What's in your neighbor's medicine cabinets may influence overdose risk in the community.
Drug overdoses are usually thought to afflict mainly the poor and troubled. But it looks like OxyContin and other opioid painkillers are changing the picture.
People in stable, middle-class neighborhoods are also dying from opioid overdoses, a study in New York City finds.
Opioids have become among the most popular drugs of abuse in the past decade, with deaths from overdoses of oxycodone, hydrocodone and codeine eclipsing those from heroin and cocaine combined.
Fatal overdoses from prescription painkillers more than tripled from 1991 to 2007, according to the Centers for Disease Control and Prevention.
To find out what was happening in New York City, researchers at Columbia University's Mailman School of Public Health mapped the 447 unintentional deaths from opioid painkiller overdoses in its five boroughs from 2000 to 2006. They then compared those deaths to heroin overdoses and accidental deaths from other causes, such as falls and drowning.
The heroin deaths were mostly in low-income neighborhoods where many people struggle with crime, fractured families and untreated mental health problems.
The prescription painkiller deaths were more common in areas where you don't see much heroin — solid working-class neighborhoods in Staten Island and parts of the Bronx.
"We were very surprised to see these very different patterns for heroin and analgesic," Magdalena Cerda, an Columbia epidemiologist and lead author of the study, tells Shots.
That may be because people in those neighborhoods are more likely to be prescribed painkillers, Cerda says. "There you see a higher percentage of policemen, firefighters, construction workers," she says. "They may have a higher percentage of back pain as a result of work-related injuries."
It's also easier to get an OxyContin prescription filled at pharmacies or physicians in middle-class neighborhoods, she adds. That's backed up by earlier studies that found that pharmacies in low-income, minority neighborhoods in the city don't have enough prescription painkillers to meet legitimate demand.
The findings were published in the American Journal of Public Health.
Cerda and her colleagues are trying to get funding to look more closely at Staten Island and figure out what's going on there. Are people first prescribed these drugs, and then start using them recreationally? Or do they become addicted while using them as prescribed? "Overdose fatalities are just the tip of the iceberg," she says.