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Ohio, West Virginia, and the District of Columbia have the largest disparity between the number of opioid-related deaths and access to treatment providers for opioid disorder in the United States (USO). This result comes from a first study of this type carried out at the University of Texas Health Sciences Center in Houston (UTHealth) to investigate regional imbalances between the need for treatment by OUD and access to service providers nationwide. The study was recently published in the Journal of Addiction Medicine.
From 2001 to 2016, the number of opioid deaths increased by 345% and in 2017 the opioid crisis was officially declared a public health emergency. According to estimates, there were nearly 50,000 opioid-related deaths in 2017, up from 40,274 in 2016, according to a study published in JAMA.
"One of the biggest hurdles that providers and policymakers face when trying to tackle the opioid crisis in the country is the lack of reliable metrics for badessing country hot spots where resources are most needed, "said James Langabeer, PhD, MBA, professor at McGovern Medical School. and the UTHealth Biomedical School, and the founder of a unique opioid intervention program called HEROES. "Previous studies and most of the referral notes have separately badyzed overdose deaths or treatment capacity, which, although useful, does not accurately describe the magnitude of the crisis. opioids. "
The Langabeer Research Center superimposed data on overdose mortality and treatment capacity to create a new measure in over 700 countries with the highest number of opioid-related deaths reported. The goal is to create a more accurate picture of the most problematic areas.
"With regard to the opioid epidemic, we tend to talk only about the number of deaths, but we hope that this study will help people understand that we also need to discuss simultaneously the number of available to help prevent the addiction from becoming fatal, "said Langabeer.
The research team calculated a ratio between program capacity and mortality, called program-to-death ratio (PPD). For example, in the 48 neighboring states, the 40,274 deaths due to opioids in 2016 and the 12,572 treatment programs generate a ratio of one treatment program to 3.2 deaths. The most affected regions – Ohio, West Virginia and the District of Columbia – generate an average of 1 program for every 8.5 deaths.
In addition, research shows that 32% of all US counties have no treatment program and that more than 19% of all counties have a treatment PPD ratio of less than 1:10.
"By and large, one-third of the country does not have access to any treatment program, and about a fifth has a few but not enough to meet the needs." Targeted policies and resource investments should focus on Harm reduction and capacity building in the affected areas, and we hope that this information will help local and federal authorities to put in place policies aimed at targeting the geographic areas most in need of badistance, "M said. Langabeer.
The southeastern region, from Texas to Florida, has relatively low mortality rates, but also the lowest rates of treatment programs in the country, while disproportionate rates are available in the north-central states and from the northwest.
"This trend observed in the Southeast States may stem from both a lack of treatment capacity and under-reporting of drug-related death causes on death certificates. actual rates of opioid-related deaths are actually higher than those reported, due to low rates of autopsies and medical toxicology reports.Clearer and more timely reports are needed in all regions to resolve this. problem comprehensively, "said Langabeer.
While the death toll in Texas is low, the Lone Star State also has the lowest number of treatment programs.
"Opioid abuse is a bit more recent in Texas than in other parts of the country." At the present time, we are seeing the most overdoses of any kind. amphetamines and cocaine, but this is changing rapidly to include opioids, largely because of the rise of fentanyl, "said Langabeer. I said. "This data gives us the opportunity to prepare ourselves with more treatment programs like HEROES to help meet the needs." HEROES is a proactive opioid intervention program created by Langabeer to provide comprehensive treatment for opioid addicts and better understand the Houston epidemic.
Langabeer and his team are currently conducting another study of the most statistically significant determinants behind their geospatial badysis.
"Now that we know where the biggest problems lie, we can dig deeper to see if there are economic, social or health-related factors behind the trends," he said.
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The team hopes to have the results of the second study by June.
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