{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:42:28Z","timestamp":1777898548176,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"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":["Public Health Rep"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics\u2013Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near\u2013real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354917709783","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T09:35:48Z","timestamp":1510047348000},"page":"80S-87S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Local Public Health Surveillance of Heroin-Related Morbidity and Mortality, Orange County, Florida, 2010-2014"],"prefix":"10.1177","volume":"132","author":[{"given":"Toni-Marie L.","family":"Hudson","sequence":"first","affiliation":[{"name":"Florida Department of Health in Orange County, Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin G.","family":"Klekamp","sequence":"additional","affiliation":[{"name":"Florida Department of Health in Orange County, Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah D.","family":"Matthews","sequence":"additional","affiliation":[{"name":"Florida Department of Health in Orange County, Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,7,10]]},"reference":[{"key":"bibr1-0033354917709783","doi-asserted-by":"publisher","DOI":"10.1177\/003335491412900507"},{"key":"bibr2-0033354917709783","unstructured":"Hedegaard H, Chen LH, Warner M. Drug-Poisoning Deaths Involving Heroin: United States, 2000-2013. Hyattsville, MD: National Center for Health Statistics; 2015. NCHS data brief 190. http:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db190.pdf. Accessed April 3, 2016."},{"issue":"01","key":"bibr3-0033354917709783","first-page":"32","volume":"64","author":"Chen LH","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"26","key":"bibr4-0033354917709783","first-page":"569","volume":"63","author":"Johnson H","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr5-0033354917709783","unstructured":"Centers for Disease Control and Prevention. Prescription painkiller overdoses in the US. https:\/\/www.cdc.gov\/vitalsigns\/painkilleroverdoses. Accessed April 3, 2016."},{"issue":"39","key":"bibr6-0033354917709783","first-page":"849","volume":"63","author":"Rudd RA","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr7-0033354917709783","unstructured":"Centers for Disease Control and Prevention. Today\u2019s heroin epidemic. http:\/\/www.cdc.gov\/vitalsigns\/heroin. Accessed April 5, 2016."},{"key":"bibr8-0033354917709783","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2011.0053"},{"key":"bibr9-0033354917709783","unstructured":"National Institute on Drug Abuse. Epidemiologic Trends in Drug Abuse: Highlights and Executive Summary. Bethesda, MD: National Institutes of Health; 2006. Proceedings of the Community Epidemiology Work Group; vol 1. https:\/\/archives.drugabuse.gov\/pdf\/cewg\/Vol1_605.pdf. Accessed March 12, 2016."},{"key":"bibr10-0033354917709783","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1204141"},{"key":"bibr11-0033354917709783","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.366"},{"key":"bibr12-0033354917709783","unstructured":"Florida Department of Law Enforcement. Drugs identified in deceased persons by Florida medical examiners: 2014 annual report. https:\/\/www.fdle.state.fl.us\/cms\/MEC\/Publications-and-Forms\/Documents\/Drugs-in-Deceased-Persons\/2014-Annual-Drug-Report-FINAL.aspx. Published 2015. Accessed April 17, 2016."},{"key":"bibr13-0033354917709783","unstructured":"US Census Bureau. 2010 population finder. https:\/\/www.census.gov\/popfinder. Published 2013. Accessed November 2015."},{"key":"bibr14-0033354917709783","unstructured":"Fla Stat Title 4, Ch 20.42."},{"key":"bibr15-0033354917709783","unstructured":"Centers for Disease Control and Prevention. Prescription drug overdose data & statistics: guide to\n                      ICD-9-CM\n                      and\n                      ICD-10\n                      codes related to poisoning and pain. https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pdo_guide_to_icd-9-cm_and_icd-10_codes-a.pdf. Published 2012. Revised August 2013. Accessed November 21, 2016."},{"key":"bibr16-0033354917709783","unstructured":"Paulozzi L. The other epidemic: prescription drug abuse in the US: ten prevention ideas from the states. Presented at: the National Conference of State Legislatures \u201cInjury Prevention Through the Life Cycle\u201d Meeting; May 14, 2009; Atlanta, GA. http:\/\/www.ncsl.org\/portals\/1\/documents\/health\/Paulozzi509.pdf. Accessed October 4, 2015."},{"key":"bibr17-0033354917709783","unstructured":"Florida Department of Health. Surveillance Systems\u2014ESSENCE. http:\/\/www.floridahealth.gov\/diseases-and-conditions\/disease-reporting-and-management\/disease-reporting-and-surveillance\/surveillance-systems.html. Accessed October 6, 2015."},{"key":"bibr18-0033354917709783","volume-title":"SAS Version 9.4","author":"SAS Institute Inc","year":"2014"},{"key":"bibr19-0033354917709783","volume-title":"ArcGIS Desktop: Release 10.3.1","author":"ESRI","year":"2015"},{"key":"bibr20-0033354917709783","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-012-0285-4"},{"key":"bibr21-0033354917709783","unstructured":"US Drug Enforcement Administration Strategic Intelligence. National heroin threat assessment summary. http:\/\/www.dea.gov\/divisions\/hq\/2015\/hq052215_National_Heroin_Threat_Assessment_Summary.pdf. Published 2015. Accessed January 7, 2016."},{"key":"bibr22-0033354917709783","unstructured":"Centers for Disease Control and Prevention. New research reveals the trends and risk factors behind America\u2019s growing heroin epidemic. https:\/\/www.cdc.gov\/media\/releases\/2015\/p0707-heroin-epidemic.html. Updated July 7, 2015. Accessed February 3, 2016."},{"key":"bibr23-0033354917709783","unstructured":"Orange County Heroin Task Force. Orange County Heroin Task Force recommendations. http:\/\/orangecountyfl.net\/Portals\/0\/Library\/Board%20Of%20County%20Commissioners\/docs\/Orange%20County%20Heroin%20Task%20Force%20%20Recommendations.pdf. Accessed November 19, 2016."}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354917709783","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0033354917709783","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354917709783","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:33:58Z","timestamp":1777628038000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0033354917709783"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":23,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1177\/0033354917709783"],"URL":"https:\/\/doi.org\/10.1177\/0033354917709783","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]}}}