The opioid epidemic's geographic footprint: 4 things to know

More than 33,000 people died from opioid overdoses in 2015, continuing a consistent upward trend in the rate of opioid-related deaths in the United States. In 1999, the number of opioid overdose deaths was 8,280. While these numbers demonstrate the human cost of the epidemic, they do not adequately convey the regional burden of the problem or its multifaceted nature.

In a recent article from The Washington Post, Christopher Ingraham analyzed the geographical burden of the opioid epidemic based on data from the CDC. While the CDC suppresses data on specific communities for privacy reasons, the agency does offer up state specific data on opioid overdose death rates and categorizes deaths by the specific type of opioid responsible. The Post article suggests the nation is not simply facing a singular opioid epidemic, but rather several at once.

Here are four things to know about the geographic footprint of the opioid epidemic.

1. Overall opioid deaths: The national rate for opioid overdose deaths per 100,000 people in 2015 was 10.4. But, when assessing this rate at the state level, it becomes clear certain regions are experienced much higher rates of death.

Kentucky, Massachusetts, New Hampshire, Ohio, Rhode Island and West Virginia had the highest rate of overall opioid overdose deaths. In each of these states, at least 36 people per 100,000 died of an opioid overdose.

2. Heroin deaths: For the first time in recent history, heroin overdoses surpassed gun homicides as the more prolific killer in 2015. The states with the highest rates of heroin related deaths were Connecticut, Ohio and West Virginia. Those states experienced at least 13.3 heroin-related overdose deaths per 100,000 people.

To protect community privacy, the CDC suppresses data for several states, mostly due to low population and low rates of overall opioid deaths, according to the Post. The CDC does not make state-level data on heroin overdoses available for Arkansas, Montana, Nebraska, North Dakota, South Dakota and Wyoming.

3. Synthetic opioid deaths: Synthetic opioids are created with chemicals not found in poppy seeds, morphine, codeine or opium. The substance primarily responsible for synthetic opioid deaths in the U.S. is fentanyl, a product 50 times more potent than morphine.

While synthetic opioid deaths have significantly impacted states like Ohio and West Virginia, the drugs have taken the largest toll on New England. In 2015, Rhode Island's synthetic opioid overdose death rate was 13.2 per 100,000 people, Massachusetts' was 14.4 and in New Hampshire — which had the highest rate in the nation — it was 24.1.

4. Classic opioid deaths: Opioids that have chemical similarities with the natural opium found in poppy plants are categorized as classic opioids. These substances include drugs like hydrocodone and oxycodone.

The top states for these types of deaths in 2015 were Utah and West Virginia. This was the only category in which Massachusetts and Ohio weren't at least near the top rankings.

"The important takeaway here is that there's not just one opiate epidemic but several," Christopher Ingraham wrote in the Post. "For policymakers, this may mean that solving the problem will similarly require a more nuanced basket of solutions than a blanket 'war on drugs.' A strategy to reduce pill overdoses in Utah may not have any effect on fentanyl deaths in Massachusetts."

More articles on population health: 
Advisory Board: Partnerships between hospitals, public health agencies can improve population health 
Optimistic women may live longer than more negative peers, study finds 
1 in 3 long-term opioid users say they're addicted: 3 survey takeaways

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