opioid poisoning deaths among illinois women of ......data snapshot: opioid poisoning deaths among...

Data Snapshot: Opioid Poisoning Deaths among

Illinois Women of Reproductive Age

Illinois Department of Public Health

Office of Women’s Health and Family Services March 2019

Background

• Opioid poisonings (i.e., “overdoses”) are on the rise nationally and in Illinois

• Neonatal abstinence syndrome, a collection of withdrawal symptomsexperienced by infants exposed to opioids in utero, is also increasing

• Opioid use among a woman of reproductive age therefore carries doubleweight, as it impacts her own health, and also the health of her children andany future pregnancies

• This analysis examines trends and demographic patterns in opioid poisoningdeaths among:

– Illinois women of reproductive age (ages 15-44 years old)

– Illinois women with a pregnancy during the last year (pregnancy-associateddeaths)

2

Methods

• Data Source: Illinois death certificates

• Time Period: 2008 – 2017 (all years are “final” data)

• “Drug poisoning death” = underlying cause of death ICD-10 codes X40-X44, X60-X64, X85, or Y10-Y14

• Among drug poisoning deaths, opioid poisonings were identified by multiple-cause mortality codes:– T40.0 = opium– T40.1 = heroin– T40.2 = natural and semi-synthetic (“prescription”)– T40.3 = methadone– T40.4 = synthetic (including fentanyl)– T40.6 = other and unknown type

3

Methods

• Among all Illinois women of reproductive age:

Mortality Rate = # 𝒐𝒑𝒊𝒐𝒊𝒅 𝒑𝒐𝒊𝒔𝒐𝒏𝒊𝒏𝒈 𝒅𝒆𝒂𝒕𝒉𝒔

# 𝒘𝒐𝒎𝒆𝒏 𝒂𝒈𝒆𝒔 𝟏𝟓−𝟒𝟒 𝒊𝒏 𝒑𝒐𝒑𝒖𝒍𝒂𝒕𝒊𝒐𝒏∗ 𝟏𝟎𝟎, 𝟎𝟎𝟎

– Population estimates derived from U.S. Census Bureau intercensal estimates (2008-2009) and postcensal estimates (2010-2017)

• Among women with a pregnancy during the last year:

Pregnancy-Associated Mortality Ratio = # 𝒐𝒑𝒊𝒐𝒊𝒅 𝒑𝒐𝒊𝒔𝒐𝒏𝒊𝒏𝒈 𝒅𝒆𝒂𝒕𝒉𝒔

# 𝒍𝒊𝒗𝒆 𝒃𝒊𝒓𝒕𝒉𝒔∗ 𝟏𝟎𝟎, 𝟎𝟎𝟎

– Live birth counts derived from Illinois birth certificates

4

DEATHS TO WOMEN OF REPRODUCTIVE AGE(WOMEN AGES 15-44)

5

Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA)

• The rate of opioid-related poisoning deaths for WRA tripled from 2008 to 2017

• 347 WRA died from opioid poisoning during 2017

• Nearly 2,000 total WRA have died from opioid poisoning since 2008

6 Data Source: Illinois death certificates, 2008-2017

4.6 4.85.6 5.7

6.4 6.47.9

8.9

11.1

13.7

0

4

8

12

16

2007 2009 2011 2013 2015 2017

Rat

e p

er

10

0,0

00

WR

A

Year

Types of Opioids Involved in Opioid-Related Poisoning Deaths among Illinois Women of Reproductive Age (WRA), 2017

• Heroin was involved in nearly half of opioid poisoning deaths among Illinois WRA in 2017

• Synthetic opioids (e.g., fentanyl) were involved in 55% of opioid poisoning deaths for WRA in 2017

7

Bars do not add up to 100% because more than one opioid may have been listed on the death certificate

