*THREAD 🧵* Here is a visualization of drug-related data from a regional perspective. I'll start with Central Florida counties that surround Orange County (Orlando). The left is drug overdose death rate, right is Rx opioid dispensing rate for each colored county from 2006-2018.
As the rate changes from year to year, the colors either get darker (increase) or lighter (decrease). It's fairly straight forward. Seeing multiple counties from a regional view is pretty eye-opening 👀.
Orange County (Orlando) is the metro center of this area with a population of over 1 million people. Note that population is not the one and only factor that influences overdose death rates... we can see the smaller Brevard and Volusia consistently have the highest rates.
From 2006 to 2010, the region's drug overdose death rate increased along with the Rx opioid dispensing rate. The theory is that non-patients were getting their hands on diverted Rx opioids and this group of users were contributing to the increase of overdose deaths.
In 2011, the Rx opioid dispensing rate started to decline due to government restrictions on doctors prescribing opioids. In 2011 and 2012, we can see the drug overdose death rates also decrease.
As the mid-2010s came, we started to see the drug overdose death rates begin to drastically increase... all while the Rx opioid dispensing rates continued their declines. The main culprit was the use of illicit fentanyl as additives & substitutes in the U.S. illicit drug supplies
A point some experts have made is that restrictions on prescribing opioids have contributed to the increase in OD deaths due to pain patients not being able to get a sufficient supply of Rx opioids to manage their pain and thus seeking illicit sources (e.g., heroin, etc).
In the slideshow, we can see that Brevard and Volusia counties have the 2 highest Rx opioid dispensing rates in this region and also seem to have the largest decrease in Rx opioid dispensing - which may be a factor in why they also have the 2 highest OD death rates in this region
Pain patients (that became desperate to treat their pain when their doctors couldn't) weren't the only group at risk as illicit fentanyl made its way into the illicit drug supplies. Non-medical users, recreational drug users, etc. have also contributed to OD death rates ⬆️
I can get deeper into analyzing this data and attempting to interpret it but I'll leave it at this for now and let you all provide some input & interpretations. I'll gladly take suggestions for more regions to do. Discussions are beneficial and constructive so let's all discuss!
While I’m at it I might as well tag some local public officials. They like data too.

On the federal level:
@DarrenSoto @RepValDemings @RepStephMurphy
@congbillposey
@RepWaltzPress
@RepWebster
@ScottFranklinFL
@RepGusBilirakis

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More from @DrDavid_IDEM

6 Nov
Here is drug-related #data for the counties in the Philadelphia PA region from 2006-2018. I'd have to dive into the math later, but it looks like counties with the largest decreases in Rx #opioids dispensing had the largest increases in drug overdose death rates. *THREAD*
Similar to my earlier tweet, in these visualizations you will generally see the counties on the left get darker (overdose death rate increasing) as the right gets lighter (Rx opioid dispensing rate decrease). This is apparent for Philadelphia, Delaware, and Bucks counties.
For those that aren't familiar: Rx opioid dispensing ⬇️ due to federal drug policies that restricted doctors from prescribing Rx opioids to their patients, in hopes of 📉 overdose deaths -- but restricting Rx opioids clearly has not solved that problem according to this data.
Read 4 tweets
12 Oct
Here are data for Rx opioid dispensing and drug overdose deaths in #America. The notable feature is the 📉 of Rx opioid disp rate having no impact in reducing overdose deaths, then the rise of illicit fentanyl contributing to a sharp 📈 in the mid-2010s.

*thread* 🧵
The U.S. drug overdose/poisoning death rate has increased almost every year since 1999 (2018 had a 📈), but in the mid-2010s, there was a larger than normal increase in that rate. The rise of illicit fentanyl in the black market has been a big contributor to this mid-2010s spike.
The health danger with illicit drug supplies is that the user has no clue exactly what is in the drug. Poor quality control by clandestine lab chemists in manufacturing these illicit drugs is nowhere near the level of QC performed by a legitimate pharmaceutical manufacturer.
Read 14 tweets
1 Sep
I’ll cap #OverdoseAwarenessDay with this. Data show there was no correlation between Rx opioid dispensing and the drug overdose death rate in 38 states & D.C (represented by the dots) in 2018. The closer R-squared (R^2) is to 1, the stronger the correlation. Here R^2 is 0.00002.
0.00002 is VERY VERY far from 1, indicating that the Rx opioid dispensing rate from state to state had no effect on drug overdose numbers.
Explanation of the data: In simple linear regression, R-squared is known as the correlation coefficient, on a scale of 0-1, 1 being a perfect linear correlation and 0 being no correlation.
Read 6 tweets
31 Aug
To compare the 3 south Florida counties’ drug #overdose data, each of them had an 83%+ increase of OD deaths from 2015 to 2016 📈. Then in 2018, all 3 saw a drop in their drug OD death count 📉.

#InternationalOverdoseAwarenessDay
My educated guess: the positive overdose death spikes in 2015 may be attributed to the rise of illicit fentanyl in the US. I’m not too sure about the negative spike in 2018. Keep in mind that 2018 was the ONLY year of nationwide #overdose death decline since 1999.
Maybe the decrease was due to programs such as @HealthyFla HEROS that distributed free naloxone/Narcan to #FirstResponders. But of course, the overdose death count jumped back up in 2019.
Read 4 tweets
31 Aug
Effective early drug education is necessary to curb drug #overdose deaths. And no, I don’t mean DARE. I taught a univ. freshman seminar class and they go through a lesson on “substance abuse” and those 18 yr olds didn’t know sh*t about drugs. #InternationalOverdoseAwarenessDay
If that’s the representation of our teenage and young adults in the US, then we need to do more in middle school & high school to educate them about drugs, responsible medical use, and the risks of irresponsible or recreational drug use. Educate them rather than scare them str8.
We can’t look at the drug epidemic as a problem that will be solved overnight, or next year, or even in 5 years. We must invest more in educating the younger generations with basic information about drugs.
Read 6 tweets
31 Aug
My next few posts will be about South #Florida, the most populated region in my state. Miami-Dade Co. also had a large surge in drug #overdose deaths in 2016 and has remained above 200 per year ever since.

#InternationalOverdoseAwarenessDay
This 135 drug #overdose death surge is within the same timing as the 248 death surge in the Jacksonville Florida area (shown in my last tweet) from 2015 to 2016. This surge also correlates to the rise of illicit fentanyl overdose spikes in the US.
The data from Miami-Dade is actually mind boggling. This county is the most populated in #Florida but has managed to maintain one of the lowest overdose deaths per 100k ppl in the state over the years.
Read 5 tweets

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