Revised March 2019
Opioid-Related Overdose Deaths
In 2017, there were 2,199 overdose deaths involving opioids in California—a rate of 5.3 deaths per 100,000 persons, which is lower than the national rate of 14.6 deaths per 100,000 persons. The main driver of drug overdose deaths were those involving prescription opioids with 1,169 deaths in 2017 (Figure 1). However, the greatest increase in opioid deaths was seen in cases involving synthetic opioids (mainly fentanyl): a more than twofold increase from 229 to 536 deaths over the past 2-years. Deaths involving heroin also increased in the same period: from 593 in 2012 to 715 deaths in 2017.
Opioid Pain Reliever Prescriptions
In 2017, California providers wrote 39.5 opioid prescriptions for every 100 persons (Figure 2). This was among the lowest prescribing rates in the country and significantly lower than the average U.S. rate of 58.7 prescriptions (CDC). The rate of overdose deaths involving opioid prescriptions decreased steadily after 2014 to 2.8 deaths per 100,000 persons (Figure 2), in 2017.
Neonatal Abstinence Syndrome (NAS)
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study showed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. That is one baby born with NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOW births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).
Between 2013 and 2016, 15,616 newborns were diagnosed with NAS/NOWS in California, or 3,409 infants per year. San Mateo, Santa Clara and Los Angeles were among counties with the lowest rates with 2.1, 2.3 and 2.9 cases per 1,000 hospital births. Among counties with the highest NAS/NOWS rates were Humboldt, Shasta and Trinity with 19.0, 19.7 and 22.5 cases per 1,000 hospital births (A. Gangopadhyaya, 2018)
HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)
- U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among new cases, 6.3 percent (2,530) were transmitted via IDU or male-to-male contact and IDU among men, and 2.3 percent (950) were transmitted via IDU among women (CDC).
- U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,466) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
- State Incidence: Of the new HIV cases in 2016, 4,961 occurred in California. Among males, 8.0 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 17.2 percent of new HIV cases were attributed to IDU (Figure 4.)(AIDSVu).
- State Prevalence: In 2015, an estimated 122,079 persons were living with a diagnosed HIV infection in California—a rate of 376 cases per 100,000 persons. Of those, 14 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 23.4 percent were living with HIV attributed to IDU (AIDSVu).
Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use1
- U.S. Incidence: In 2016, there were an estimated 41,200 new cases of acute HCV2 (CDC). Among cases reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
- U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
- State Incidence: There were approximately 60 new cases of acute HCV (0.2 per 100,000 persons) reported in California in 2016 (CDC).
- State Prevalence: In California, there are an estimated 321,900 persons living with Hepatitis C (2013-2016 annual average), a rate of 1,090 cases per 100,000 persons (HepVu).
- Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
- Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.
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NIH HEAL (Helping to End Addiction Long-term) Initiative
New Opioid Overdose Materials for Patients
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