Table 1.
Fatal opioid overdose standardized mortality ratios (SMR) and population attributable fractions (PAF) associated with exposure to opioid prescription and critical encounter touchpoints in past 12 months, Massachusetts, 2014.
| Touchpoint | Person years (%)a | Opioid deaths (%)a | Opioid death incidence rate per 100,000 person years |
SMR (95% CI)b | PAF (95% CI)b |
|---|---|---|---|---|---|
| All residentsc | 6,717,390 (100%) | 1315 (100%) | 19.6 | N/A | N/A |
| Any touchpoint | 183,089 (2.7%) | 681 (51.8%) | 372 | 35.2 (32.6, 37.9) | 0.50 (0.47, 0.53) |
| Any opioid prescription touchpointd | 148,535 (2.2%) | 269 (20.5%) | 181 | 12.6 (11.1, 14.1) | 0.19 (0.17, 0.21) |
| High dosage | 36,330 (0.5%) | 100 (7.6%) | 275 | 15.1 (12.1, 18.0) | 0.07 (0.06, 0.09) |
| Benzodiazepine co-prescribing | 50,130 (0.7%) | 132 (10.0%) | 263 | 18.0 (14.9, 21.1) | 0.09 (0.08, 0.11) |
| Multiple prescribers | 95,656 (1.4%) | 165 (12.5%) | 172 | 10.5 (8.9, 12.1) | 0.11 (0.10, 0.13) |
| Multiple pharmacies | 39,890 (0.6%) | 114 (8.7%) | 286 | 14.4 (11.8, 17.1) | 0.08 (0.07, 0.10) |
| Any critical encounter touchpoint | 38,948 (0.6%) | 491 (37.3%) | 1261 | 68.4 (62.4, 74.5) | 0.37 (0.34, 0.39) |
| Opioid detoxification | 16,541 (0.2%) | 259 (19.7%) | 1,844 | 66.1 (58.0, 74.1) | 0.19 (0.17, 0.22) |
| Nonfatal opioid overdosee | 9,208 (0.1%) | 223 (17.0%) | 2,422 | 111 (96.7, 126) | 0.17 (0.15, 0.19) |
| Injection-related infectionf | 5,752 (0.1%) | 81 (6.4%) | 1,408 | 54.1 (42.43 65.8) | 0.06 (0.05, 0.07) |
| Release from incarceration | 14,686 (0.2%) | 126 (9.6%) | 858 | 30.0 (24.8, 35.3) | 0.09 (0.08, 0.11) |
Percentages are relative to all residents; the categories identified are not mutually exclusive and column percentages do not add to 100%.
Standardized for age group and sex.
Data for Massachusetts residents ages 11 years or older in 2014.
Opioid prescription touchpoints identified as: three or more months in past year with more than 100 mg average daily morphine equivalents or opioid and benzodiazepine co-prescribing, or one or more quarters in past year with three or more different opioid prescribers or pharmacies dispensing opioids.
Nonfatal opioid overdose identified from ambulance, emergency department, outpatient observation, or inpatient discharge for opioid overdose without death in subsequent 7 days.
Emergency department, outpatient observation, or inpatient discharge for cellulitis, abscess, osteomyelitis, or endocarditis likely due to injection based on past 12-month history of diagnosis of opioid use disorder or hepatitis C virus.