BACKGROUND: The United States is currently experiencing an epic epidemic of overdose deaths involving opioids. Studies have shown that a significant proportion of the overdose deaths are due to prescription drugs and opioid analgesics were estimated to be responsible for 75% of those deaths in 2010. Further, between the years 2000 and 2014 opioid related deaths have increased by 200%. Drug poisoning deaths just involving heroin have increased by 55% from the year 2000 to 2010. Thus, this is a growing public health problem. In this growing epidemic, the magnitude of the problem is particularly acute in some regions of the country than others. In particular, the Midwest region appears to be the epicenter of the epidemic. Between the years 2000 and 2013, the Midwest region saw an 11-fold increase in age-adjusted drug-poisoning deaths involving heroin. In recent years, drug-poisoning death rate involving heroin has increased from 7.9 per 100,000 in 2010 to 12.2 per 100,000 population in 2014. The heroin poisoning death rate in St. Louis County in 2014 was 3.6 times the national rate.
METHODS: We will use a standardized data collection form that will be provided to all first responders who administer naloxone. This will be distributed to first responders via an electronic web link that can be downloaded to mobile devices such as phones. Data of interest will include: age, gender, race, over dose location (apartment, street, school, restaurant, and outdoor public place), zip code of residence, zip code where the overdose was administered, whether EMS was called or not, outcome of the naloxone administration, type of overdose substance (prescription opioid, heroin, other), any side effects, naloxone administered before or not, past opioid overdose. Descriptive analysis will be conducted to determine the number of overdose reversals and logistic regression analysis will be used to determine risk factors for overdose. GIS mapping will be used to map hot spots in the county.
RESULTS: Since the program was launched in March 2016, the Saint Louis County Police have administered 46 doses of Naloxone that resulted in 36 reversals as of the end of October 2016. It is anticipated that this number will be significantly higher when data is collected from the entire county.
CONCLUSIONS: Data collected by first responders will enhance surveillance of the growing epidemic of opioids overdoses in Saint Louis County. It will also help determine risk factors and areas of high concern in the county.