Opioid Epidemic in Orange County
Joe Long, Data Analyst
December 2019
Opioid Epidemic in Orange County
Drug abuse and its related problems are among society’s most pervasive health and social concerns. Causes of drug-induced deaths include dependent and non-dependent use of drugs (both legal and illegal use) and also poisoning from medically prescribed drugs. Addicted persons frequently engage in self-destructive and criminal behavior, which can result in injury or death. In addition, recreational drug-use can lead to unintentional overdose and death.
## Objectives :
- Collecting data from various public sources for data relating to drug overdose issues in Orange County, in California, and in the nation, for trend analysis and for comparison
- Looking into supply side of opioid prescription in Orange county
Video Introduction
#Cautions: Two different coding classification systems were utilized:
Cause-of-death between 1999 to present were coded using the Tenth Revision of the International Classification of Diseases codes (ICD-10). Cause-of-death between 1989 and 1998 were coded using the Ninth Revision of the International Classification of Deseases Codes (ICD-9).
Dada Source : https://www.cdc.gov/drugoverdose/data/statedeaths.html
National Trends
Total number and rate of opioid prescriptions dispensed, United States, 2006–2017
| YEAR | Total |
|---|---|
| 2010 | 32729 |
| 2011 | 35498 |
| 2012 | 35788 |
| 2013 | 38080 |
| 2014 | 41382 |
| 2015 | 46512 |
| 2016 | 58022 |
| 2017 | 64437 |
## Warning: Ignoring unknown parameters: stat
Opioid Prescription, nationally by year.
| Year | Total.Number.of.Prescriptions | Prescribing.Rate.Per.100.Persons |
|---|---|---|
| 2006 | 215917663 | 72.4 |
| 2007 | 228543773 | 75.9 |
| 2008 | 237860213 | 78.2 |
| 2009 | 243738090 | 79.5 |
| 2010 | 251088904 | 81.2 |
| 2011 | 252167963 | 80.9 |
| 2012 | 255207954 | 81.3 |
| 2013 | 247090443 | 78.1 |
| 2014 | 240993021 | 75.6 |
| 2015 | 226819924 | 70.6 |
| 2016 | 214881622 | 66.5 |
| 2017 | 191218272 | 58.7 |
Key Highlights
After a steady increase in the overall national opioid prescribing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons.
The overall national opioid prescribing rate declined from 2012 to 2017, and in 2017, the prescribing rate had fallen to the lowest it had been in more than 10 years at 58.7 prescriptions per 100 persons (total of more than 191 million total opioid prescriptions).
However, in 2017, prescribing rates continue to remain very high in certain areas across the country. In 16% of U.S. counties, enough opioid prescriptions were dispensed for every person to have one. While the overall opioid prescribing rate in 2017 was 58.7 prescriptions per 100 people, some counties had rates that were seven times higher than that.
Raw data : Opioid Overdose Death count by state
Cost estimates by economic categories, 2015-2019
| Healthcare | Mortality | Criminal | Family_support | Education | Lost_Productivity | Total | |
|---|---|---|---|---|---|---|---|
| 2015 | 36.7 | 47.3 | 8.9 | 9.3 | 1.4 | 20.7 | 124.3 |
| 2016 | 51.7 | 62.2 | 9.2 | 8.5 | 1.3 | 23.5 | 156.4 |
| 2017 | 55.8 | 71.2 | 9.8 | 7.8 | 1.2 | 25.0 | 170.8 |
| 2018 | 60.4 | 72.6 | 10.9 | 7.8 | 1.2 | 26.5 | 179.4 |
| 2019 | 65.1 | 74.1 | 12.2 | 7.8 | 1.3 | 28.0 | 188.5 |
| Grand_total | 269.7 | 327.4 | 50.9 | 41.1 | 6.5 | 123.7 | 819.3 |
The economics of opioid epidemic
2010 Mapping _ Historial perspective
| STATE | Count |
|---|---|
| California | 4011 |
| Florida | 2978 |
| Texas | 2043 |
| Pennsylvania | 1801 |
