Epi Data Brief. New York City Department of Health and Mental Hygiene December 2015, No. 66

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Ernest Reed
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1 Epi Data Brief Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New York City, In 2014, there were 797 overdose deaths in New York City (NYC) (11.7 per 100,000 residents), compared with 788 overdose deaths in 2013 (11.6 per 100,000 residents). Rates of unintentional drug overdose deaths increased by 42% for the period 2010 to 2014, from 8.2 per 100,000 residents in 2010 to 11.7 per 100,000 residents in Number of deaths Age-adjusted rate per 100,000 *Data for 2014 are preliminary and subject to change Source: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics In 2014, nearly all (97%) overdose deaths involved more than one substance. Approximately eight in ten (79%) overdose deaths involved an opioid. Benzodiazepines were found in 54% of overdose deaths involving opioid analgesics, 41% of deaths involving heroin, and 55% of deaths involving methadone in Age-adjusted rate per 100, December 2015, No. 66 Unintentional overdose deaths, New York City, * Number of deaths All Opioids Heroin Methadone Opioid Analgesics Opioid analgesic-involved overdose death rates in NYC did not change in 2014 compared with 2013 (3.2 per 100,000 residents in both 2013 and 2014). The rate of heroin-involved overdose deaths increased each year for a cumulative 88% increase. The rate more than doubled from 3.1 per 100,000 residents in 2010 to 6.7 per 100,000 residents in Unintentional overdose deaths by opioid type involved (not mutually exclusive), New York City, * * Data for 2014 are preliminary and subject to change Source: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics Age-adjusted Rate per 100,000 Data Source: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics: Mortality data were collected through an in-depth review of data and charts from the Health Department s Bureau of Vital Statistics and the Office of the Chief Medical Examiner for Methadone is reported separately and not included in opioid analgesic analyses. Data for 2014 are preliminary and subject to change. Definitions: Rate Calculation: DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated October 8 th, Rates from 2014 use estimates from These rates will differ from previously reported rates based on Census counts or previous versions of population estimates. Rates are age-adjusted to Census 2000 US standard population, except those for specific age groups. Neighborhood poverty: Based on ZIP code and defined as percentage of residents with incomes below 100% of the federal poverty level, per American Community Survey , in four groups: low (<10%), medium (10 %-< 20%), high (20 %-< 30%), and very high (>=30%). Authored by: Denise Paone, Ellenie Tuazon, Michelle Nolan, Shivani Mantha

2 Epi Data Brief, No. 66 Page 2 Definitions: Opiates are sedative narcotics containing opium; most common opiates include, morphine, methadone,eine and heroin. Opioid analgesics: Commonly known as prescription pain relievers, such as oxycodone (Percocet ) and hydrocodone (Vicodin ). Methadone is a synthetic opioid used medically as an analgesic and to treat opioid dependence. Methadone is reported separately from opioid analgesics in New York City. We highlight opioid analgesics and heroin as they are involved in the majority of opioid-involved overdoses. Unintentional overdose deaths involving opioid analgesics, 2014 Opioid analgesics were involved in 27% of overdose deaths in NYC in In 2014, the rate of overdose deaths involving opioid analgesics was highest among Staten Island residents (7.8 per 100,000). In Queens, the rate decreased from 2.6 per 100,000 residents in 2013 to 2.4 per 100,000 residents in Unintentional overdose deaths involving heroin, 2014 In 2014, heroin was involved in 57% of all overdose deaths in NYC, making it the most common substance involved in overdose deaths. In 2014, heroin-involved overdose death rates increased in all boroughs except Queens. From 2000 to 2014, rates of heroin-involved overdose deaths were highest among Bronx residents in all years, except 2006, 2008, and In 2014, Staten Island residents had the highest rate (11.5 per 100,000, 42 deaths). More than half (55%) of heroin-involved overdose deaths among NYC residents were among residents of Brooklyn (29%, 116 deaths) and the Bronx (26%, 103 deaths) in From 2013 to 2014, rates of heroin-involved overdose deaths increased more than 50% in the neighborhoods of Bedford Stuyvesant, Coney Island, and Stapleton-St. George. Rates more than doubled in the Bensonhurst- Bay Ridge, Port Richmond, and East Harlem neighborhoods. From 2010 to 2014, New Yorkers aged 35 to 54 had the highest rate of overdose deaths involving heroin. Among New Yorkers aged 15 to 34, the rate of heroin-involved overdose deaths more than doubled from 2.1 per 100,000 in 2010 to 5.4 per 100,000 in 2014, a 157% increase. Unintentional overdose deaths involving heroin by race/ ethnicity, New York City, * Age-adjusted rate per 100, Age-adjusted rate per 100,000 White N.H. Hispanic Black N.H. * Data for 2014 are preliminary and subject to change; N.H.=non-Hispanic Source: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics Unintentional overdose deaths involving heroin by borough of residence, New York City, * Staten Island Manhattan Queens Bronx Brooklyn * Data for 2014 are preliminary and subject to change Source: NYC Office of the Chief Medical Examiner and NYC DOHMH Bureau of Vital Statistics In 2014, residents of the highest poverty neighborhoods had a higher rate of overdose deaths involving heroin (10.6 per 100,000) than neighborhoods with lower poverty. The rate of heroin-involved overdose deaths decreased among Hispanic New Yorkers, from 7.9 to 6.9 per 100,000 from 2013 to The rate of overdose deaths involving heroin remained highest among White New Yorkers (10.4 per 100,000). MORE New York City Health Data and Publications For complete tables of data prepared for this Brief, visit nyc.gov/html/doh/downloads/pdf/epi/datatable66.pdf Visit EpiQuery the Health Department s online, interactive health data system at nyc.gov/health/epiquery Data & Statistics at nyc.gov/health/data December 2015

