JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
The Epidemiology of Fatal Accidental Overdoses in East Baton Rouge Parish from 2013-2016: A Four Year Study
Jacob Stover, Joseph Grace
Since 2013, drug overdoses have increased substantially in East Baton Rouge (EBR) Parish. While on the national scale the opioid epidemic has been given significant media attention, fatal accidental overdoses in EBR have not been thoroughly investigated to discern any endemic characteristics (for the purpose of this paper anytime“overdose”ismentioned it is a fatal, accidental overdose). This study sought to identify and tabulate several characteristics of fatal accidental overdoses inEBR from2013-2016, primarily focusing on the demographics of the decedents, the location of overdoses by ZIP code, and the drugs involved. The study found that opioids, including heroin, played a role in 81%of fatal overdoses in EBR from2013- 2016, and overdoses involving heroin increased by 51%between 2014 and 2015. Similar to what has been seen nationally, beginning in2016, fentanyl relateddeaths inEBR jumped tounprecedented levels, contributing to more deaths than all previous years combined. We found that benzodiazepines were exceedingly common, effectively just as prevalent as heroin, and that opioids were concurrently used in 92% of cases that involved benzodiazepines. Our study also showed that women near the average age of menopause made up over 60% of all female overdoses that did not involve heroin. Of the 47 ZIP codes in EBR, seven were responsible for 63%of the overdoses in the parish, and only one was significantly below themedian household income of Louisiana, the remainder were split between the average or significantly higher.
INTRODUCTION
East Baton Rouge Parish has been deeply impacted by the opioid and prescription drug abuse epidemic that has struck the U.S. Recently EBR has seen an increase in non-fatal overdoses, especially those involving heroin. Most alarmingly, since 2015, there has been a significant rise in fentanyl related deaths. This study was created to try and identify any trends in the overdoses experienced by the parish between 2013 and 2016. Variables such as age, gender, race, drugs involved, ZIP code where the overdose occurred, and month when the overdose occurred were tabulated and analyzed. The overdoses studied in this survey were put into one of two categories, those that involved heroin and those that did not, and then analyzed. It is the hope of the authors that any trends identified by this study can be used by healthcare, government, and law enforcement officials to develop and improve measures to address this problem.
each decedent for analysis. Toxicology samples were shipped to and analyzed by either AIT Laboratories or NMS Labs for the presence of drugs and their metabolites. Overdoses were divided into two categories: Those that involved heroin, as indicated through the presence of 6-Monoacetyl Morphine, and those that did not, from January 1, 2013- December 31, 2016. Decedent demographic information, the compounds that were present in their toxicology, the ZIP code where the overdose occurred, and the ZIP code of the decedent’s residence were recorded for each overdose case. The presence of the following classes of drugs were recorded in the spreadsheet for each individual case: opioids, benzodiazepines, cocaine, amphetamines and methamphetamines, anti-depressants, fentanyl (also included within the opioid results), and “other.” The “other” category was for compounds that did not show up on a regular basis across the study, including but not limited to: synthetic cannabinoids, cocaethylene, acetaminophen, and beta-blockers. If an individual was transported to a hospital after overdosing and later died as a result of the overdose, then the ZIP code of where the individual overdosed was entered for the location,
METHODS
For purposes of this experiment the only fatal overdoses which were tabulated were those determined to be accidental in nature by the EBR Coroner’s Office.
Samples of blood, urine, tissue, and/or vitreous were taken from
102 J La State Med Soc VOL 170 JULY/AUG 2018
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