Birth year may indicate drug overdose mortality risk
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The year and generation that someone is born could impact their risk for overdose death, according to a recent study published in Nature Medicine.
Hawre Jalal, MD, PhD, assistant professor of health policy and management at the University of Pittsburgh Graduate School of Public Health, told Healio Primary Care that the findings suggest early substance use treatment is as or even more important than treatment later in life, and “detailed attention to one’s unique experiences as determined by birth year and other factors may be important in effective management of substance or opioid use disorder.”
Jalal and colleagues evaluated a total of 661,565 drug overdose deaths reported by the CDC between 1979 and 2017. They plotted mortality trajectories based on birth year and birth generation — Baby Boomers (1945-1964), Generation X (1965-1980) and Millennials (1981-1990).
The researchers found that among Baby Boomers, overdose deaths increased from five per 100,000 in those born in 1945 to 28 per 100,000 deaths in those born in 1960. They explained that the increase in death from overdose may be linked to generational factors commonly associated with Baby Boomers, such as experimenting with drugs, dissatisfaction with the Vietnam War and increased cigarette use.
Compared with Baby Boomers, Jalal and colleagues determined that peak mortality shifted to a younger age with nearly each new birth year cohort in Generation X. They found that within this generation, the estimated peak age of overdose mortality shifted from 60 years to 40 years.
According to the researchers, this shift to younger age groups suggests that birth cohorts could have spread substance use behaviors to younger birth cohorts.
“Drug-sharing behaviors show strong age homophily, and among persons with substance use disorder, the risk of subsequent substance use is greater among their younger than among their older siblings,” they wrote.
Among Millenials, Jalal and colleagues found that the projected peak age of overdose mortality remained near 40 years of age, but the estimated amplitude increased from 32 per 100,000 among those born in 1980 to approximately 90 per 100,000 among those born in 1990. They explained that this may be attributed to the increase in heroin use among the generation and the increase in drug overdose deaths since 2013, likely due to fentanyl.
“We show that overdose death risk increases from one birth year to the next,” Jalal said. “These patterns are independent of age alone. For example, we found a person born in 1975 to have lower risk of overdose death than one born just 5 years later.”
He explained the findings “indicate that the birth year determines one’s path of overdose deaths.”
“Thus, early prevention and treatment of substance use are important,” he said. – by Erin Michael
Disclosures: The authors report no relevant financial disclosures. The study was funded by the NIH and the Robert Wood Johnson Foundation.