Kentucky Overdose Impact Update, 2020Dana Quesinberry, JD, DrPH
Kentucky Injury Prevention Research Center
August 2020
Faculty Disclosure
I have no financial relationships to disclose.
Educational Need/Practice GapGap = Availability of timely, actionable data on drug overdose to inform harm reduction strategies
Need = Access to timely, actionable data on drug overdose
ObjectivesUpon completion of this educational activity, you will be able to:• Identify current drug overdose trends• Describe the burden of drug overdose by age and
geographic location• Distinguish between drug overdose myths and drug
overdose surveillance
Expected OutcomesAt the conclusion of the presentation, participants will be able to
1. Identify longitudinal trends in drug overdose mortality and morbidity
2. Identify changes to drug overdose trends during the COVID-19 pandemic
Drug Overdose SurveillanceTraditional Data Sources• Mortality – Death Certificates• Morbidity – Emergency Department and
Inpatient Hospitalization Discharge Data
New and More Timely Data Sources• Mortality – Drug Overdose Fatality Surveillance
System• Morbidity – Syndromic Surveillance and
Emergency Medical Services run data
Overdose Trends through 2019 - Mortality
Overdose Trends through 2019 - Morbidity
0
2000
4000
6000
8000
10000
12000
14000
16000
2016 2017 2018 2019
Overdose Emergency Department Encounters by Substance, 2016 to 2019
Any Drug Any Opioid Heroin Non Heroin Opioid Stimulant Cocaine Non Cocaine Stimulant
All Cause Mortality During COVID 19
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
1 year and under
2-4 years
5-9 years
10-14 years
15-19 years
20-24 years
25-34 years
35-44 years
45-54 years
55-64 years
65-74 years
75 years and older
All Ages
Proportion of Mortality by Cause during March-May 2020 (COVID-19 Pandemic Period)
Overdose Suicide Other Injury COVID Other illness/conditions
Number of Resident Drug Overdose DeathsKentucky, Jan 2017- July 2020
(Data as of July 24, 2020; Data for 2020 are provisional; Data for March - July, 2020 are incomplete)Deaths identified via ICD-10 coding and literal text scan classifier
144158
147 147
122107105
119
95102
122 125
105118
98
119
87
107 105
123
104105
10493
111105
127121
99 98107
8798
119120
144
119
140147
164
221
102
0
50
100
150
200
250
2017
/01
2017
/02
2017
/03
2017
/04
2017
/05
2017
/06
2017
/07
2017
/08
2017
/09
2017
/10
2017
/11
2017
/12
2018
/01
2018
/02
2018
/03
2018
/04
2018
/05
2018
/06
2018
/07
2018
/08
2018
/09
2018
/10
2018
/11
2018
/12
2019
/01
2019
/02
2019
/03
2019
/04
2019
/05
2019
/06
2019
/07
2019
/08
2019
/09
2019
/10
2019
/11
2019
/12
2020
/01
2020
/02
2020
/03
2020
/04
2020
/05
2020
/06
Num
ber
Source: KY Office of Vital Statistics. Data as of July 24th, 2020. Data are provisional and subject to change. Produced by the Kentucky Injury Prevention and Research Center, University of Kentucky.
Urban/Rural Impact of Drug Overdose Deaths
Counties with Highest April Overdose Mortality
CountsCounty Count
Jefferson 31Fayette 16Kenton 8Clark 6Madison 6Campbell 5
• Urban counties had higher counts
• A mixture of urban and rural counties (n=36) had higher counts of overdoses in April, but were suppressed
• Some rural counties had as many death in April as they have had annually in past years
Specific Drug/Drug Class Involvement in Drug Overdose Deaths
April 2020
Drug Class/Type Count
Opioid 106
Synthetic Opioid 87
Heroin 10
Cocaine 5
Psychostimulants with abuse potential
47
Benzodiazepines 34
• Overdose deaths included in the analysis are only those overdose deaths with ICD 10 codes (n=129)
• The drug type/class categories are not mutually exclusive. Decedents may have had one or more present
• For psychostimulants with abuse potential category, internal analyses with previous data have shown that ~90% of these cases are methamphetamine-related, but the category includes MDMA and prescription amphetamines
Timely Surveillance
Questions?
Dana QuesinberryAsst. Professor, Dept. Health Management and PolicyCollege of Public Health, University of KentuckyResearch Core DirectorKentucky Injury Prevention and Research Center, A bona fide agent of the Kentucky Department for Public [email protected]