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Iowa Opioid Summary

Revised March 2019

Opioid-Involved Overdose Deaths

In 2017, there were 206 overdose deaths­­­ involving opioids in Iowa—a rate of 6.9 deaths per 100,000 persons compared to the average national rate of 14.6 deaths per 100,000 persons. The greatest rise occurred among heroin-involved deaths (Figure 1), which more than quadrupled from 14 deaths in 2012 to 61 deaths in 2017.  Deaths involving synthetic opioids other than methadone (mainly fentanyl), rose threefold from 29 cases in 2011 to 92 cases in 2017. Since 1999, prescription opioid-involved deaths steadily rose to a peak of 132 in 2012, but since then, they have declined by 20 percent to 104 cases in 2017.

See textFigure 1. Number of overdose deaths involving opioids in Iowa, by opioid category. Drug categories presented are not mutually exclusive, and deaths might have involved more than one substance. Source: CDC WONDER.

Opioid Pain Reliever Prescriptions

In 2017, Iowa providers wrote 56.4 opioid prescriptions for every 100 persons (Figure 2). The average U.S. rate in the same year was 58.7 prescriptions per 100 persons (CDC). 

The rate of overdose deaths involving opioid prescriptions has not significantly risen or increased? in the past several years with 3.4 deaths per 100,000 persons reported in 2017.

See textFigure 2. Iowa rate of overdose deaths involving prescription opioids and the opioid prescribing rate. Source: CDC and CDC WONDER.

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 revealed 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. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOWS births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).

To date, there is no standard in NAS/NOWS provider and hospital coding practices (CDC). As a result, there is variability in trends and in the rate reported by states. The most recent data on the rate of babies born with NAS/NOWS in Iowa is from 2014 and is based on state inpatient databases.  From 2008 to 2014, the rate of NAS/NOWS increased 300 percent from 0.7 cases per 1,000 hospital births to 2.8 cases per 1,000 hospital births (Healthcare Cost and Utilization Project).

See textFigure 3. NAS/NOWS Incidence rate and hospital costs for treatment in the United States. Source: T.N.A. Winkelman, et al., 2018.

HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)

See text Figure 4. Iowa: Estimated percent of male vs. female with new HIV diagnoses, by transmission category, 2016. Source: CDC and www.AIDSVU.org.
  • 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 males, 6.3 percent (2,530) of new cases were transmitted via IDU or male-to-male contact and IDU. Among females, 2.3 percent (950) were transmitted via IDU (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 (150,4661) 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, 133 occurred in Iowa. Among males, 9.5 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. There were no reports of new HIV cases transmitted via IDU among women (Figure 4) (AIDSVu).
  • State Prevalence: In 2015, an estimated 2,427 persons were living with a diagnosed HIV infection in Iowa—a rate of 93 cases per 100,000 persons. Of those, 17.0 percent of cases among males were attributed to IDU or male-to-male contact and IDU. Among females, 17.3 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 case 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: This data is not available for the state of Iowa (CDC).
  • State Prevalence: In Iowa, there are an estimated 12,800 persons living with Hepatitis C (2013-2016 annual average), a rate of 540 cases per 100,000 persons (HepVu).

The National Institute of Health Funds Center of Excellence in Pain Education

This is the logo for the NIH Pain Consortium: Centers of Excellence in Pain Education.

Iowa is home to one of the eleven Centers of Excellence in Pain Education (CoEPEs): The University of Iowa. The CoEPEs act as hubs for the development, evaluation, and distribution of pain management curriculum resources for medical, dental, nursing, pharmacy and other schools to improve how health care professionals are taught about pain and its treatment.

Additional Resources

NIH RePORTER FY2018 NIH-funded projects related to opioid use and use disorder in Iowa: 1

Notes

  1. 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.
  2. Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.

This page was last updated March 2019

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