| Ohio | 1576 |
| New York | 1388 |
| Michigan | 1192 |
| Illinois | 1135 |
| Arizona | 1073 |
| North Carolina | 863 |
2017 National trend
| STATE | Count |
|---|---|
| Pennsylvania | 5326 |
| Florida | 5002 |
| Ohio | 4984 |
| California | 4805 |
| New York | 3814 |
| New Jersey | 2685 |
| Texas | 2604 |
| Illinois | 2550 |
| Michigan | 2438 |
| Maryland | 2237 |
California state
| County | Rate per 100K |
|---|---|
| Trinity | 33.53 |
| Lake | 23.01 |
| Plumas | 18.11 |
| Calaveras | 17.41 |
| Amador | 15.69 |
| San Francisco | 14.96 |
| Mendocino | 14.64 |
| Lassen | 14.53 |
| Inyo | 14.45 |
| Ventura | 10.66 |
| Humboldt | 10.52 |
| Nevada | 10.50 |
| Kern | 10.32 |
| Imperial | 10.23 |
| Sutter | 10.05 |
| Sonoma | 8.72 |
| Santa Cruz | 8.22 |
| Merced | 7.76 |
| Orange | 7.37 |
| San Diego | 7.32 |
Opioid Emergency Department Visits 2018 California
| Rate | Count | |
|---|---|---|
| < 5 yr olds | 4.1 | 100 |
| 5 to 9 yr olds | 0.36 | 9 |
| 10 to 14 yr olds | 1.65 | 42 |
| 15 to 19 yr olds | 13.24 | 337 |
| 20 to 24 yr olds | 41.38 | 1122 |
| 25 to 29 yr olds | 53.11 | 1660 |
| 30 to 34 yr olds | 41.47 | 1210 |
| 35 to 39 yr olds | 31.51 | 868 |
| 40 to 44 yr olds | 24.43 | 611 |
| 45 to 49 yr olds | 20.41 | 524 |
| 50 to 54 yr olds | 20.33 | 509 |
| 55 to 59 yr olds | 22.07 | 556 |
| 60 to 64 yr olds | 21.39 | 484 |
| 65 to 69 yr olds | 18.46 | 342 |
| 70 to 74 yr olds | 12.98 | 186 |
| 75 to 79 yr olds | 12.9 | 126 |
| 80 to 84 yr olds | 10.55 | 70 |
| 85+ yr olds | 10.22 | 76 |
Orange County 2018
249 ( 7.4 /100k) Deaths Related to Any Opioid Overdose
799 ( 9.2 /100k) ED Visits Related to Any Opioid Overdose
275 ( 5.5 /100k) Hospitalizations Related to Any Opioid Overdose
1,399,866 ( 391.4 /1k) Prescriptions for Opioids
| YEAR | VALUE |
|---|---|
| 2010 | 313 |
| 2011 | 319 |
| 2012 | 320 |
| 2013 | 358 |
| 2014 | 372 |
| 2015 | 381 |
| 2016 | 415 |
| 2017 | 372 |
Opioid Emergency Department Visits 2018 Orange County _ BY Age Group
| Rate | Count | |
|---|---|---|
| < 5 yr olds | 2.13 | Less than six |
| 5 to 9 yr olds | 0.53 | Less than six |
| 10 to 14 yr olds | 1.5 | Less than six |
| 15 to 19 yr olds | 14.64 | 30 |
| 20 to 24 yr olds | 65.2 | 137 |
| 25 to 29 yr olds | 92.77 | 226 |
| 30 to 34 yr olds | 47.94 | 104 |
| 35 to 39 yr olds | 41.8 | 88 |
| 40 to 44 yr olds | 19.81 | 40 |
| 45 to 49 yr olds | 16.94 | 38 |
| 50 to 54 yr olds | 13.5 | 30 |
| 55 to 59 yr olds | 16.55 | 36 |
| 60 to 64 yr olds | 12.26 | 23 |
| 65 to 69 yr olds | 6.74 | 10 |
| 70 to 74 yr olds | 8.49 | 10 |
| 75 to 79 yr olds | 8.37 | 7 |
| 80 to 84 yr olds | 10.44 | 6 |
| 85+ yr olds | 9.49 | 6 |
Opioid Emergency Department Visits 2018 Orange County _ by race
| Race | Rate | |
|---|---|---|
| White | White | 46.40 |
| Black | Black | 8.09 |
| Latino | Latino | 14.70 |
| Native American | Native American | 11.38 |
| Asian | Asian | 2.43 |
Drug Suppies
For the first time, a database maintained by the Drug Enforcement Administration that tracks the path of every single pain pill sold in the United States — by manufacturers and distributors to pharmacies in every town and city — has been made public.
The Washington Post sifted through nearly 380 million transactions from 2006 through 2012 that are detailed in the DEA’s database and analyzed shipments of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies. The Post is making this data available at the county and state levels in order to help the public understand the impact of years of prescription pill shipments on their communities.
