Table 3.
Characteristics and comparisons of opioid overdose deaths in San Francisco County 2006–2012 by classification as “expanded” heroin death or injection-related (n=816)
| “Expanded” Heroin OR Injection-Related Opioid Overdose Death† | Other Opioid Deaths | p-value | |
|---|---|---|---|
|
|
|
||
| N (%) | N (%) | ||
| n✜ | 254 (31.1) | 562 (68.9) | |
|
| |||
| DECEDENT DEMOGRAPHICS | |||
| Age (mean, SD) | 45.2 (11.9) | 48.6 (11.7) | p<0.001 |
| Race | |||
| White | 162 (63.8) | 363 (64.6) | 0.933 |
| Black/African American | 56 (22.0) | 114 (20.3) | |
| Hispanic/Latino | 22 (8.7) | 54 (9.6) | |
| Other/Mixed | 14 (5.5) | 31 (5.5) | |
| Gender | |||
| Cis-Female | 56 (22.0) | 183 (32.6) | 0.004 |
| Cis-Male | 195 (76.8) | 376 (66.9) | |
| Transfemale | 3 (1.2) | 3 (0.5) | |
| DECEDENT HISTORY | |||
| History of Heroin Use* | 112 (44.1) | 60 (10.7) | p<0.001 |
| History of Injection Drug Use | 127 (50.0) | 59 (10.5) | p<0.001 |
| DEATH SCENE DETAILS | |||
| Location Found | |||
| Private Residence | 102 (40.2) | 317 (56.4) | p<0.001 |
| SRO | 97 (38.2) | 142 (25.3) | |
| Public Space | 37 (14.6) | 46 (8.2) | |
| Other | 18 (7.1) | 57 (10.1) | |
| Who Found Victim | |||
| Cohabitant | 90 (35.4) | 245 (43.6) | 0.015 |
| Non-cohabitant layperson | 30 (11.8) | 87 (15.5) | |
| Paramedic or Police Officer | 14 (5.5) | 33 (5.9) | |
| Passerby | 22 (8.7) | 25 (4.4) | |
| Residence Staff/Social Worker | 94 (37.0) | 169 (30.1) | |
| Prescription Opioids Found At Scene | 61 (24.0) | 263 (46.8) | p<0.001 |
| Dead on the Scene | 187 (73.6) | 429 (76.3) | 0.526 |
| OTHER CAUSAL SUBSTANCES | |||
| Benzodiazepines Involved | 21 (8.3) | 135 (24.0) | p<0.001 |
| Cocaine Involved | 162 (63.8) | 193 (34.3) | p<0.001 |
| Methamphetamine Involved | 44 (17.3) | 49 (8.7) | 0.001 |
| Methadone Involved** | 84 (33.1) | 250 (44.5) | 0.002 |
Percentages for n are calculate out of 816, the total number of opioid overdose deaths in San Francisco County 2006–2012
”Expanded” heroin deaths include all “standard” heroin cases as well as those in which the toxicology report demonstrated a presence and suggestive ratio of morphine to codeine that has been shown to correlate with heroin metabolism, or in which the toxicology report demonstrated a presence of morphine and either 1) the death scene had characteristics suggestive of heroin (e.g. heroin found on the scene, witness reports of heroin use prior to death); 2) the death scene had evidence of injection drug use; or 3) the decedent had a noted history of heroin use.
As described in the text, these characteristics were included in our definition of “expanded” heroin deaths; associated percentages and p-values should be interpreted accordingly.
We cannot distinguish methadone prescribed for pain from methadone opioid replacement therapy.