Abstract
This article explores trends and correlates of Chicago’s opiate-related overdose (OD) deaths. We manually examined data from every death certificate filed between 1999 and 2003 to identify all Chicago residents’ accidental deaths involving acute intoxication with illicit opiates, OD, or opiate poisoning. The analysis includes an examination of contextual characteristics in 77 Chicago neighborhoods. Negative binomial regression analysis permits the calculation of incidence rate ratios (IRR) associated with time trends. OD incidence peaked in 2000 and then declined markedly by 2003 [year 2000–2003 IRR = 0.65, 95% confidence interval (CI) (0.54, 0.78)]. Over the 2000–2003 period, overall incidence of fatal OD declined by 34%. Over this period, the sharpest observed declines occurred among African-Americans [IRR = 0.64, 95% CI (0.51, 0.81)] and Hispanics/Latinos [IRR = 0.53, 95% CI (0.32, 0.88)]. The opiate-related fatality incidence also declined among non-Hispanic whites [IRR = 0.743, 95% CI (0.52, 1.06)]. Even at the end of the study period, illicit opiate-related OD accounted for 35% of all accidental deaths to Chicago adults aged 18–64, with 45% of OD deaths occurring among African-American men. In summary, illicit opiate OD in Chicago peaked in 2000 and markedly declined by 2003. Opiate OD continues to pose a major threat of mortality to Chicago adults.
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Notes
For estimation purposes an “injection drug user” is defined as anyone who has injected any illicit substance (e.g., heroin, cocaine, crystal methamphetamine) at least once in the past year.
“Opiate-related” means that the postmortem toxicology report indicated illicit opiate poisoning/intoxication as a primary cause of death.
For example, the coding of multiple drug combination does not reveal the specific drugs involved.
The Social Science Research Committee at the University of Chicago established “community areas” in the late 1920s. A CA consists of an aggregation of census tracts with a collectively shared history and sociocultural public sphere. CA boundaries have remained stable over the past 75 years to allow for cross-time comparisons. The United States Census Bureau has officially sanctioned these areas and organizes Chicago’s census data by tract and by CA.
Naloxone is the generic version of Narcan®.
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Scott is with the Department of Sociology, Egan Urban Center, DePaul University, Chicago, IL, USA; Thomas is with the Chicago Department of Public Health, Chicago, IL, USA; Pollack is with the School of Social Service Administration, University of Chicago, Chicago, IL, USA. Ray is with the Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, USA.
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Scott, G., Thomas, S.D., Pollack, H.A. et al. Observed Patterns of Illicit Opiate Overdose Deaths in Chicago, 1999–2003. J Urban Health 84, 292–306 (2007). https://doi.org/10.1007/s11524-007-9157-7
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DOI: https://doi.org/10.1007/s11524-007-9157-7