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AUTHORS: Thomas J. Stopka, Ashley Donahue, Marga Hutcheson, David Meyers, Kenneth Chui - Department of Public Health and Community Medicine, Tufts University School of Medicine
ABSTRACT: The opioid epidemic presents a major public health challenge and contributes to a larger syndemic, which includes non-prescription opioid misuse, heroin injection, opioid overdoses, and hepatitis C virus (HCV) and HIV clusters. Over the past decade, Massachusetts has experienced major syndemic challenges with increases in all opioid-related morbidities and mortalities, including an increase of 163% in fatal opioid overdoses, from 525 in 2005 to 1,379 in 2015, an increase of 137% in reported HCV cases among 15-29 year olds, and elevated HCV infection rates among Baby Boomers, born between 1945-1965. As this syndemic continues to grow, it may be a harbinger of future increases in HIV and HIV-HCV co-infection rates. Little is known, however, about the overlapping spatial distributions of these disease outcomes and geographic clustering patterns. We combined surveillance and primary data to map and derive a greater understanding of the Massachusetts syndemic. Through the use of various GIS and spatial epidemiological methods, we identified spatial hotspot clusters (p < 0.05) on the neighborhood, census tract, municipality, and state levels. We identified locations where injection drug use, overdose, HCV and HIV clusters were a concern, and where enhanced prevention, treatment, and care can help combat the opioid epidemic in Massachusetts.