Data Source: Illinois death certificates, 2017

48.7%

25.6%

7.5%

54.8%

5.5%

0%

20%

40%

60%

80%

100%

% o

f O

pio

id P

ois

on

ing

De

ath

s

Opioid Type

Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Opioid Type

• The rate of heroin-relateddeaths for WRA increased 11-fold in nine years

• The rate of synthetic-opioid-related deaths for WRA increased 9-fold in four years


0

2

4

6

8

2007 2009 2011 2013 2015 2017

Rat

e p

er

10

0,0

00

WR

A

Year

Heroin Prescription Methadone Synthetic

Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Race/Ethnicity

• The opioid poisoning death rate is highest among non-Hispanic White WRA

• But White, Black, and Hispanic WRA all have experienced increases in opioid-related deaths over the last decade


0

4

8

12

16

20

2007 2009 2011 2013 2015 2017

Rat

e p

er

10

0,0

00

WR

A

Year

White, Non-Hispanic Black, Non-Hispanic Hispanic

Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Age Group

• The rate of opioid-related deaths is highest among women 30 and older

• All groups have seen an increase in opioid-related deaths, but the relative increase was smallest among women ages 15-24


0

4

8

12

16

20

2007 2009 2011 2013 2015 2017

Rat

e p

er

10

0,0

00

WR

A

Year

15-24 25-29 30-34 35-39 40-44

Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age, By County of Residence

• The rate of opioid-related deaths is highest among WRA living in urban counties outside the Chicago area

• All areas have experienced an increase in opioid-related deaths for WRA over the last decade


0

4

8

12

16

20

24

2007 2009 2011 2013 2015 2017

Rat

e p

er

10

0,0

00

WR

A

Year

Cook County Collar Counties

Other Urban Counties Rural Counties

PREGNANCY-ASSOCIATED DEATHS(DEATHS WITHIN ONE YEAR OF PREGNANCY)

12

Average Annual Number of Pregnancy-Associated Deaths Due to Opioid Poisoning, Illinois Residents, 2009-2017

• The number of pregnant/ postpartum women dying from an opioid-related poisoning increased over time

• In 2017 alone, there were 18 pregnancy-associated deaths related to opioid poisoning


4 8 130

2

4

6

8

10

12

14

2009-2011 2012-2014 2015-2017

Ave

rage

An

nu

al #

of

De

ath

s

3-Year Period

Pregnancy-Associated Mortality Ratio for Opioid-Related Poisoning Deaths, Illinois Residents, 2008-2017

• Pregnancy-associated deaths related to opioid poisoning increased 10-fold over a 9-year period

• The pregnancy-associated mortality ratio related to opioid poisonings nearly doubled in just one year from 2016 to 2017


1.1

2.91.8

2.5

5.0

3.8

5.76.3

6.5

12.0

0

2

4

6

8

10

12

14

2007 2009 2011 2013 2015 2017

Rat

io p

er

10

0,0

00

live

bir

ths

Year

Proportion of Pregnancy-Associated Deaths that were due to Opioid Poisoning, Illinois Residents, 2008-2017

• Opioid-related poisonings have also become a leading cause of pregnancy-associated death

• In 2017, opioid poisoning was the most common causeof pregnancy-associated death

• In 2017, nearly 1 in 5 deaths of pregnant or postpartum women were due to opioid poisoning


2.5%

18.8%

0%

4%

8%

12%

16%

20%

2007 2009 2011 2013 2015 2017

% o

f P

reg-

Ass

oci

ate

d D

eat

hs

Year

Pregnancy-Associated Mortality Ratio for Opioid Poisoning Deaths, Illinois 2013-2017 combined

• Pregnancy-associated deaths caused by opioid poisonings were most common among white women, women with a high school education or less, and women residing in small/medium urban counties outside the Chicago area


6.8 9.92.3

4.81.7

7.9 6.5 6.4 14.5 3.0 3.5 7.2 12.8 6.80

4

8

12

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Race/Ethnicity Age Group Education County of Residence

For more information, contact:Amanda Bennett

[email protected]

This analysis was supported by the

Illinois Maternal and Child Health (Title V) Block Grant Program17

mailto:[email protected]

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