{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:16:12Z","timestamp":1780553772191,"version":"3.54.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:00:00Z","timestamp":1539043200000},"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":[[2018,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>In Allegheny County, Pennsylvania, the incidence of opioid-related overdose deaths increased from 17.4 per 100\u2009000 population in 2008 to 23.9 per 100\u2009000 population in 2014. Our objectives were to describe local demographic characteristics of this epidemic, identify public human services targets for intervention, determine temporal relationships between use of public human services and overdose mortality, and provide recommendations about potentially beneficial interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used autopsy data from the Allegheny County Medical Examiner to link people who died of overdoses from 2008 through 2014 to their premortem incarcerations and use of mental health services and substance use disorder services. We calculated the frequency of use of public human services by decedents and the interval between the last use of these services and overdose death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 1399 decedents, 957 (68.4%) had a public human service encounter before overdose death. Of these 957 decedents, 531 (55.5%) had ever been incarcerated, 616 (64.4%) had ever used a mental health service, and 702 (73.4%) had ever used a substance use disorder service. Of 211 decedents incarcerated in the year before their overdose death, 54 (25.6%) overdosed within 30 days of their last release from jail. Of 510 decedents using mental health services in the year before death, 231 (45.3%) overdosed within 30 days of their last use of the services. Of 350 decedents using substance use disorder services in the year before their overdose death, 134 (38.3%) overdosed within 30 days of their last use of the services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Merging data on overdose mortality with data on use of public human services can be a useful strategy to identify trends in, and factors contributing to, the opioid epidemic; to target interventions; and to stimulate collaboration to address the epidemic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354918803938","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T19:02:37Z","timestamp":1539111757000},"page":"658-666","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Linking Opioid-Overdose Data to Human Services and Criminal Justice Data: Opportunities for Intervention"],"prefix":"10.1177","volume":"133","author":[{"given":"Karen","family":"Hacker","sequence":"first","affiliation":[{"name":"Director\u2019s Office, Allegheny County Health Department, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latika Davis","family":"Jones","sequence":"additional","affiliation":[{"name":"Office of Behavioral Health, Bureau of Drug & Alcohol Services, Allegheny County Department of Human Services, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LuAnn","family":"Brink","sequence":"additional","affiliation":[{"name":"Bureau of Assessment, Statistics, and Epidemiology, Allegheny County Health Department, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Wilson","sequence":"additional","affiliation":[{"name":"Bureau of Public Policy and Community Relations, Allegheny County Health Department, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Cherna","sequence":"additional","affiliation":[{"name":"Director\u2019s Office, Allegheny County Department of Human Services, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Dalton","sequence":"additional","affiliation":[{"name":"Office of Data Analysis, Research, and Evaluation, Allegheny County Department of Human Services, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric G.","family":"Hulsey","sequence":"additional","affiliation":[{"name":"Office of Data Analysis, Research, and Evaluation, Allegheny County Department of Human Services, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"bibr1-0033354918803938","unstructured":"Centers for Disease Control and Prevention. Prescription opioid overdose data. 2017. https:\/\/www.cdc.gov\/drugoverdose\/data\/overdose.html. Accessed December 3, 2017."},{"key":"bibr2-0033354918803938","unstructured":"Kaiser Family Foundation. Opioid overdose deaths by gender. 