be a drug addict,” Post said. “It doesn’t matter if you’re on Percocet because you broke your back while mining, or if you’re a high school student who died because you were in your grandma’s medicine cabinet. Opioid addiction and overdose prevention should be considered now.” I have. “

According to Post, this could be in the form of a methadone or buprenorphine center, which provides addiction treatment with drug therapy for overdose of heroin or synthetic and semi-synthetic opioids, but is usually only open in urban areas. increase. There are no medication-assisted treatment options in rural areas, she said, adding that what works in big cities is likely to be less useful in rural areas.

“The only way forward is to raise awareness to prevent opioid use disorders and provide culturally appropriate, non-stimulatory pharmacotherapy in rural areas,” Post said.

The study is titled “Geographic trends in opioid overdose in the United States from 1999 to 2020.” Other Northwestern co-authors include Marian Mason and Eileen Quan.