Abstract

Background: Kentucky has one of the highest opioid overdose mortality rates in the United States. Accurate estimates of people with opioid use disorder (OUD) are critical to plan for the scope of interventions required to reduce overdose and opioid misuse. Commonly used household surveys are known to underestimate OUD at the state-level and do not provide county-level estimates.

Methods: We performed a multi-sample capture-recapture analysis to estimate OUD prevalence in Kentucky in 2018 and 2019. We utilized four statewide datasets that were linked at the individual level: 1) Registry of Vital Statistics, 2) Emergency Medical Services (EMS), 3) Kentucky’s Prescription Drug Monitoring Program (PDMP), and 4) Kentucky Medicaid. We included persons aged 18–64 years who resided in Kentucky between 2018 and 2019. We identified individuals with administrative data consistent with OUD in each of the datasets, including a fatal opioid-involved overdose (Vital Statistics), EMS runs for suspected opioid overdose, receipt of buprenorphine for OUD treatment (PDMP), or Medicaid claims for OUD. Observed and estimated counts of OUD cases and prevalence of OUD among the adult population in Kentucky.

Results: The estimated statewide OUD prevalence was 5.5 % and 5.9 % for 2018 and 2019, respectively, ranging from 1.3 % to 17.7 % across Kentucky counties. As expected, counties with the highest OUD rates were Appalachian counties (eastern area) of the state.

Conclusions: Our analysis reveals a substantially larger proportion of KY residents have OUD than previously estimated. Our approach offers a model for states needing county-level estimates of OUD.

Document Type

Article

Publication Date

2023

Notes/Citation Information

0376-8716/© 2022 Elsevier B.V. All rights reserved.

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.drugalcdep.2022.109710

Funding Information

This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL Initiative under award numbers UM1DA049406 and UM1DA049412 with additional support from the National Institute on Drug Abuse [DP2DA051864] to J.A.B. The funder played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; nor the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative. Drs. Chandler and Villani were substantially involved in UM1DA049406 and UM1DA049412, consistent with their role as Scientific Officers. They had no substantial involvement in the other cited grant. The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy or position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies.

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