Fentanyl related overdose in Indianapolis: Estimating trends using multilevel Bayesian models

Area of Science:

• Public Health
• Epidemiology
• Toxicology

Background:

• The opioid epidemic's trajectory is linked to evolving prescribing practices.
• Fentanyl is a primary driver of current overdose fatalities, yet heroin has dominated past assessments.
• Accurate tracking of fentanyl-related deaths is crucial for effective public health interventions.

Purpose of the Study:

• To analyze the temporal trends and demographic patterns of fentanyl-related overdose deaths in Marion County, Indiana.
• To provide a more precise assessment of fentanyl's role in overdose fatalities over time.
• To inform targeted public health strategies for mitigating fentanyl-induced mortality.

Main Methods:

• Utilized coroner data from Marion County, Indiana, encompassing 1583 overdose deaths from January 2010 to April 2017.
• Employed Bayesian multilevel models to predict the likelihood of lethal fentanyl-related overdose.
• Included victim demographics (age, race, sex) and geographic data (zip code) alongside the date of death in the analysis.

Main Results:

• Fentanyl was present in 23.8% of overdose deaths over the study period, with rates increasing exponentially from 2010-2017.
• Fentanyl overdose rates, initially lower among Black individuals, rose rapidly to surpass White individuals.
• Black females face a high risk of fentanyl overdose, contrasting with White females who have a low risk. Younger and middle-aged groups were most affected.

Conclusions:

• Fentanyl detection in fatal overdoses has significantly increased in Marion County.
• Public health policies and programs must prioritize education for populations at highest risk of fentanyl exposure and death.
• Interventions should be tailored to address the specific needs of high-risk demographic groups to reduce fentanyl-related mortality.