In a recent study, researchers estimate that more than 275,000 people—or 4.6% of people over the age of 11 in Massachusetts- have opioid use disorder.
This figure is nearly four times higher than previous estimates based on national data.
The study is led by researchers at Boston Medical Center.
It involved an analysis of several linked public health data sets, allowing for a more accurate picture of the impact of opioids in the state.
The results show that better surveillance systems need to be deployed locally and nationally to make more accurate opioid use disorder prevalence data available to better address the epidemic.
Traditional methods to estimate prevalence only count those who have interacted with the health care system, which is included in both state and national records.
However, for those who don’t encounter the system and perhaps overdose, they would not be included in any estimates.
People with substance use disorders are less likely to seek medical care or be insured.
In addition, when people are asked about sensitive topics, like drug use, by their provider or in a health survey, they typically don’t self-report for many reasons, including stigma.
For this study, the researchers examined the Massachusetts Public Health Data Warehouse.
It is a novel database that links data from 16 state agencies and could support a comprehensive analysis of health care system utilization and fatal and non-fatal opioid overdoses rates.
Through a capture-recapture analysis, the researchers were able to identify those known to have an opioid use disorder based on their encounters with the health care system as well as estimate those who have the disorder but aren’t included in the data.
According to the team, in 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72% and 2.87%, respectively.
That increased to 3.87% in 2013, and even more, to 4.6% in 2015.
Surprisingly, those between the ages of 11 and 25 experienced the greatest increase in the prevalence of all age groups.
The number of “known” persons increased throughout the study period—from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015.
The data was also sorted by county, and counties with rural populations had some of the highest prevalence estimates, including:
Barnstable (5.03%); Berkshire (6.06%); Bristol (5.81%); Hampden (5.34%); and Worcester (4.38%).
For Suffolk County, which encompasses Boston, the prevalence in 2015 was 3.36%.
The researchers suggest that fentanyl is likely a cause in the surge of overdoses in Massachusetts.
And the increased prevalence of opioid use disorder is likely also contributing to the continuing increase in overdose deaths.
Given the clinical complexity of opioid use disorder, better surveillance can help increase the accuracy of diagnosing and treating the disease.
Unlike diseases such as HIV or hepatitis C virus, where a blood test can diagnose a patient, opioid use disorder is based on a clinical diagnosis.
The finding is published in the American Journal of Public Health.
Copyright © 2018 Knowridge Science Report. All rights reserved.
Source: American Journal of Public Health.
