Unintentional deaths from drug poisoning by urbanization of area—New Mexico, 1994-2003

Morbidity and Mortality Weekly Report, Sept 9, 2005 by N. Shah, M.G. Landen

TABLE 1. Number * and percentage of deaths from unintentional drug
poisoning, by urbanization of area and selected characteristics--New
Mexico, 1994-2003

                                        Metropolitan
                                       area ([dagger])

Characteristic                          No.      (%)

Sex
  Female                                 331    (23.4)
  Male                                 1,081    (76.6)
Race/Ethnicity
  White, non-Hispanic                    602    (42.6)
  Hispanic (of any race)                 728    (51.6)
  All others                              82     (5.8)
Years of death
  1994-1995                              178    (12.6)
  1996-1997                              209    (14.8)
  1998-1999                              328    (23.2)
  2000-2001                              318    (22.5)
  2002-2003                              379    (26.8)
Type of drug that caused
poisoning death ([section])
  Any illicit drug                     1,018    (72.1)
  Any prescription drug                  525    (37.2)
  Specific illicit drugs
    Heroin                               743    (52.6)
    Cocaine                              549    (38.9)
    Methamphetamine                       57     (4.0)
  Specific prescription drugs
    Methadone                            184    (13.0)
    Other opioid painkiller **           277    (19.6)
    Antidepressant **                    137     (9.7)
    Tranquilizer/Muscle relaxant **      180    (12.8)
    Other prescription drug **            26     (1.8)
  Over-the-counter drug **               113     (8.0)
  Alcohol and drug cointoxication        407    (28.8)

Total                                  1,410    (71.3)

                                        Micropolitan
                                       area ([dagger])

Characteristic                          No.     (%)

Sex
  Female                                116    (23.2)
  Male                                  384    (76.8)
Race/Ethnicity
  White, non-Hispanic                   167    (33.4)
  Hispanic (of any race)                311    (62.2)
  All others                             22     (4.4)
Years of death
  1994-1995                              68    (13.6)
  1996-1997                              78    (15.6)
  1998-1999                             101    (20.2)
  2000-2001                              96    (19.2)
  2002-2003                             157    (31.4)
Type of drug that caused
poisoning death ([section])
  Any illicit drug                      356    (71.2)
  Any prescription drug                 201    (40.2)
  Specific illicit drugs
    Heroin                              244    (48.8)
    Cocaine                             192    (38.4)
    Methamphetamine                      34     (6.8)
  Specific prescription drugs
    Methadone                            49     (9.8)
    Other opioid painkiller **          114    (22.8)
    Antidepressant **                    51    (10.2)
    Tranquilizer/Muscle relaxant **      75    (15.0)
    Other prescription drug **            8     (1.6)
  Over-the-counter drug **               39     (7.8)
  Alcohol and drug cointoxication       194    (38.8)

Total                                   500    (25.3)

                                             Nonstatistical
                                             area ([dagger])

Characteristic                         No.     (%)

Sex
  Female                                17    (25.0)
  Male                                  51    (75.0)
Race/Ethnicity
  White, non-Hispanic                   31    (45.6)
  Hispanic (of any race)                36    (52.9)
  All others                             1     (1.5)
Years of death
  1994-1995                              9    (13.2)
  1996-1997                             13    (19.1)
  1998-1999                              7    (10.3)
  2000-2001                             15    (22.1)
  2002-2003                             24    (35.3)
Type of drug that caused
poisoning death ([section])
  Any illicit drug                      39    (57.4)
  Any prescription drug                 34    (50.0) ([paragraph])
  Specific illicit drugs
    Heroin                              24    (35.3) ([paragraph])
    Cocaine                             21    (30.9)
    Methamphetamine                      4     (5.9) ([paragraph])
  Specific prescription drugs
    Methadone                            7    (10.3)
    Other opioid painkiller **          26    (38.2) ([paragraph])
    Antidepressant **                    7    (10.3)
    Tranquilizer/Muscle relaxant **      9    (13.2)
    Other prescription drug **           1     (1.5)
  Over-the-counter drug **               3     (4.4)
  Alcohol and drug cointoxication       25    (36.8) ([paragraph])

Total                                   68     (3.4)

* N = 1,978; excludes four decedents with missing residence data.