3 Epi Data Tables December 2015, No. 66 Unintentional Drug Poisoning (Overdose) Deaths Involving Opioids in New York City, Data Tables Table 1. Number and rate of unintentional drug poisoning (overdose) deaths, New York City, Map 1 & 2. Table 2. Table 3. Map 3 & 4. Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) deaths by neighborhood of residence, and Number and rate of unintentional drug poisoning (overdose) deaths involving heroin, New York City, Number and rate of unintentional drug poisoning (overdose) deaths involving opioid analgesics, New York City, Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) deaths involving opioids and benzodiazepines by neighborhood of residence, and Data Sources Bureau of Vital Stastics/Office of the Chief Medical Examiner: Mortality data were collected through an in-depth review of data and charts from the Health Department s Bureau of Vital Statistics and the Office of the Chief Medical Examiner for Methadone is reported separately and not included in opioid analgesic analyses. Data for 2014 are preliminary and subject to change. Rate Calculation: NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. These rates will differ from previously reported rates based on Census counts or previous versions of population estimates. Rates are age-adjusted to Census 2000, except those for specific age groups. Neighborhood poverty is based on ZIP code and is defined as the percentage of residents with incomes below 100% of the Federal Poverty Level, per American Community Survey , in four groups: low (<10%), medium (10 %-< 20%), high (20 %-< 30%), and very high (>=30%). To access the related Epi Data Brief, go to

4 Page 2 Table 1. Number and rate of unintentional drug poisoning (overdose) deaths, New York City, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. Rates per 100,000 New Yorkers are age adjusted, except those for specific age groups Number Percent Rate Number Percent Rate Number Percent Rate Number Percent Rate Total Unintentional Drug Poisoning Deaths % % % % 11.7 Gender Male % % % % 18.3 Female % % % % 5.8 Race/Ethnicity Black (non-hispanic) % % % % 10.4 Hispanic % % % % 11.5 White (non-hispanic) % % % % 17.3 Age (years) % % % % % % % % % % % % % % % % % % % % % % % % 3.8 Borough of Residence Bronx % % % % 15.7 Brooklyn % % % % 9.7 Manhattan % % % % 10.4 Queens 97 17% % % % 6.8 Staten Island 69 12% % % % 20.6 Borough of Death Bronx % % % % 16.8 Brooklyn % % % % 10.9 Manhattan % % % % 13.4 Queens % % % % 7.3 Staten Island 77 12% % % % 20.1 Neighborhood Poverty * Low (wealthiest) % % % % 10.3 Medium % % % % 8.1 High % % % % 10.7 Very High % % % % 16.5 Drug Type** Alcohol % % % % 5.3 Benzodiazepines % % % % 4.4 Cocaine % % % % 4.8 Heroin % % % % 6.7 Methadone % % % % 1.9 Opioid Analgesics % % % % 3.2 Top 5 NYC Neighborhoods^ Rate Rate Willowbrook 23.6 Hunts Point-Mott Haven 28.3 Hunts Point-Mott Haven 23.6 South Beach-Tottenville 26.7 Stapleton-St George 21.3 East Harlem 24.7 South Beach-Tottenville 20.0 Crotona-Tremont 19.2 Highbridge-Morrisania 17.5 Highbridge-Morrisania Data for 2014 are preliminary and subject to change. Percentage of deaths within subgroup are calculated among categories presented. *Neighborhood poverty (based on ZIP code) was defined as percent of residents with incomes below 100% of the federal poverty level (Census 2000), separated into four groups: low (<10%), medium (10%-<20%), high (20%-<30%) and very high (>=30%). **Drug Type, not mutually exclusive.; percent will not equal 100%. ^Top five of 42 NYC Neighborhoods

5 Page 3 Map 1. Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) by neighborhood* of residence, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. *The United Hospital Fund (UHF) classifies New York City into 42 neighborhoods, comprised of contiguous ZIP codes.

6 Page 4 Map 2. Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) by neighborhood* of residence, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. *The United Hospital Fund (UHF) classifies New York City into 42 neighborhoods, comprised of contiguous ZIP codes. 1 Data for 2014 are preliminary and subject to change.

