Count models with an application to opiod-involved overdose mortality in the state of Indiana

Opioids are medications that can be legally prescribed and used to treat pain. The downside of opioids is that they can lead to opioid addiction or opioid Use Disorder (OUD) or even death. Indiana’s opioid-involved overdose mortality rate continues to rise, with 1246 opioid overdose deaths in 2019 and 18.5 deaths per 100,000 population (2021, Indiana Department of Health). This study’s objective is to undertake a thorough county-level evaluation of Indiana’s opioid overdose risk, identify vulnerable counties, and identify indicators that are strongly associated with opioidinvolved overdose mortality. Data on opioid-related and socioeconomic factors for 92 counties in the State of Indiana were gathered from publicly accessible state and federal sources. Next, we created county-level vulnerability scores using a negative binomial regression-weighted ranking method with mean standardized covariates, an opioid-involved overdose death outcome, and the log of the population as the offset. Results from both Frequentist and Bayesian approaches were compared in this analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, median income, gini index, county-level opioid use disorder(OUD) treatment service facilities, average household size in the county, drug submissions, classification of counties as rural or urban or mixed, and median income in the past 12 months were significantly associated with opioid-involved overdose mortality with p − value < 0.05. Based on these indicators, we identified 22 counties in the state of Indiana falling within the category of most vulnerable to opioid-involved overdose mortality. Marion, Allen, Lake, St.Joseph, Johnson, Delaware, Clark, and La Porte were identified as the most vulnerable counties in the state of Indiana in all the approaches used in this analysis. Our method can be used to analyze opioid-related public health vulnerabilities in other state and local public health authorities.