Table 1. Comparison of Characteristics of 93 Municipalities in Massachusetts in the First Quarter of 2013 and the Second Quarter of 2019a.
| Characteristic | First quarter of 2013b | Second quarter of 2019 | ||||
|---|---|---|---|---|---|---|
| Mean (SD) | P value | Mean (SD) | P value | |||
| Municipalities that eventually developed program (n = 58) | Municipalities that did not develop program (n = 35) | Municipalities that developed program (n = 58) | Municipalities that did not develop program (n = 35) | |||
| Quarterly opioid fatality rate, per 100 000 population | 4.6 (4.8) | 3.7 (3.4) | .36 | 7.4 (6.0) | 7.9 (5.0) | .70 |
| Quarterly opioid EMS response rate, per 100 000 populationc | 45.0 (34.8) | 56.5 (52.8) | .21 | 79.9 (59.6) | 109.7 (62.2) | .02 |
| Age, % | ||||||
| <25 y | 30.1 (4.2) | 30.7 (3.6) | .46 | 28.8 (4.2) | 29.2 (3.3) | .58 |
| 25-44 y | 26.1 (5.2) | 26.6 (3.0) | .58 | 25.2 (5.5) | 25.9 (3.2) | .48 |
| 45-54 y | 15.4 (2.4) | 15.7 (1.8) | .66 | 13.5 (2.2) | 13.7(1.5) | .60 |
| 55-64 y | 12.8 (2.2) | 12.7 (1.8) | .80 | 13.9 (2.3) | 13.8 (1.6) | .90 |
| ≥65 y | 15.6 (4.7) | 14.4 (2.3) | .14 | 18.7 (5.0) | 17.3 (2.5) | .14 |
| Sex, % | ||||||
| Female | 51.8 (1.5) | 51.3 (1.4) | .12 | 51.6 (1.5) | 51.3 (1.1) | .27 |
| Male | 48.2 (1.5) | 48.7 (1.4) | .12 | 48.4 (1.5) | 48.7 (1.1) | .27 |
| Race and ethnicity, % | ||||||
| African American/Black | 4.7 (6.7) | 5.4 (7.6) | .64 | 5.4 (6.9) | 5.9 (7.2) | .75 |
| American Indian/Alaska Native | 0.21 (0.3) | 0.21 (0.2) | .94 | 0.20 (0.5) | 0.19 (0.2) | .91 |
| Asian | 4.4 (4.9) | 4.2 (4.8) | .84 | 5.2 (5.4) | 4.8 (4.8) | .69 |
| Hispanic/Latinx | 7.8 (10.9) | 11.3 (14.6) | .19 | 9.2 (11.4) | 13.0 (15.1) | .17 |
| Pacific Islander | 0.02 (0.05) | 0.01 (0.04) | .50 | 0.04 (0.04) | 0.04 (0.04) | .73 |
| White | 84.8 (13.3) | 83.0 (14.1) | .54 | 82.5 (13.5) | 81.2 (13.0) | .66 |
| Otherd | 5.9 (6.8) | 7.2 (8.8) | .43 | 6.7 (6.9) | 7.9 (7.6) | .42 |
| Educational level, % | ||||||
| High school education or less | 38.5 (12.6) | 42.6 (8.7) | .10 | 35.6 (12.5) | 39.5 (8.7) | .12 |
| College or more | 61.5 (12.6) | 57.4 (8.7) | .10 | 64.4 (12.5) | 60.5 (8.7) | .12 |
| Vacancy units, per 1000 population | 53.8 (95.6) | 37.2 (30.5) | .32 | 52.5 (100) | 34.7 (30.2) | .31 |
| Naloxone kits distributed by OEND program, per 1000 population | 0.28 (0.21) | 0.28 (0.27) | .94 | 1.19 (1.18) | 1.62 (1.79) | .17 |
| Municipality programs, No. (%) | ||||||
| Public safety equipped with naloxone | 20 (34.5) | 11 (31.4) | .77 | 20 (34.5) | 11 (31.4) | .77 |
| Drug court or a jail diversion program | 29 (50.0) | 15 (42.9) | .51 | 29 (50.0) | 15 (42.9) | .51 |
| MOAPC program established | 0 | 0 | NA | 36 (62.1) | 23 (65.7) | .83 |
| Drug arrests, per 1000 population | 0.32 (0.30) | 0.41 (0.50) | .27 | 0.23 (0.34) | 0.25 (0.33) | .77 |
| Releases from incarceration, per 1000 population | 0.14 (0.12) | 0.13 (0.10) | .54 | 0.11 (0.10) | 0.11 (0.10) | .92 |
| BSAS methadone admissions, per 1000 population | 0.34 (0.27) | 0.51 (0.42) | .02 | 0.03 (0.05) | 0.11 (0.17) | <.001 |
| BSAS residential admissions, per 1000 population | 2.17 (1.17) | 2.09 (1.09) | .73 | 2.11 (1.37) | 2.40 (1.29) | .31 |
| Fentanyl-related deaths among opioid-related deaths, % | 6.0 (20.1) | 15.0 (33.3) | .11 | 78.6 (37.4) | 82.4 (35.7) | .63 |
| Buprenorphine prescription for OUD, per 1000 population | 7.8 (3.1) | 8.4 (4.3) | .45 | 11.1 (4.9) | 13.6 (6.9) | .04 |
| Cancer-related death rate, per 100 000 population | 47.1 (19.5) | 41.3 (15.6) | .14 | 40.4 (12.2) | 37.8 (12.3) | .33 |
| Municipal population, No. | ||||||
| Mean | 52 769 | 36 842 | .28 | 54 230 | 37 762 | .28 |
| Median | 30 510 | 32 352 | 31 278 | 33 854 | ||
Abbreviations: BSAS, Massachusetts Bureau of Substance Addiction Services; EMS, emergency medical service; MOAPC, Massachusetts Opioid Abuse Prevention Collaborative; NA, not applicable; OEND, opioid education and naloxone distribution; OUD, opioid use disorder.
Ninety-three municipalities were eligible based on a threshold of 30 overdose-related emergency encounters in 2015. The first quarter was from January to March 2013, and the second from April to June 2019.
Comparison was based on the municipal-level factors in the first quarter of 2013 and by whether the municipality eventually established a postoverdose outreach program during the study period. The cumulative number of towns with outreach programs was 1 by 2013, 7 by 2014, 19 by 2015, 33 by 2016, 42 by 2017, 54 by 2018, and 58 by June 2019.
Data were available from 2014 to 2019 from the Massachusetts Ambulance Trip Record Information System. Baseline comparison was based on data in the first quarter of 2014.
Included multiracial and other.