7 Page 5 Table 2. Number and rate of unintentional drug poisoning (overdose) deaths involving heroin, New York City, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. Rates per 100,000 New Yorkers are age adjusted, except those for specific age groups Total Unintentional Drug Poisoning Deaths Number Percent Rate Number Percent Rate Number Percent Rate Number Percent Rate % % % % 11.7 Total Unintentional Drug Poisoning Deaths % % % % 6.7 Involving Heroin Gender Male % % % % 10.8 Female 62 22% % % % 3.0 Race/Ethnicity Black (non-hispanic) 61 22% % % % 4.9 Hispanic 79 28% % % % 6.9 White (non-hispanic) % % % % 10.4 Age (years) % % % % % % % % % % % % % % % % % % % % % % % % 1.8 Age (years-collapsed) % % % % % % % % % % % % 5.1 Borough of Residence Bronx 75 30% % % % 9.6 Brooklyn 58 23% % % % 5.7 Manhattan 51 20% % % % 4.9 Queens 47 19% % % % 3.7 Staten Island 22 9% % % % 11.5 Borough of Death Bronx 80 28% % % % 10.5 Brooklyn 66 23% % % % 6.8 Manhattan 68 24% % % % 6.3 Queens 47 17% % % % 4.1 Staten Island 23 8% % % % 11.2 Neighborhood Poverty * Low (wealthiest) 46 18% % % % 4.9 Medium 73 29% % % % 4.7 High 52 21% % % % 5.7 Very High 82 32% % % % 10.6 Top 5 NYC Neighborhoods^ Rate Rate Hunts Point-Mott Haven Hunts Point-Mott Haven Union Square South Beach-Tottenville Highbridge-Morrisania Crotona-Tremont South Beach-Tottenville East Harlem Fordham-Bronx Park Fordham-Bronx Park 1 Data for 2014 are preliminary and subject to change. Percentage of deaths within subgroup are calculated among categories presented. *Neighborhood poverty (based on ZIP code) was defined as percent of residents with incomes below 100% of the federal poverty level per American Community Survey , separated into four groups: low (<10%), medium (10%-<20%), high (20%-<30%) and very high (>=30%). ^Top five of 42 NYC Neighborhoods

8 Page 6 Table 3. Number and rate of unintentional drug poisoning (overdose) deaths involving opioid analgesics, New York City, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. Rates per 100,000 New Yorkers are age adjusted, except those for specific age groups Total Unintentional Drug Poisoning Deaths Total Unintentional Drug Poisoning Deaths Involving Opioid Analgesics Gender Number Percent Rate Number Percent Rate Number Percent Rate Number Percent Rate % % % % % % % % 3.2 Male % % % % 4.6 Female 60 27% % % % 1.9 Race/Ethnicity Black (non-hispanic) 24 11% % % % 1.8 Hispanic 40 19% % % % 3.0 White (non-hispanic) % % % % 5.7 Age (years) % % % % % % % % % % % % % % % % % % % % % % % % 1.2 Age (years-collapsed) % % % % % % % % % % % % 2.6 Borough of Residence Bronx 40 20% % % % 3.5 Brooklyn 48 24% % % % 2.7 Manhattan 31 15% % % % 2.6 Queens 42 21% % % % 2.4 Staten Island 40 20% % % % 7.8 Neighborhood Poverty * Bronx 41 19% % % % 3.7 Brooklyn 52 24% % % % 2.8 Manhattan 38 17% % % % 3.0 Queens 45 20% % % % 2.6 Staten Island 44 20% % % % 7.9 Neighborhood Poverty* Low (wealthiest) 59 29% % % % 4.1 Medium 67 33% % % % 2.4 High 33 16% % % % 2.7 Very High 42 21% % % % 3.3 Top 5 NYC Neighborhoods^ Rate Rate Willowbrook 12.9 South Beach-Tottenville 10.6 South Beach-Tottenville 12.5 East Harlem 7.6 Stapleton-St George 10.0 Port Richmond 7.4 Rockaway 7.1 Hunts Point-Mott Haven 7.0 Crotona-Tremont 5.7 Ridgewood Data for 2014 are preliminary and subject to change. Percentage of deaths within subgroup are calculated among categories presented. *Neighborhood poverty (based on ZIP code) was defined as percent of residents with incomes below 100% of the federal poverty level (Census 2000), separated into four groups: low (<10%), medium (10%-<20%), high (20%-<30%) and very high (>=30%). ^Top five of 42 NYC Neighborhoods

9 Page 7 Map 3. Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) deaths involving opioids and benzodiazepines by neighborhood* of residence, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. *The United Hospital Fund (UHF) classifies New York City into 42 neighborhoods, comprised of contiguous ZIP codes.

10 Page 8 Map 4. Top five New York City neighborhoods: Rates of unintentional drug poisoning (overdose) deaths involving opioids and benzodiazepines by neighborhood* of residence, Source: Bureau of Vital Statistics/Office of the Chief Medical Examiner, New York City; Rates calculated using NYC DOHMH population estimates, modified from US Census Bureau intercensal population estimates , updated December Rates for 2014 use estimates from 2013, the most recent available year. Analysis by Health Department's Bureau of Alcohol and Drug Use Prevention, Care and Treatment. *The United Hospital Fund (UHF) classifies New York City into 42 neighborhoods, comprised of contiguous ZIP codes. 1 Data for 2014 are preliminary and subject to change.

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