Revised March 2019
Opioid-Involved Overdose Deaths
Texas continues to have one of the lowest rates of drug overdose deaths involving opioids. In 2017, there were 1,458 overdose deaths involving opioids in Texas—a rate of 5.1 deaths per 100,000 persons, compared to the national rate of 14.6 deaths per 100,000 persons.
A rising trend in opioid-involved overdose deaths was seen in cases related to synthetic opioids (mainly fentanyl) or heroin. Over the last decade, deaths involving fentanyl tripled from 118 in 2007 to 348 deaths in 2017. Heroin-involved overdose deaths more than doubled in the same period from 214 to 569 deaths. The highest number of deaths in 2017—646— involved prescription opioids (Figure 1).
Opioid Pain Reliever Prescriptions
In 2017, Texas providers wrote 53.1 opioid prescriptions for every 100 persons (Figure 2), compared to the average U.S. rate of 58.7 prescriptions. This is the lowest rate in the state since 2006 when data became available (CDC).
The overall rate of overdose deaths involving opioid prescriptions has shown a slight uptick in recent years but remains statistically unchanged since 2007. In 2017, the age-adjusted death rate was 2.3 deaths per 100,000 persons.
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).
There were more than 1,300 cases of NAS/NOWS in Texas among Medicaid recipients in 2015. Nearly 1 in 3 were reported in Bexar county (Texas Health and Human Services).
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 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, 4,464 occurred in Texas. Among males, 6.4 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 15.1 percent of new HIV cases were attributed to IDU (Figure 4) (AIDSVu).
- State Prevalence: In 2015, an estimated 81,873 persons were living with a diagnosed HIV infection in Texas—a rate of 368 cases per 100,000 persons. Of those, 15.0 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 19.5 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: There were approximately 40 new cases of acute HCV (0.1 per 100,000 persons) reported in Texas in 2016 (CDC).
- State Prevalence: In Texas, there are an estimated 205,800 persons living with Hepatitis C (2013-2016 annual average), a rate of 1,040 cases per 100,000 persons (HepVu).
- Texas Health and Human Services, Substance Abuse and Neonatal Abstinence Syndrome
- Centers for Disease Control and Prevention, Opioid Overdose
- 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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