Journal of Urban Health

, Volume 92, Issue 4, pp 758–772 | Cite as

Opioid Overdose Deaths in the City and County of San Francisco: Prevalence, Distribution, and Disparities

  • Adam J Visconti
  • Glenn-Milo Santos
  • Nikolas P. Lemos
  • Catherine Burke
  • Phillip O Coffin
Article

Abstract

Drug overdose is now the leading cause of unintentional death nationwide, driven by increased prescription opioid overdoses. To better understand urban opioid overdose deaths, this paper examines geographic, demographic, and clinical differences between heroin-related decedents and prescription opioid decedents in San Francisco from 2010 to 2012. During this time period, 331 individuals died from accidental overdose caused by opioids (310 involving prescription opioids and 31 involving heroin). Deaths most commonly involved methadone (45.9 %), morphine (26.9 %), and oxycodone (21.8 %). Most deaths also involved other substances (74.9 %), most commonly cocaine (35.3 %), benzodiazepines (27.5 %), antidepressants (22.7 %), and alcohol (19.6 %). Deaths were concentrated in a small, high-poverty, central area of San Francisco and disproportionately affected African-American individuals. Decedents in high-poverty areas were significantly more likely to die from methadone and cocaine, whereas individuals from more affluent areas were more likely die from oxycodone and benzodiazepines. Heroin decedents were more likely to be within a younger age demographic, die in public spaces, and have illicit substances rather than other prescription opioids. Overall, heroin overdose death, previously common in San Francisco, is now rare. Prescription opioid overdose has emerged as a significant concern, particularly among individuals in high-poverty areas. Deaths in poor and affluent regions involve different causative opioids and co-occurring substances.

Keywords

Opiate overdose Overdose Prescription opiate Opioid analgesic Opioid San Francisco Naloxone Opioid safety 

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Copyright information

© The New York Academy of Medicine 2015

Authors and Affiliations

  • Adam J Visconti
    • 1
    • 3
    • 4
  • Glenn-Milo Santos
    • 1
  • Nikolas P. Lemos
    • 2
  • Catherine Burke
    • 1
    • 3
  • Phillip O Coffin
    • 1
  1. 1.San Francisco Department of Public HealthSan FranciscoUSA
  2. 2.Office of the Chief Medical Examiner of the City and County of San FranciscoSan FranciscoUSA
  3. 3.University of California, San Francisco School of MedicineSan FranciscoUSA
  4. 4.Georgetown University – Providence Hospital, Family Medicine Residency ProgramColmar ManorUSA

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