Urban scaling of opioid analgesic sales in the United States.

Opioid misuse is a public health crisis in the United States. The origin of this crisis is associated with a sharp increase in opioid analgesic prescribing. We used the urban scaling framework to analyze opioid prescribing patterns in US commuting zones (CZs), i.e., groups of counties based on commu...

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Autores principales:	Pricila H Mullachery, Usama Bilal
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f18bee20587e41ce81465535b9df12c0
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spelling	oai:doaj.org-article:f18bee20587e41ce81465535b9df12c02021-12-02T20:19:19ZUrban scaling of opioid analgesic sales in the United States.1932-620310.1371/journal.pone.0258526https://doaj.org/article/f18bee20587e41ce81465535b9df12c02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258526https://doaj.org/toc/1932-6203Opioid misuse is a public health crisis in the United States. The origin of this crisis is associated with a sharp increase in opioid analgesic prescribing. We used the urban scaling framework to analyze opioid prescribing patterns in US commuting zones (CZs), i.e., groups of counties based on commuting patterns. The urban scaling framework postulates that a set of scaling relations can be used to predict health outcomes and behaviors in cities. We used data from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System (ARCOS) to calculate counts of oxycodone/hydrocodone pills distributed to 607 CZs in the continental US from 2006 to 2014. We estimated the scaling coefficient of opioid pill counts by regressing log(pills) on log(population) using a piecewise linear spline with a single knot at 82,363. Our results show that CZs with populations below the knot scaled superlinearly (β = 1.36), i.e., larger CZs had disproportionally larger pill counts compared to smaller CZs. On the other hand, CZs with populations above the knot scaled sublinearly (β = 0.92), i.e., larger CZs had disproportionally smaller pill counts compared to smaller CZs. This dual scaling pattern was consistent across US census regions. For CZs with population below the knot, the superlinear scaling of pills is consistent with the explanation that an increased number of successful matches between prescribers and users will lead to higher prescribing rates. The non-linear scaling behavior observed could be the result of a combination of factors, including stronger health care systems and prescribing regulation in largely populated commuting zones, as well as high availability of other opioids such as heroin in these commuting zones. Future research should explore potential mechanisms for the non-linearity of prescription opioid pills.Pricila H MullacheryUsama BilalPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258526 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Pricila H Mullachery Usama Bilal Urban scaling of opioid analgesic sales in the United States.
description	Opioid misuse is a public health crisis in the United States. The origin of this crisis is associated with a sharp increase in opioid analgesic prescribing. We used the urban scaling framework to analyze opioid prescribing patterns in US commuting zones (CZs), i.e., groups of counties based on commuting patterns. The urban scaling framework postulates that a set of scaling relations can be used to predict health outcomes and behaviors in cities. We used data from the Drug Enforcement Administration's Automated Reports and Consolidated Ordering System (ARCOS) to calculate counts of oxycodone/hydrocodone pills distributed to 607 CZs in the continental US from 2006 to 2014. We estimated the scaling coefficient of opioid pill counts by regressing log(pills) on log(population) using a piecewise linear spline with a single knot at 82,363. Our results show that CZs with populations below the knot scaled superlinearly (β = 1.36), i.e., larger CZs had disproportionally larger pill counts compared to smaller CZs. On the other hand, CZs with populations above the knot scaled sublinearly (β = 0.92), i.e., larger CZs had disproportionally smaller pill counts compared to smaller CZs. This dual scaling pattern was consistent across US census regions. For CZs with population below the knot, the superlinear scaling of pills is consistent with the explanation that an increased number of successful matches between prescribers and users will lead to higher prescribing rates. The non-linear scaling behavior observed could be the result of a combination of factors, including stronger health care systems and prescribing regulation in largely populated commuting zones, as well as high availability of other opioids such as heroin in these commuting zones. Future research should explore potential mechanisms for the non-linearity of prescription opioid pills.
format	article
author	Pricila H Mullachery Usama Bilal
author_facet	Pricila H Mullachery Usama Bilal
author_sort	Pricila H Mullachery
title	Urban scaling of opioid analgesic sales in the United States.
title_short	Urban scaling of opioid analgesic sales in the United States.
title_full	Urban scaling of opioid analgesic sales in the United States.
title_fullStr	Urban scaling of opioid analgesic sales in the United States.
title_full_unstemmed	Urban scaling of opioid analgesic sales in the United States.
title_sort	urban scaling of opioid analgesic sales in the united states.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f18bee20587e41ce81465535b9df12c0
work_keys_str_mv	AT pricilahmullachery urbanscalingofopioidanalgesicsalesintheunitedstates AT usamabilal urbanscalingofopioidanalgesicsalesintheunitedstates
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Urban scaling of opioid analgesic sales in the United States.

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