DEMOGRAPHIC ANGLE TO OPIOID PROBLEM

[Note:  This posting is a continuation of a report on the development of a civics unit of study.  This unit is directing students to formulate informed positions on the opioid epidemic.]

As indicated, this blog has been reporting on the opioid epidemic.  If new to this blog, the reader is invited to use the archive feature and review the last half dozen or so postings to become familiar with what has so far been reported.  This treatment is now going to review a list of factoids and insights that help describe and explain this epidemic and its harmful effects on the American public.

          More specifically, the following list of factoids and insights will highlight demographic information.  First are the factoids; they are:

·        American incidence of overdosing mostly affects whites, Native Americans, and working-class residents.[1]  For example, Native Americans have witnessed a 500% upsurge in opioid induced overdose fatalities between the years 1999 and 2015 – this reflects the highest increase of any identifiable demographic group.[2]

·        In the US, rural areas have experienced highest rates – as measured as a percent of the population – of opioid overdoses.  To quote Andrew Sullivan, “[Opioid epidemic] toll in one demographic – mostly white, working-class, and rural – vastly outweighs its impact among urbanites.”[3]

·        Alarmingly, from information gathered since 2006, one-third of all new abusers of prescribed drugs, were teenagers (particularly 12- to 17-year-olds).  A breakdown of this reported fact shows that that abuse outnumbered any illicit drug use with the exception of the use of marijuana.[4]

·        Opioid prescription rates in 2012 (as noted in an earlier posting) varied significantly among the various states of the US.  This is true even though reported incidence of pain does not vary across the US.  To summarize the variance, the highest rate, in Alabama, is roughly three times greater than in the lowest rated state of Hawaii.[5]

·        There is no evidence that differing amounts of opioids leads to better results in pain relief.  This is measured in terms of pain relief or patient satisfaction.[6]

·        Research has discovered that from the years 2000 to 2012, use of a variety of drugs – marijuana or hashish, cocaine or crack, heroin, non-prescribed methadone, among others – as measured by increases in admission for treatment was noticeably observed affecting people 55 and older irrespective of other demographic classifications.[7]

·        Among other findings, categorizing this older population’s admissions are as follows:  among African Americans the rate is 21% to 28%, among females 20% to 24%, among high school graduates 63% to 75%, among the homeless 15% to 19%, among unemployed 77% to 84%, and among those with psychiatric problems 17% to 32% of admissions.[8]

·        Some noted, exceptional incidence of death attributable to opioids among states and communities are as follows:  Palm Beach County, Florida, overdose deaths rose from149 in 2012 to 588 in 2016;[9] Middletown, Ohio saw opiate deaths of 967 in 2016;[10] Pennsylvania death rate due to opioids rose 44% in the year between 2016 and 2017 resulting in Governor Tom Wolf declaring a state of emergency.[11]

·        “The rising death rates for young white adults, ages 25 to 34, make them the first generation since the Vietnam War years of the mid-1960s to experience higher death rates in early adulthood than the generation that preceded it.”[12]

In terms of generalizations, the following insights are offered:

·        Among lower levels of opioid abuse among black Americans – as speculated by a physician – are caused by doctors harboring stereotypic beliefs associating blacks with drug abuse and, therefore, these doctors’ reluctance to prescribe the drug to black patients.[13]

·        Researchers hypothesize that the reason doctors from various states prescribe opioids at different rates of frequency is due to a lack of agreement among medical professionals as to the appropriate amounts of medication patients need.[14]  This writer would add that there does not seem to be evidence that this variance is contingent on geographic location.

·        There seems to be a consensus evolving that chief among the reasons for this epidemic are the social, psychological, and physiological problems among users.  Apparently, these types of issues are being found to be the chief factors leading to users among whites as opposed to blacks in the population.[15] 

This concludes this posting’s review of factoids and insights regarding demographic factors and the opioid epidemic.  Apparently, more needs to be learned about how demographic factors are affecting opioid use and misuse.  Next posting will begin looking at government reactions to this crisis.

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[1] Dan Nolan and Chris Amico, “How Bad Is the Opioid Epidemic?” Frontline, February  23, 2016, accessed July 12, 2018, https://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/ .

[2] “Native American Overdose Deaths Surge Since Opioid Epidemic,” R and D, March 15, 2018, accessed August 2, 2018, https://www.rdmag.com/news/2018/03/native-american-overdose-deaths-surge-opioid-epidemic .

[3] Andrew Sullivan, “The Opioid Epidemic Is This Generation’s AIDS Crisis,” New York Magazine/Daily Intelligencer, March 16, 2017, accessed August 2, 2018, http://nymag.com/daily/intelligencer/2017/03/the-opioid-epidemic-is-this-generations-aids-crisis.html .

[4] “Prescription for Danger,” Office of National Drug Control – 2008 Policy Report, for example, see https://obamawhitehouse.archives.gov/ondcp/prescription-drug-abuse1 , accessed August 1, 2018.

[5] “Prescribing Data,” Centers for Disease Control and Prevention, n. d., accessed August 2, 2018, https://www.cdc.gov/drugoverdose/data/prescribing.html .

[6] Dan Nolan and Chris Amico, “How Bad Is the Opioid Epidemic?” Frontline.

[7] “Trends in Substance Use Admissions among Older Adults,” BMC Health Services Research, vol. 17, 584, August 22, 2017, accessed August 2, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568321/ .

[8] Ibid.

[9] Jeff Parrott, “Patient Brokering Exacerbates Opioid Crisis in Florida,” South Bend Tribune, April 2, 2017, accessed August 2, 2018, https://www.southbendtribune.com/patient-brokering-exacerbates-opioid-crisis-in-florida/article_b8c68a56-165f-11e7-9c1d-bf6403fa10a5.html .

[10] Emily de La Bruyere, “Middletown, Ohio, a City under Siege:  ‘Everyone I Know Is on Heroin,’” Yahoo News, August 2, 2017, accessed August 2, 2018, https://www.yahoo.com/news/middletown-ohio-city-siege-everyone-know-heroin-155314072.html .

[11] Katie Meyer and Brett Sholtis (WITF), “Gov. Tom Wolf Declares ‘State of Emergency’ in Pa. Opioid Epidemic,” WHFF, January 10, 2018, accessed August 2, 2018, https://whyy.org/segments/video-gov-tom-wolf-declare-state-emergency-pa-opioid-epidemic/ .

[12] Ibid.

[13] Gina Kolata and Sarah Cohne, “Drug Overdoses Propel Rise in Mortality Rates of Young Whites, The New York Times, January 16, 2016, accessed August 2, 2018, https://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html .

[14] Dan Nolan and Chris Amico, “How Bad Is the Opioid Epidemic?” Frontline.

[15] “Trends in Substance Use Admissions among Older Adults,” BMC Health Services Research.