According to the American Statistical Association, drug overdose deaths are now the leading cause of injury and death in the United States. As of 2016, 2.1 million Americans have an opioid use disorder.

In the Public Health Data Challenge, we mapped out the crude rate of drug-related deaths for each state, and I chose to extend the project for this class to look at the state with the highest crude rate, but also the largest change over time.

As you can see, West Virginia has had both the largest change in crude death rate, but also the largest crude rate in 2016 compared to the other 49 states.

deathPercByStateData %>%
  ungroup() %>%
  filter(Year == 2006) %>%
  summarise(natAvg = mean(deathPerc)) %>%
  knitr::kable(caption = "National Average Death Percentage in 2006")

deathPercByStateData %>%
  ungroup() %>%
  filter(Year == 2006, State == "West Virginia") %>%
  summarise(WVAvg = mean(deathPerc)) %>%
  knitr::kable(caption = "West Virginia's Average Death Percentage in 2006")

WV's was nearly double the national average in 2006!

deathPercByStateData %>%
  ungroup() %>%
  filter(Year == 2016) %>%
  summarise(natAvg = mean(deathPerc)) %>%
  knitr::kable(caption = "National Average Death Percentage in 2016")

deathPercByStateData %>%
  ungroup() %>%
  filter(Year == 2016, State == "West Virginia") %>%
  summarise(WVAvg = mean(deathPerc)) %>%
  knitr::kable(caption = "West Virginia's Average Death Percentage in 2016")

Wow! West Virginia sees an increase from 2.172% in 2006 to 5.314% in 2016! That's more than double the national average in 2016, and almost 2.5X higher than their average in 2006.

Clearly, there is a huge problem going on. Maybe taking a look at the opioid prescription rates will help…

According to the National Institute of Drug Abuse (NIDA), in 2016, West Virginia had the highest rate of opioid-related overdose deaths in the United States―a rate of 43.4 deaths per 100,000―and up from a low 1.8 deaths per 100,000 in 1999.

In 2013, West Virginia providers wrote 110 opioid prescriptions per 100 persons (2.08 million prescriptions). In the same year, the average U.S. rate was 78 opioid prescriptions per 100 persons (NIDA). Clearly, doctors need to be doing more with prescribing less.

As you might expect, death rates are going up!

The original idea for a solution revolves around a current program that operates in Georgetown, KY–The Gathering Place Mission.

Perks of this program:

• rigorous drug testing
• drug education
• plan of action to become productive citizen (not on drugs)

Another option would be to create regulations for opioid prescriptions so that the sheer number of them would go down. The main issue that West Virginia faced was that doctors there were prescribing 40 more prescriptions per 100 persons than the national average, so there were larger numbers of opioids in the hands of addicts.