2018. https:\/\/www.kff.org\/other\/state-indicator\/opioid-overdose-deaths-by-gender\/?currentTimeframe=0&selectedDistributions=total&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed August 27, 2018."},{"key":"bibr3-0033354918803938","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6450a3"},{"key":"bibr4-0033354918803938","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"bibr5-0033354918803938","unstructured":"Centers for Disease Control and Prevention. Opioid overdoses. 2018. https:\/\/www.cdc.gov\/drugoverdose\/index.html. Accessed January 14, 2018."},{"key":"bibr6-0033354918803938","unstructured":"Drug Enforcement Agency, Philadelphia Division, University of Pittsburgh School of Pharmacy. Analysis of overdose deaths in Pennsylvania, 2016. 2017. https:\/\/www.duq.edu\/assets\/Documents\/forensics\/Forensic%20Fridays\/OCT%2027\/Handouts\/DEA-PHL-DIR-034-17%20Analysis%20of%20Overdose%20Deaths%20in%20Pennsylvania%202016A[4080].pdf. Accessed September 6, 2018."},{"key":"bibr7-0033354918803938","first-page":"1","volume":"22","author":"Warner M","year":"2009","journal-title":"NCHS Data Brief"},{"key":"bibr8-0033354918803938","unstructured":"Kaiser Family Foundation. Opioid overdose death rates and all drug overdose death rates per 100,000 population (age-adjusted). 2016. https:\/\/www.kff.org\/other\/state-indicator\/prescription-opioid-overdose-deaths-and-death-rate-per-100000-population-age-adjusted\/?activeTab=map&currentTimeframe=0&selectedDistributions=prescription-opioid-overdose-deaths&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed June 26, 2018."},{"key":"bibr9-0033354918803938","unstructured":"Allegheny County. Allegheny County analytics. 2017. https:\/\/www.alleghenycountyanalytics.us. Accessed December 3, 2017."},{"key":"bibr10-0033354918803938","volume-title":"Opioid-Related Overdose Deaths in Allegheny County; Risks and Opportunities for Intervention","author":"Hulsey EB","year":"2016"},{"key":"bibr11-0033354918803938","unstructured":"Pennsylvania Department of Drug and Alcohol Programs. The department\u2019s focus on addressing overdose. Updated March 2018. http:\/\/www.ddap.pa.gov\/overdose\/Pages\/Department%20Focus%20on%20Addressing%20Overdose.aspx. Accessed September 6, 2018."},{"key":"bibr12-0033354918803938","volume-title":"Continuum of Care Approach: Western Pennsylvania\u2019s Response to the Opioid Epidemic","author":"Miller T","year":"2016"},{"key":"bibr13-0033354918803938","unstructured":"Centers for Disease Control and Prevention. Synthetic opioid overdose data. 2016. https:\/\/www.cdc.gov\/drugoverdose\/data\/fentanyl.html. Accessed December 3, 2017."},{"key":"bibr14-0033354918803938","unstructured":"Allegheny County Department of Human Services. Allegheny County Data Warehouse. Updated 2018. https:\/\/www.alleghenycountyanalytics.us\/index.php\/dhs-data-warehouse. Accessed July 15, 2018."},{"key":"bibr15-0033354918803938","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)","author":"American Psychiatric Association","year":"1994"},{"key":"bibr16-0033354918803938","volume-title":"ArcGIS Version 10.3","author":"ESRI","year":"2016"},{"key":"bibr17-0033354918803938","unstructured":"ESRI. ArcGIS Version 10.3: Hot Spot Analysis. Redlands, CA: ESRI; 2016. http:\/\/giscollective.org\/tutorials\/gis-techniques\/spatial-statistics\/hot-spot-analysis. Accessed June 13, 2018."},{"key":"bibr18-0033354918803938","first-page":"1","volume":"190","author":"Hedegaard H","year":"2015","journal-title":"NCHS Data Brief"},{"key":"bibr19-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.03.024"},{"key":"bibr20-0033354918803938","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304187"},{"key":"bibr21-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1186\/1940-0640-7-3"},{"key":"bibr22-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa064115"},{"key":"bibr23-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1111\/add.13200"},{"key":"bibr24-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00264.x"},{"key":"bibr25-0033354918803938","doi-asserted-by":"publisher","DOI":"10.2174\/1874473711104040292"},{"key":"bibr26-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7129.426"},{"key":"bibr27-0033354918803938","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7396.959"},{"key":"bibr28-0033354918803938","unstructured":"American Addiction Centers. Fentanyl vs. heroin: the similarities and differences between two powerful opioids. 2018. https:\/\/americanaddictioncenters.org\/fentanyl-treatment\/similarities\/#overdose. 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