{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:19:29Z","timestamp":1777897169045,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background<\/jats:italic>\n                    : Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. This study aims to (1) estimate the rates of opioid-related overdoses, (2) estimate the association of benzodiazepine co-ingestion with opioid-related deaths, (3) estimate associations between socioeconomic indicators and opioid-related deaths, and (4) map the distribution of fatal overdoses, in Orange County (OC), California.\n                    <jats:italic toggle=\"yes\">Methods<\/jats:italic>\n                    : An ecologic study was conducted of all opioid- related deaths (1205 total) from 2010 to 2014 obtained from the OC Coroner Division database (1065 OC residents, 55 nonresidents, 85 OC homeless) (analyzed 2016\u20132017). Rates of opioid overdose, benzodiazepine co-ingestion prevalence, and associations with socioeconomic status (SES; education, poverty, median income) using ZIP code analysis in the residential and homeless communities were calculated.\n                    <jats:italic toggle=\"yes\">Results<\/jats:italic>\n                    : Of 1205 deaths, 904 involved prescription-type opioids, 223 involved heroin, 39 involved both, and 39 not stated; 973 were classified unintentional overdoses, 180 suicides, and 52 undetermined; 49% of cases involved benzodiazepines. Prescription-type opioid and heroin death rates for residents were 5.4\/ 100,000 person-years (95% confidence interval [CI]: 5.0\u20135.8) and 1.2\/100,000 person-years (95% CI: 1.0\u20131.4), respectively. Males, age group 45\u201354, and Caucasian race had the highest rate (13.6\/100,000) of opioid mortality. The highest death rates were seen in homeless adults, at 136\/100,000 person-years for prescription-type opioids (95% CI: 99.0\u2013185.5) and 156\/100,000 person-years for heroin (95% CI: 116.8\u2013209.5).\n                    <jats:italic toggle=\"yes\">Conclusions<\/jats:italic>\n                    : The burden of prescription-type opioid\u2013related deaths in OC affects all demographics and levels of SES; there is a disproportionately high rate of opioid-related deaths in the OC homeless population.\n                  <\/jats:p>","DOI":"10.1080\/08897077.2018.1442899","type":"journal-article","created":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T11:24:55Z","timestamp":1519212295000},"page":"80-86","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Socioeconomic and Geographical Disparities in Prescription and Illicit Opioid-Related Overdose Deaths in Orange County, California, from 2010\u20132014"],"prefix":"10.1177","volume":"40","author":[{"given":"John R.","family":"Marshall","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of California, Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen F.","family":"Gassner","sequence":"additional","affiliation":[{"name":"University of Miami School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig L.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richelle J.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahram","family":"Lotfipour","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharath","family":"Chakravarthy","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, Irvine, Irvine, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Rudd R Seth P David F Scholl L. Increases in drug and opioid-involved overdose deaths\u2014United States 2010\u20132015. CDC Morb and Mortal Wkly Rep. https:\/\/www.cdc.gov\/mmwr\/volumes\/65\/wr\/mm655051e1.htm. Published December 2016. February 2 2017. doi:10.15585\/mmwr.mm655051e1.","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_3_2_3_2","unstructured":"Prescription Opioid Overdose Data. 2016. Centers for Disease Control and Prevention Web site. https:\/\/www.cdc.gov\/drugoverdose\/data\/overdose.html. Published Decembere 16 2016. January 7 2017."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.05.030"},{"key":"e_1_3_2_5_2","unstructured":"Drug & Alcohol Overdose Hospitalization & Death in Orange County. Orange County Health Care Agency and Orange County Sheriff Coroner Department. Santa Ana California. http:\/\/ochealthinfo.com\/about\/admin\/pubs\/od. Published 2016. December 30 2016."},{"key":"e_1_3_2_6_2","unstructured":"Opioids drive continued increase in drug overdose deaths. Centers for Disease Control and Prevention Web site. http:\/\/www.cdc.gov.media\/releases\/2013\/p0220_drug_overdose_deaths.html. Published 2016. Jan 7 2017."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1406143"},{"key":"e_1_3_2_8_2","unstructured":"Deaths: Final Data for 2010. xxx Web site. http:\/\/www.cdc.gov\/nchs\/data\/nvsr\/nvsr61\/nvsr61_04_tables.pdf#I05. Published 2013. January 8 2017."