Substance Use
Trends in opioid-related overdose outcomes by county-level rurality and measures of OUD treatment availability, Florida, 2015-2024 Melissa Ward* Melissa Ward Ward Ward Florida International University
Introduction: Floridians experience substantial harm from opioid misuse, and access to opioid use disorder (OUD) treatment differs markedly across the state. This study examined how trends in rates of opioid-related overdoses (ODs) in Florida varied by county-level classifications of rurality and OUD treatment availability from 2015 to 2024.
Methods: Counts of opioid-involved OD deaths and emergency medical service (EMS) responses to suspected opioid-involved ODs were obtained from the Florida Department of Health Substance Use Dashboard. Population denominators were derived from 2023 American Community Survey 5-year estimates. Counties were classified as rural or nonrural according to HRSA designations, and according to measures of treatment availability derived from SAMHSA data including availability of medications for OUD and rates of buprenorphine prescribers. The National Cancer Institute’s Joinpoint Trend Analysis Software was used to identify significant changes in linear trends over time and estimate annual percentage change (APC).
Results: While nonrural counties had the highest rates of opioid-related ODs, rural counties experienced more accelerated increases in rates over shorter time periods, including significant increased APCs of 30% for fatal ODs from 2019-2022 and 55% for EMS responses from 2018-2021. In comparison, nonrural counties showed significant increased APCs of 12% from 2015-2022 and 36% from 2015-2021 for fatal ODs and EMS responses, respectively. Similar results were observed for counties classified at the lowest levels of OUD treatment availability compared to counties classified at the highest levels of availability.
Conclusion: Rural counties and counties with the lowest levels of treatment availability experienced significant increases in opioid-related ODs over short periods of time. Decision makers should ensure under-resourced counties have adequate support to identify and respond to rapid changes in the opioid crisis.
