Senior Vice President, Chief Science Officer (Inflexxion, Inc.).
Geographic information systems and pharmacoepidemiology: using spatial cluster detection to monitor local patterns of prescription opioid abuse
Article first published online: 16 APR 2010
Copyright © 2010 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 19, Issue 6, pages 627–637, June 2010
How to Cite
Brownstein, J. S., Green, T. C., Cassidy, T. A. and Butler, S. F. (2010), Geographic information systems and pharmacoepidemiology: using spatial cluster detection to monitor local patterns of prescription opioid abuse. Pharmacoepidem. Drug Safe., 19: 627–637. doi: 10.1002/pds.1939
- Issue published online: 9 JUN 2010
- Article first published online: 16 APR 2010
- Manuscript Accepted: 31 JAN 2010
- Manuscript Revised: 25 JAN 2010
- Manuscript Received: 21 MAY 2009
- NIDA. Grant Number: DA024489
- Endo Pharmaceuticals and King Pharmaceuticals, Inc.
- cluster detection;
- opioid abuse;
- post-marketing surveillance
Understanding the spatial distribution of opioid abuse at the local level may facilitate public health interventions.
Using patient-level data from addiction treatment facilities in New Mexico from ASI-MV® Connect, we applied geographic information system (GIS) in combination with a spatial scan statistic to generate risk maps of prescription opioid abuse and identify clusters of product- and compound-specific abuse. Prescribed opioid volume data was used to determine whether identified clusters are beyond geographic differences in availability.
Data on 24 452 patients residing in New Mexico were collected. Among those patients, 1779 (7.3%) reported abusing any prescription opioid (past 30 days). According to opioid type, 979 patients (4.0%) reported abuse of any hydrocodone, 1007 (4.1%) for any oxycodone, 108 (0.4%) for morphine, 507 (2.1%) for Vicodin® or generic equivalent, 390 (1.6%) for OxyContin®, and 63 (0.2%) for MS Contin® or generic equivalent. Highest rates of abuse were found in the area surrounding Albuquerque with 8.6 patients indicating abuse per 100 interviewed patients. We found clustering of abuse around Albuquerque (P = 0.001; Relative Risk = 1.35, and a radius of 146 km). At the compound level, we found that drug availability was partly responsible for clustering of prescription opioid abuse. After accounting for drug availability, we identified a second foci of Vicodin® abuse in the southern rural portion of the state near Las Cruces, NM and El Paso, Texas and bordering Mexico (RR = 2.1; P = 0.001).
A better understanding of local risk distribution may have implications for response strategies to future introductions of prescription opioids. Copyright © 2010 John Wiley & Sons, Ltd.