Research Article

Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016

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Science  21 Sep 2018:
Vol. 361, Issue 6408, eaau1184
DOI: 10.1126/science.aau1184
  • Exponential growth in overdose deaths.

    The smooth overall U.S. overdose mortality curve (left panel) is a composite of multiple subepidemics, as revealed by changing patterns of overdose deaths by age distribution (middle panel; color indicates deaths per 100,000 persons), and by geography (right panel; color shows hotspots), for prescription opioids (upper) and heroin (lower). Subepidemic patterns for other drugs are shown in the full manuscript.

  • Fig. 1 Mortality rates from unintentional drug overdoses.

    (A and B) Mortality rates for (A) individual drugs and (B) all drugs. Detailed data for individual drugs are only available from 1999 to 2016, although additional data for all drugs are available since 1979 (this area is grayed out). The exponential equation and fit are shown for all drugs. (Synth Opioids OTM: synthetic opioids other than methadone. This category includes fentanyl and its analogs.)

  • Fig. 2 Heatmaps showing the subepidemics by demography and urbanicity.

    Total number of deaths in each category from 1999 through 2016 are shown in the upper left corner of each plot. The colors indicate age-adjusted mortality rates per 100,000 people. (Synth Opioids OTM: synthetic opioids other than methadone. This category includes fentanyl and its analogs.)

  • Fig. 3 Geospatial hotspot analysis by drug and period.

    The Gi* statistics are standardized using pooled statistics across all drugs and periods. The various shades of red and blue indicate pooled standard deviations above and below the pooled mean, respectively, as shown in the legend. The small black circles indicate major cities with populations greater than 300,000 people. None of the regions were less than 2 pooled standard deviations below the pooled average. (Synth Opioids OTM: synthetic opioids other than methadone. This category includes fentanyl and its analogs.)

Supplementary Materials

  • Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016

    Hawre Jalal, Jeanine M. Buchanich, Mark S. Roberts, Lauren C. Balmert, Kun Zhang, Donald S. Burke

    Materials/Methods, Supplementary Text, Tables, Figures, and/or References

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    • Materials and Methods 
    • Figs. S1 and S2
    • Table S1 
    • References 

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