BACKGROUND: Missouri remains the final state in the Union without a prescription drug monitoring program. Due to this and other factors, the state has seen markedly high rates of prescription drug abuse, leading to illicit drug abuse. In KCMO, the drug overdose death rate has been consistenstly higher than the national average, and the numbers keep climbing. Kansas City, along with other major cities in the state, is forging ahead to do what can be done with a regional approach. These approaches have never been taken before, so innovative methods are required to make this process successful. If we understand which populations of our city are most likely to suffer from this epidemic, then we can be more informed as we attempt to help those populations and target our efforts.
METHODS: We reviewed data from Kansas City Missouri Fire Department EMS patient records over a 34-month time period (2013-2015) and 2010-2014 data from the American Community Survey. We calculated incidence rates and patient demographic and temporal patterns of drug overdose. Logistic regression analysis was used to determine the significant factors associated with drug overdose among race, sex, and life expectancy area.
RESULTS: Of 236,069 EMS incidents during the study period, there were 2,552 patients with a recorded drug overdose in EMS data (1.1% of incidents). The overall incidence rate was 1.8 patients with a drug overdose per 1,000 persons per year. Findings indicated drug overdoses peaked in summer months (July and August). The incidence of drug overdose was highest among male patients, black patients, and those in the 25-54 year age group. Males were more likely to experience a drug overdose than females (adjusted odds ratio [AOR] 2.0; 1.8-2.2). Black patients were more likely to experience a drug overdose than white patients (AOR 1.2; 1.1-1.3). Patients who lived in the lowest life expectancy area were more likely to experience a drug overdose than those who lived in a moderate or high life expectancy area (AOR 1.4; 1.3-1.6).
CONCLUSIONS: From the total number of drug overdoses recorded in the EMS data, we know that this dataset does not provide a complete picture of all events throughout the city. However, this data is consistent with previous findings in other datasets. Additionally, this dataset uniquely captures those patients who do not end up in the hospital, and therefore, helps to provide a more complete picture of the epidemic.