Study finds opiate overdoses can lead to poor mental health | Health

A new study by the University of Cincinnati reports that the opioid epidemic is taking a heavy toll on people in disproportionate groups from Cape Cod to San Diego.

Fatal opioid overdoses are most common in six states: Ohio, Pennsylvania, Kentucky, West Virginia, Indiana, and Tennessee. But researchers identified 25 fatal opioid overdose hotspots nationwide using data from the Centers for Disease Control and Prevention.

Diego Cuadros, associate professor and co-author at UCSD, said the study illustrates how the problem of substance use disorders can be both pervasive and localized.

Quadros is director of the University of California’s Health Geography and Disease Modeling Laboratory, which applies geographic information, perspectives, and methods to the study of health, disease, and health care. As an epidemiologist, he studies the effects of diseases such as malaria, HIV and Covid-19.

“Not everyone is at a similar risk,” Cuadros said. “We wanted to identify characteristics that put people at greater risk for a fatal overdose.”

Opioid health interventions have largely focused on therapies such as administering naloxone and other life-saving therapies. But Cuadros said prevention can be effective if vulnerable populations can be identified. To this end, the researchers found that white males aged 25 to 29 were most at risk of fatal opioid overdose followed by white males aged 30 to 34. The study also identified an increased risk for black males between the ages of 30 and 34.

The study also found an association between fatal overdose and mental and physical distress using surveys of both physically and mentally unhealthy days. Mental distress increases the relative risk of death from a drug overdose by as much as 39 percent.

“We’ve seen a strong association with mental health and substance use disorders, especially opioids,” Quadros said. “What is happening now is that we are more than a year into a pandemic. The mental health of the entire population has deteriorated, which means we will see an increase in opioid overdoses.”

Researchers are trying to understand why men experience a more fatal overdose than women and what life span between the ages of 30 and 45 makes people more susceptible to the epidemic.

“Maybe you have more responsibilities or financial responsibilities or stress at the time,” Quadros said. “Maybe there are physiological changes or changes in our brain that we don’t know yet.”

“This is a complex epidemic. For HIV we have one virus or agent. Same with malaria. Same with Covid-19. It’s a virus,” Cuadros said. “But with opioids, we have many factors. At the beginning of the epidemic, it was heroin. By 2010, I switched to prescription opioids.”

Countries are now seeing more overdoses of synthetic opioids such as fentanyl.

The study also tracked the migration of overdoses between 2005 and 2017 from the southwestern states to the northeast. Several UCSD groups identified in the Southwest and Northeast had relatively higher levels of physical and mental distress.

Co-author Neil McKinnon, former dean of the James L. Winkle School of Pharmacy at the University of California, said the analysis can help health policymakers and clinicians by identifying individual and societal factors associated with an increased risk of death from substance use disorder. He is now Dean of Augusta University, Georgia.

“We hope that agencies like RecoveryOhio will use the risk factors we identified in this analysis to plan proactive strategies and allocate resources to respond to this pandemic,” McKinnon said.

Previously, UCSD researchers identified 12 areas in Ohio that had disproportionately high rates of fatal opioid overdose.

“We started in Ohio,” Cuadros said. “We know we’re in this state with the biggest burden of the problem.”

Likewise, he said, it would be useful to study populations in the United States where opioids do not take a heavy toll on families to understand the problem.

“Sometimes we focus too much on where the problem is. It helps to look at the areas where the problem is not so urgent,” Cuadros said.

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