Top pharmacies from 2006 to 2012, in Orange County, California.
data source : https://www.washingtonpost.com/graphics/2019/investigations/dea-pain-pill-database/
| buyer_name | buyer_city | total_dosage_unit |
|---|---|---|
| MISSION COMMUNITY PHARMACY INC | FOUNTAIN VALLEY | 6938300 |
| KAISER FOUNDATION HOSPITALS | ANAHEIM | 6202360 |
| CKC INVESTMENT INC | FULLERTON | 3962640 |
| ASSURED PHARMACY | SANTA ANA | 3858930 |
| GARFIELD BEACH CVS, L.L.C. | ORANGE | 3744400 |
| WALGREEN CO. | HUNTINGTON BEACH | 3739980 |
| WALGREEN CO. | ANAHEIM | 3570160 |
| PHARMERICA | CYPRESS | 3511000 |
| WALGREEN CO. | HUNTINGTON BEACH | 3467410 |
| KAISER FOUNDATION HLTH PLN | HUNTINGTON BEACH | 3416400 |
| GARFIELD BEACH CVS, L.L.C. | SAN CLEMENTE | 3340200 |
| WALGREEN CO. | GARDEN GROVE | 3319500 |
| WALGREEN CO. | TUSTIN | 3309670 |
| KAISER FOUN HLTH PLAN INC | GARDEN GROVE | 3271020 |
| WALGREEN CO. | ANAHEIM | 3064700 |
| PHARMACY ADVANTAGE | LOS ALAMITOS | 3004200 |
| WALGREEN CO. | ANAHEIM | 2922900 |
| THRIFTY PAYLESS INC. | COSTA MESA | 2861470 |
| WHITE FRONT DRUG AND DISCOUNT | COSTA MESA | 2681960 |
| GARFIELD BEACH CVS, L.L.C. | HUNTINGTON BEACH | 2646500 |
Top drug distributors in Orange County
Data source : Washington Post.
a database maintained by the Drug Enforcement Administration that tracks the path of every single pain pill sold in the United States — by manufacturers and distributors to pharmacies in every town and city — has been made public.
The Washington Post sifted through nearly 380 million transactions from 2006 through 2012 that are detailed in the DEA’s database and analyzed shipments of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies. The Post is making this data available at the county and state levels in order to help the public understand the impact of years of prescription pill shipments on their communities.
##
## Attaching package: 'hpackedbubble'## The following object is masked from 'package:datasets':
##
## CO2City of Villa Park
With population of 6,000 people.
Top pharmacies from 2006 _ 2012
| Pharmacy | Count of Prescription |
|---|---|
| VILLA PARK PHARMACY | 761540 |
| EDWARDS, RUDOLPH H MD | 3900 |
| GOLDMAN, RICHARD LYLE MD INC | 800 |
| RYAN, JOHN J MD | 500 |
| GIBBS, KATHRYN A MD | 400 |
| LESTER, JOEL N MD | 100 |
| FONTANESI, ROBERT V DDS | 100 |
City of Los Alamitos
With population of 12,000 people.
Top pharmacies from 2006 _ 2012
| Pharmacy | Count of Prescription |
|---|---|
| PHARMACY ADVANTAGE | 3004200 |
| SO-LOW DRUGS | 1374400 |
| EVERGREEN PHARMACEUTICAL OF CALIFORNIA, INC. | 1291260 |
| LOS COYOTES PHARMACY | 1100030 |
| LOS ALAMITOS PHARMACY GROUP INC | 830600 |
| PHARMACY ADVANTAGE | 378500 |
| GARFIELD BEACH CVS, L.L.C. | 276600 |
| COMPOUND CENTRAL PHARMACY | 244360 |
| UNIPHARMA INC | 162120 |
| FEIWELL, LAWRENCE ALLEN MD | 83340 |
| AIELLO, WILLIAM P MD | 40500 |
| LEE, YOUNG H. | 36100 |
| TRIFF, EUGENE N DDS | 35400 |
| GLASSER, ANDREA M DVM | 14400 |
| HORVATH, CLAUDIA | 9500 |
| LOWE, FRANKLIN MD | 4250 |
| SHINDER, ARNOLD LOUIS DO | 3500 |
| CHOI, HICHANG J MD | 3220 |
| NAMBA, MICHAEL M DDS | 1950 |
| CHOU, STANLEY K MD | 1330 |
| COOPER, GREG WILLIAM DDS | 1000 |
| GREEN, FRANKLIN P DDS | 900 |
| STROHMYER, H.A.,DDS | 800 |
| STAPAKIS, ALISON | 540 |
| HAMER, EDGAR E. MD | 500 |
| PETERSON, CHRISTI | 400 |
| CARUANA, FRANK C DPM | 400 |
| ZAGNOEV, MICHAEL | 300 |
| YEE, SANDRA M DDS | 300 |
| COFFEE, BERNIE A DDS APC | 300 |
| TRIPLETT, JOHNNY | 300 |
| WINER, HOWARD JAY DDS | 288 |
| LITMAN, ARTHUR G MD | 200 |
| PINCHES, JOHN LLOYD III DO | 100 |