Association between altitude, prescription opioid misuse, and fatal overdoses
Objective: Prescription opioid misuse and fatal overdoses have increased significantly over the last two decades. Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. Therefo...
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doaj-50ed6298ed5e4a51857b80f1c6ff5c4d2020-11-24T21:29:04ZengElsevierAddictive Behaviors Reports2352-85322019-06-019Association between altitude, prescription opioid misuse, and fatal overdosesHendrik J. Ombach0Lindsay S. Scholl1Amanda V. Bakian2Kai T. Renshaw3Young-Hoon Sung4Perry F. Renshaw5Shami Kanekar6Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States; Corresponding author.Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United StatesDepartment of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United StatesDepartment of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United StatesDepartment of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United StatesDepartment of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States; Utah Science Technology and Research (USTAR) Initiative, Salt Lake City, UT, 84108, United States; Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United States; Salt Lake City Veterans Affairs Health Care System, 500 Foothill Drive, Salt Lake City, UT, 84148, United StatesDepartment of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States; Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United StatesObjective: Prescription opioid misuse and fatal overdoses have increased significantly over the last two decades. Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. Therefore, we examined the relationships between living at altitude, and prescription opioid misuse and fatal overdoses. Method: State-level past year rates of prescription opioid misuse were retrieved from the Substance Abuse and Mental Health Services Administration. County-level overdose data were extracted from the Centers for Disease Control and Prevention. Multiple linear regression models were fit to determine the relationship between average state elevation and state rates of opioid misuse. Logistic regression models were fit to determine the relationship between county elevation and county-level fatal opioid overdose prevalence. Results: After controlling for state opioid prescribing rates and other confounders, we identified a significant positive association between mean state altitude and state-level opioid misuse rates for women, but not men. We also found a significant positive association between county-level altitude and prevalence of fatal opioid overdose. Conclusions: Living at altitude is thus demographically associated with increasing rates of misuse of prescription opioids, as well as of cocaine and methamphetamine. Animal studies suggest that the hypobaric hypoxia exposure involved with living at altitude may disrupt brain neurochemistry, to increase reward benefits of drugs of abuse. This increased misuse of both stimulants and opioids may increase likelihood of overdose at altitude, with overdoses by opioid use also potentially facilitated by altitude-related hypoxia. Keywords: Prescription opioids, Drug misuse, Opioid overdose, Hypobaric hypoxia, Altitudehttp://www.sciencedirect.com/science/article/pii/S2352853218301548 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hendrik J. Ombach Lindsay S. Scholl Amanda V. Bakian Kai T. Renshaw Young-Hoon Sung Perry F. Renshaw Shami Kanekar |
spellingShingle |
Hendrik J. Ombach Lindsay S. Scholl Amanda V. Bakian Kai T. Renshaw Young-Hoon Sung Perry F. Renshaw Shami Kanekar Association between altitude, prescription opioid misuse, and fatal overdoses Addictive Behaviors Reports |
author_facet |
Hendrik J. Ombach Lindsay S. Scholl Amanda V. Bakian Kai T. Renshaw Young-Hoon Sung Perry F. Renshaw Shami Kanekar |
author_sort |
Hendrik J. Ombach |
title |
Association between altitude, prescription opioid misuse, and fatal overdoses |
title_short |
Association between altitude, prescription opioid misuse, and fatal overdoses |
title_full |
Association between altitude, prescription opioid misuse, and fatal overdoses |
title_fullStr |
Association between altitude, prescription opioid misuse, and fatal overdoses |
title_full_unstemmed |
Association between altitude, prescription opioid misuse, and fatal overdoses |
title_sort |
association between altitude, prescription opioid misuse, and fatal overdoses |
publisher |
Elsevier |
series |
Addictive Behaviors Reports |
issn |
2352-8532 |
publishDate |
2019-06-01 |
description |
Objective: Prescription opioid misuse and fatal overdoses have increased significantly over the last two decades. Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. Therefore, we examined the relationships between living at altitude, and prescription opioid misuse and fatal overdoses. Method: State-level past year rates of prescription opioid misuse were retrieved from the Substance Abuse and Mental Health Services Administration. County-level overdose data were extracted from the Centers for Disease Control and Prevention. Multiple linear regression models were fit to determine the relationship between average state elevation and state rates of opioid misuse. Logistic regression models were fit to determine the relationship between county elevation and county-level fatal opioid overdose prevalence. Results: After controlling for state opioid prescribing rates and other confounders, we identified a significant positive association between mean state altitude and state-level opioid misuse rates for women, but not men. We also found a significant positive association between county-level altitude and prevalence of fatal opioid overdose. Conclusions: Living at altitude is thus demographically associated with increasing rates of misuse of prescription opioids, as well as of cocaine and methamphetamine. Animal studies suggest that the hypobaric hypoxia exposure involved with living at altitude may disrupt brain neurochemistry, to increase reward benefits of drugs of abuse. This increased misuse of both stimulants and opioids may increase likelihood of overdose at altitude, with overdoses by opioid use also potentially facilitated by altitude-related hypoxia. Keywords: Prescription opioids, Drug misuse, Opioid overdose, Hypobaric hypoxia, Altitude |
url |
http://www.sciencedirect.com/science/article/pii/S2352853218301548 |
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