Heroin-Related Overdoses and Deaths — Wisconsin, 2003–2012 - CANCELLED (June 16)

BACKGROUND:   In the United States during 2003–2012, heroin use increased >2-fold to ~669,000 persons; during 2011, ~258,000 heroin-related emergency department (ED) visits occurred. We examined Wisconsin data to characterize trends in heroin overdose and fatalities as a surrogate for heroin use to support intervention strategies.

METHODS:   A nonfatal case was defined as an ED visit or hospitalization with a principle diagnosis of heroin overdose; two statewide discharge databases included data for 2003–2012. A heroin-related fatality included drug overdose as the underlying cause and heroin poisoning as any contributing cause; death certificate data were available for 2003–2011. Rural areas were defined using the Rural-Urban Commuting Area Codes and accounted for 1.7 million (30%) of Wisconsin’s population (5.7 million). We computed annual age-adjusted rates; we used chi-square tests to assess demographic characteristics.

RESULTS:   During 2003–2012, a total of 1,429 ED patients were treated and released (patients’ median age: 25 years) (74% male) and 809 were hospitalized (patients’ median age: 28 years) (71% male) due to heroin overdose. Age-adjusted ED visit rates increased from 0.9/100,000 persons in 2003 to 7.2/100,000 in 2012; overdose hospitalizations increased during the same period (0.7/100,000 to 3.2/100,000). Non-Hispanic whites accounted for a higher proportion of hospitalizations during 2008–2012 (87%), compared with 2003–2007 (76%; P ≤0.01). Five hundred five heroin-related fatalities (patients’ median age: 33 years) (84% male) occurred during 2003–2011. Statewide, fatalities increased from 0.5/100,000 in 2003 to 2.4/100,000 in 2011; in rural areas, fatalities increased from 0 in 2003 to 22 in 2011.

CONCLUSIONS:   Since 2003, Wisconsin has had a substantial increase in heroin overdoses; strengthened prevention and treatment initiatives are needed throughout the state.