Estimating the prevalence of illicit opioid use in New York City using multiple data sources

Jennifer Mcneely,Sharmila Shah,Denise Paone,Daliah Heller,Marc N Gourevitch,Shana Wright

doi:10.1186/1471-2458-12-443

Abstract

BackgroundDespite concerns about its health and social consequences, little is known about the prevalence of illicit opioid use in New York City. Individuals who misuse heroin and prescription opioids are known to bear a disproportionate burden of morbidity and mortality. Service providers and public health authorities are challenged to provide appropriate interventions in the absence of basic knowledge about the size and characteristics of this population. While illicit drug users are underrepresented in population-based surveys, they may be identified in multiple administrative data sources.MethodsWe analyzed large datasets tracking hospital inpatient and emergency room admissions as well as drug treatment and detoxification services utilization. These were applied in combination with findings from a large general population survey and administrative records tracking prescriptions, drug overdose deaths, and correctional health services, to estimate the prevalence of heroin and non-medical prescription opioid use among New York City residents in 2006. These data were further applied to a descriptive analysis of opioid users entering drug treatment and hospital-based medical care.ResultsThese data sources identified 126,681 cases of opioid use among New York City residents in 2006. After applying adjustment scenarios to account for potential overlap between data sources, we estimated over 92,000 individual opioid users. By contrast, just 21,600 opioid users initiated drug treatment in 2006. Opioid users represented 4 % of all individuals hospitalized, and over 44,000 hospitalizations during the calendar year.ConclusionsOur findings suggest that innovative approaches are needed to provide adequate services to this sizeable population of opioid users. Given the observed high rates of hospital services utilization, greater integration of drug services into medical settings could be one component of an effective approach to expanding both the scope and reach of health interventions for this population.

Highlights

Despite concerns about its health and social consequences, little is known about the prevalence of illicit opioid use in York State Department of Health (New) York City
Prescription opioid users may be poorly reached by traditional drug treatment services, treatment admissions in New York State do display a steady increase from this group over the past 15 years
Research on opioid use has largely focused on heroin-using populations, with much less known about the treatment needs and access to care issues experienced by prescription opioid users [12]

Summary

Introduction

Despite concerns about its health and social consequences, little is known about the prevalence of illicit opioid use in New York City. While there is great concern about the impact of illicit drug use in New York City, use of heroin and prescription opioids, since the 1970s there have been few rigorous efforts to estimate its prevalence [1]. A related third event is a newly increased emphasis on integrating addiction treatment into nonspecialty medical settings such as primary care clinics. This is exemplified in the current strategic plan issued by the federal Office of National Drug Control Policy, which emphasizes early identification of substance use disorders and expansion of treatment through mainstream healthcare settings [15]

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