([dagger]) Metropolitan areas have at least one urban area with
[greater than or equal to] 50,000 population. Micropolitan areas have
at least one urban area with 10,000-49,999 population. All other areas
are nonstatistical areas.

([section]) Types of drugs that caused poisoning deaths are not
mutually exclusive. More than one type of drug might have caused
death; the sum of the drug types exceeds the total number of deaths.

([paragraph]) p<0.05.

** Opioid painkillers other than methadone were morphine, codeine,
oxycodone, hydrocodone, meperidine, propoxyphene, hydromorphone,
fentanyl, pentazocine, and tramadol. Antidepressants were
amitriptyline, bupropion, citalopram, desipramine, doxepin,
venlafaxine, imipramine, fluoxetine, paroxetine, trazodone, sertraline,
amoxapine, and fluvoxamine. Tranquilizers/muscle relaxants were
clonazepam, diazepam, chlordiazepoxide, lorazepam, temazepam,
alprazolam, zolpidem, meprobamate, lithium, carisoprodol,
cyclobenzoprine, and chloral hydrate. Other prescription drugs were
anti-arrythmics, anticonvulsants, COX-2 inhibitors, and atypical
antipsychotics. Over-the-counter drugs included acetaminophen,
salicylate, ibuprofen, diphenhydramine, doxylamine, and
ephedrine/pseudoephedrine.

TABLE 2. Number and rate * of deaths from unintentional drug
poisoning, by urbanization of area and drug type--New Mexico,
1994-2003

                                                          Rate
                                       Total
                                                      Metropolitan
Type of drug ([dagger])             No.     Rate    area ([section])

Any illicit drug                   1,415     8.1           9.0
Any prescription drug                762     4.4           4.7
Specific illicit drugs
  Heroin                           1,013     5.8           6.6
  Cocaine                            763     4.4           4.8
  Methamphetamine                     95     0.6           0.5
Specific prescription drugs
  Methadone                          240     1.4           1.6
  Other opioid painkiller
    ([paragraph])                    418     2.4           2.5
  Antidepressant ([paragraph])       196     1.1           1.2
  Tranquilizer/Muscle relaxant
    ([paragraph])                    265     1.5           1.6
Over-the-counter drug
  ([paragrapgh])                     155     0.9           1.0
Alcohol and drug
  cointoxication                     627     3.6           3.6

Total                              1,982    11.4          12.6

                                         Rate                Rate

                                     Micropolitan       Nonstatistical
Type of drug ([dagger])            area ([section])    area ([section])

Any illicit drug                         6.8                 4.4
Any prescription drug                    3.8                 3.6
Specific illicit drugs
  Heroin                                 4.7                 2.6
  Cocaine                                3.7                 2.4
  Methamphetamine                        0.6                 0.5
Specific prescription drugs
  Methadone                              0.9                 0.7
  Other opioid painkiller
    ([paragraph])                        2.2                 2.8
  Antidepressant ([paragraph])           1.0                 0.8
  Tranquilizer/Muscle relaxant
    ([paragraph])                        1.4                 1.0
Over-the-counter drug
  ([paragrapgh])                         0.7                 --
Alcohol and drug
  cointoxication                         3.7                 2.7

Total                                    9.5                 7.4

* Per 100,000 population, age-adjusted to the 2000 U.S. standard
population.

([dagger]) Types of drugs that caused poisoning deaths are not mutually
exclusive. More than one type of drug might have caused death; the sum
of the drug types exceeds the total number of deaths.

([section]) Metropolitan areas have at least one urban area with
[greater than or equal to] 50,000 population. Micropolitan areas
have at least one urban area with 10,000-49,999 population. All other
areas are nonstatistical areas.

