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Following public health intervention, opioid overdose deaths decrease in Staten Island

Following the implementation of a public health intervention, opioid-associated overdose death rates significantly decreased in Staten Island, New York.

From 2000 to 2011, the rate of unintentional overdose deaths due to opioids increased from 2.0 per 10.7 per 100,000 residents in Staten Island, a 435% increase, according to study researcher Denise Paone, EdD, of the New York City Department of Health and Mental Hygiene, and colleagues.

Significant disparities existed between opioid overdose death rates in Staten Island and other New York City boroughs. In 2011, the rate of opioid overdose deaths was 3 to 4.5 times higher in Staten Island vs. the Bronx, Brooklyn, Manhattan and Queens.

Due to the alarmingly high mortality rates, the New York City Department of Health and Mental Hygiene implemented a five-part public health intervention with citywide and Staten Island-specific targets in 2011, including:

• citywide opioid prescribing guidelines;
• a data brief for local media reporting on Staten Island mortality and prescribing data;
• Staten Island town hall meetings held by the New York City commissioner of health and meetings with Staten Island stakeholders;
• a Staten Island campaign promoting prescribing guidelines; and
• public service announcements that aired citywide, with additional airings in Staten Island.

To assess the impact of the public health interventions, Paone and colleagues reviewed mortality and toxicology data from New York City death certificates and from the Office of the Chief Medical Examiner and data for opioid prescriptions filled by New York City residents from the New York State Prescription Monitoring Program.

From 2011 to 2013, opioid overdose mortality rates decreased by 29%, from 10.7 to 7.6 per 100,000 Staten Island residents.

A combined rate for the four other boroughs did not change from 2011 to 2013, remaining at 2.6 per 100,000 residents for both years.

In Staten Island, heroin-associated overdose deaths fluctuated between 2011 and 2013 but had an overall net increase of 39%, from 6.2 to 8.6 per 100,000 residents.

Among the four other boroughs, heroin-associated overdose deaths increased from 3.7 in 2011 to 5 per 100,000 residents in 2013, an overall increase of 35%.

Overall drug overdose death rates decreased by 4% in Staten Island, from 18.4 in 2011 to 17.6 per 100,000 residents in 2013. The four other boroughs experienced a 20% increase in drug overdose death rates, from 7.9 in 2011 to 9.5 per 100,000 residents in 2013.

“After implementation of targeted and general public health initiatives, Staten Island saw 2 years of decreases in opioid analgesic high-dose prescribing and opioid analgesic-involved overdose mortality; the decreases followed 11 years of increases,” Paone and colleagues wrote. “The fact that some of these initiatives were statewide or citywide, whereas others were Staten Island-specific, suggests that the community-specific initiatives might have been key to the decreases in Staten Island without corresponding decreases citywide. This tailored and intensive approach might be effective in other jurisdictions with high rates of opioid analgesic-involved mortality.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.