TY  - JOUR
PY  - 2023//
TI  - County-level variation in synthetic opioid and heroin overdose incidents in Pennsylvania during the COVID-19 pandemic
JO  - Applied geography
A1  - Holmes, Louisa M.
A1  - King, Brian H.
SP  - e102977
EP  - e102977
VL  - 155
IS  - 
N2  - OBJECTIVE  Evaluate differences in synthetic opioid overdose rates, including semi-synthetic heroin, by individual demographic (N = 14,665) and county-level (N = 67) characteristics in Pennsylvania between 2018 and 2020, and before and after the onset of the COVID-19 pandemic.     Method  We used the 2018-2021 Pennsylvania Opioid Overdose Information Network data, which include information on overdose incidents in Pennsylvania that require emergency response. We performed multilevel negative binomial regressions to measure individual and county-level differences in overdose rates, controlling for differences by year.     Results  At the state level, there were no significant changes in overdose incident rates by year, but 11 counties experienced significant rate increases 2018-19 to 2020-21. Black individuals demonstrated a nine times higher incident rate than White individuals. Additionally, people living in counties with higher educational attainment, higher poverty, and higher population density had lower overdose incident rates than their counterparts.     Conclusions  The synthetic opioid overdose rate has accelerated since the onset of the COVID-19 pandemic, but this trend varies across counties. Particular attention should be paid to the counties with significant increases since the onset of the COVID-19 pandemic in 2020, and more local and regional analyses are required to understand community needs in the face of the ongoing opioid epidemic.<p />  <p>Language: en</p>
LA  - en
SN  - 0143-6228
UR  - http://dx.doi.org/10.1016/j.apgeog.2023.102977
ID  - ref1
ER  -