},{"key":"e_1_3_2_9_2","unstructured":"Chen LH Hedegaard H Warner M. Drug-Poisoning Deaths Involving Opioid Analgesics: United States 1999\u20132011. Vol. 166: National Center for Health Statistics; 2014. Data Brief No. 166. http:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db166.pdf. January 8 2017."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-015-9967-y"},{"key":"e_1_3_2_11_2","unstructured":"Drug Abuse Warning Network National Estimates of Drug-Related Emergency Department Visits. US Department of Health and Human Services Web site. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/DAWN2k11ED\/DAWN2k11ED\/DAWN2k11ED.pdf. Published 2011. February 8 2017."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2016.08.022"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2014.05.015"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(02)00342-3"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301347"},{"key":"e_1_3_2_16_2","unstructured":"Premature Mortality in Orange County. Orange County Health Care Agency Santa Ana California. 2014 [Cited in Drug & Alcohol Overdose Hospitalization & Death in Orange County 2017 Jan 6. Accessed March 1 2017."},{"key":"e_1_3_2_17_2","unstructured":"Chandler J. Fatal drug overdoses reach 10 year high in Orange County. OC Register. [Date] 2016. http:\/\/www.ocregister.com\/articles\/drug-716050-county-overdoses.html. Accessed Dec 7 2017."},{"key":"e_1_3_2_18_2","unstructured":"US Census American Factfinder Web site. https:\/\/factfinder.census.gov. Published 2016. Dec 7 2017."},{"key":"e_1_3_2_19_2","unstructured":"Census Redistricting Data (Public Law 94-171). 2010 Census of Population and Housing. US Census Bureau Web site. https:\/\/www.census.gov\/prod\/cen2010\/doc\/pl94-171.pdf. Published 2011. Aug 29 2016."},{"key":"e_1_3_2_20_2","unstructured":"Olsen B. (personal communication)Orange County California Coroner's Office. Received November 19 2017."},{"key":"e_1_3_2_21_2","unstructured":"Factfinder. Orange County CA. https:\/\/factfinder.census.gov\/faces\/nav\/jsf\/pages\/community_facts.xhtml?src=bkmk. Published 2010. August 29 2016."},{"key":"e_1_3_2_22_2","unstructured":"Schatz MK Bennett T Heidenreich G Gale K. Orange Cty Homeless Count & Surv Rep. July 2015. http:\/\/ocpartnership.net\/images\/website\/1236\/files\/211oc_2015_final_pitreport_funders_8-5-2015_2124.pdf. Aug 29 2016."},{"key":"e_1_3_2_23_2","unstructured":"Schatz MK Halcon E Bennett T. Orange Cty Homeless Count & Surv Rep. 2013; July 2013. http:\/\/ocpartnership.net\/images\/website\/1236\/files\/final_ocp_2013_pitreport_final_report_082013_658.pdf. Aug 29 2016."},{"key":"e_1_3_2_24_2","unstructured":"Connery PK Ithiphol K Connery L. Orange Cty Homeless Census & Surv Compr Rep. July 2011. http:\/\/www.ocpartnership.net\/images\/website\/1236\/files\/2011_oc_homeless_report_final_472.pdf. Aug 29 2016."},{"key":"e_1_3_2_25_2","unstructured":"Connery P Brutschy S Albee K. Orange Cty Homeless Census and Surv July 2009 http:\/\/www.ocpartnership.net\/mages\/website\/1236\/files\/2009_pit_final_report_341.pdf. Aug 29 2016."},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.7.1100"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-5-58"},{"key":"e_1_3_2_28_2","unstructured":"Post office changes. In: USPS Postal Bulletin. Washington DC: US Postal Service; 2009. https:\/\/about.usps.com\/postal-bulletin\/welcome.htm. Sep 8 2016."},{"key":"e_1_3_2_29_2","unstructured":"US Census Bureau. 2010 ZCTA to County Relationship File. https:\/\/www.census.gov\/geo\/maps-data\/data\/zcta_rel_download.html. Published 2016. Sep 8 2016."},{"issue":"6","key":"e_1_3_2_30_2","first-page":"1","article-title":"Warnings unheeded: The risks of co-prescribing opioids and benzodiazepines","volume":"23","author":"Babalonis S","year":"2015","unstructured":"Babalonis S, , Walsh S. Warnings unheeded: The risks of co-prescribing opioids and benzodiazepines. Pain: Clin Updates 2015; 23(6): 1\u20137.","journal-title":"Pain: Clin Updates"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0897190013515001"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2014.10.024"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.083600"}],"container-title":["Substance Abuse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2018.1442899","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1080\/08897077.2018.1442899","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2018.1442899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:49:44Z","timestamp":1777625384000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1080\/08897077.2018.1442899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1080\/08897077.2018.1442899"],"URL":"https:\/\/doi.org\/10.1080\/08897077.2018.1442899","relation":{},"ISSN":["0889-7077","1547-0164"],"issn-type":[{"value":"0889-7077","type":"print"},{"value":"1547-0164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}