ArticleThe International journal on drug policy2019
Opioid overdose deaths and potentially inappropriate opioid prescribing practices (PIP): A spatial epidemiological study.
Article in The International journal on drug policy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Advances in prescription drug monitoring program research: a literature synthesis (June 2018 to December 2019).Current opinion in psychiatry · 2020Pooled it
- Exploration of Factors Associated with Clinicians' Opioid Prescribing "Typologies" for Acute Pain.Journal of prevention (2022) · 2026Article
- Impact of the COVID-19 pandemic on opioid toxicity mortality rates in Nova Scotia: An interrupted time series analysis (2009-2023).Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Non-fatal Overdose and Associated Factors Among People Who Use Opioids: Findings From a Cross-sectional Study.Journal of community health · 2025Article
- Spatial analysis of county-level determinants of overdose mortality in the United States using spatial machine learning.BMC public health · 2025Article
- Identifying spatiotemporal patterns in opioid vulnerability: investigating the links between disability, prescription opioids and opioid-related mortality.BMC public health · 2025Article
- Predicting fatal opioid-involved overdoses: A social-ecological framework matched to a linked-data warehouse.The International journal on drug policy · 2025Article
- A place-based spatial analysis of racial inequities in overdose in St. Louis County Missouri, United States.The International journal on drug policy · 2024Article
- Risk factors for persistent fatal opioid-involved overdose clusters in Massachusetts 2011-2021: a spatial statistical analysis with socio-economic, accessibility, and prescription factors.BMC public health · 2024Article
- Applied risk mapping and spatial analysis of address-level decedent data to inform opioid overdose interventions: The Massachusetts HEALing Communities Study.Drug and alcohol dependence · 2023Article
- Use of Big Data and Ethical Issues for Populations With Substance Use Disorder.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Examining Increasing Racial Inequities in Opioid Overdose Deaths: a Spatiotemporal Analysis of Black and White Decedents in St. Louis, Missouri, 2011-2021.Journal of urban health : bulletin of the New York Academy of Medicine · 2023Article
- Opioid-related mortality: Dynamic temporal and spatial trends by drug type and demographic subpopulations, Massachusetts, 2005-2021.Drug and alcohol dependence · 2023Article
- Narrative minireview of the spatial epidemiology of substance use disorder in the United States: Who is at risk and where?World journal of clinical cases · 2023Review
- Fatal overdose: Predicting to prevent.The International journal on drug policy · 2022Article
- Examining the spatial risk environment tied to the opioid crisis through a unique public health, EMS, and academic research collaborative: Lowell, Massachusetts, 2008-2018.Preventive medicine reports · 2021Article
- A Novel Imputation Approach for Sharing Protected Public Health Data.American journal of public health · 2021Article
- Methodological approaches for the prediction of opioid use-related epidemics in the United States: a narrative review and cross-disciplinary call to action.Translational research : the journal of laboratory and clinical medicine · 2021Review
- Examining Opioid Overdose Deaths across Communities Defined by Racial Composition: a Multiscale Geographically Weighted Regression Approach.Journal of urban health : bulletin of the New York Academy of Medicine · 2021Article
- An epigenetic, transgenerational model of increased mental health disorders in children, adolescents and young adults.European journal of human genetics : EJHG · 2021Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
introductionOpioid overdose deaths quintupled in Massachusetts between 2000 and 2016. Potentially inappropriate opioid prescribing practices (PIP) are associated with increases in overdoses. The purpose of this study was to conduct spatial epidemiological analyses of novel comprehensively linked data to identify overdose and PIP hotspots.
methodsSixteen administrative datasets, including prescription monitoring, medical claims, vital statistics, and medical examiner data, covering >98% of Massachusetts residents between 2011-2015, were linked in 2017 to better investigate the opioid epidemic. PIP was defined by six measures: ≥100 morphine milligram equivalents (MMEs), co-prescription of benzodiazepines and opioids, cash purchases of opioid prescriptions, opioid prescriptions without a recorded pain diagnosis, and opioid prescriptions through multiple prescribers or pharmacies. Using spatial autocorrelation and cluster analyses, overdose and PIP hotspots were identified among 538 ZIP codes.
resultsMore than half of the adult population (n = 3,143,817, ages 18 and older) were prescribed opioids. Nearly all ZIP codes showed increasing rates of overdose over time. Overdose clusters were identified in Worcester, Northampton, Lee/Tyringham, Wareham/Bourne, Lynn, and Revere/Chelsea (Getis-Ord Gi*; p < 0.05). Large PIP clusters for ≥100 MMEs and prescription without pain diagnosis were identified in Western Massachusetts; and smaller clusters for multiple prescribers in Nantucket, Berkshire, and Hampden Counties (p < 0.05). Co-prescriptions and cash payment clusters were localized and nearly identical (p < 0.05). Overlap in PIP and overdose clusters was identified in Cape Cod and Berkshire County. However, we also found contradictory patterns in overdose and PIP hotspots.
conclusionsOverdose and PIP hotspots were identified, as well as regions where the two overlapped, and where they diverged. Results indicate that PIP clustering alone does not explain overdose clustering patterns. Our findings can inform public health policy decisions at the local level, which include a focus on PIP and misuse of heroin and fentanyl that aim to curb opioid overdoses.
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