([paragraph]) Opioid painkillers other than methadone were morphine,
codeine, oxycodone, hydrocodone, meperidine, propoxyphene,
hydromorphone, fentanyl, pentazocine, and tramadol. Antidepressants
were amitriptyline, bupropion, citalopram, desipramine, doxepin,
venlafaxine, imipramine, fluoxetine, paroxetine, trazodone,
sertraline, amoxapine, and fluvoxamine. Tranquilizers/muscle
relaxants were clonazepam, diazepam, chlordiazepoxide, lorazepam,
temazepam, alprazolam, zolpidem, meprobamate, lithium, carisoprodol,
cyclobenzoprine, and chloral hydrate. Over-the-counter drugs included
acetaminophen, salicylate, ibuprofen, diphenhydramine, doxylamine,
and ephedrine/pseudoephedrine.

** Fewer than four cases.

TABLE 3. Likelihood of selected types of drugs causing death from
unintentional poisoning, * by urbanization of area and drug type--New
Mexico, 1994-2003

                                Metro-             Micropolitan
                               politan           areas ([dagger])
                                areas
                              ([dagger])       AOR          (95% CI
Type of drug                  (referent)   ([section])   ([paragraph]))

Any illicit drug                 1.0          0.65        (0.45-0.93)
Any prescription drug            1.0          1.71        (1.23-2.38)
Specific illicit drugs
  Heroin                         1.0          0.83        (0.60-1.15)
  Cocaine                        1.0          0.75        (0.55-1.04)
  Methamphetamine                1.0          1.29        (0.62-2.68)
Specific prescription drugs
  Methadone                      1.0          1.51        (0.92-2.48)
  Other opioid pain-
    killer **                    1.0          1.21        (0.83-1.77)
  Antidepressant **              1.0          1.38        (0.82-2.31)
  Tranquilizer/Muscle
    relaxant **                  1.0          1.42        (0.93-2.17)
Alcohol and drug
  cointoxication                 1.0          1.68        (1.21-2.33)

                                Nonstatistical
                               areas ([dagger])

Type of drug                  AOR     (95% CI)

Any illicit drug              0.40   (0.21-0.76)
Any prescription drug         2.41   (1.32-4.40)
Specific illicit drugs
  Heroin                      0.55   (0.30-1.02)
  Cocaine                     0.58   (0.32-1.08)
  Methamphetamine             0.94   (0.27-3.28)
Specific prescription drugs
  Methadone                   2.12   (0.84-5.36)
  Other opioid pain-
    killer **                 2.23   (1.19-4.17)
  Antidepressant **           1.09   (0.41-2.88)
  Tranquilizer/Muscle
    relaxant **               1.26   (0.55-2.88)
Alcohol and drug
  cointoxication              1.58   (0.87-2.87)

* Multivariate logistic model adjusted for sex, race/ethnicity, age,
New Mexico geographic region, and year of death.

([dagger]) Metropolitan areas have at least one urban area with
[greater than or equal to] 50,000 population. Micropolitan areas
have at least one urban area with 10,000-49,999 population. All other
areas are nonstatistical areas.

([section]) Adjusted odds ratio.

([paragraph]) Confidence interval.

** Opioid painkillers other than methadone were morphine, codeine,
oxycodone, hydrocodone, meperidine, propoxyphene, hydromorphone,
fentanyl, pentazocine, and tramadol. Antidepressants were
amitriptyline, bupropion, citalopram, desipramine, doxepin,
venlafaxine, imipramine, fluoxetine, paroxetine, trazodone, sertraline,
amoxapine, and fluvoxamine. Tranquilizer/muscle relaxants were
clonazepam, diazepam, chlordiazepoxide, lorazepam, temazepam,
alprazolam, zolpidem, meprobamate, lithium, carisoprodol,
cyclobenzoprine, and chloral hydrate.