Comparative Biostatistical Analysis of Regional Drug Overdose Death Rates During National Drug Control Strategy Implementation
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Date
2022-04
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Abstract
Prior to 2010, the U.S. Department of Health and Human Services estimated that drug abuse cost the United States more than $151 billion annually in lost productivity, healthcare, and criminal justice costs. In an effort to redefine and treat drug addiction with an emphasis on treatment as opposed to incarceration, the Obama Administration implemented a six-year science-based drug policy reform plan, beginning in 2010, that contained more than 100 specific reforms. This study examines the annual and regional changes in rates of drug overdose deaths in the U.S. during the six years of active policy implementation and the three years following. Using the R software, two-tailed 2-sample proportion tests were performed to determine statistically significant differences in death rates under various parameters, including geographic region and population demographics. Annual death rates in Ohio specifically were compared to states in other regions of the country. A series of pairwise death rate comparisons was compiled to determine trends in efficacy of the drug reforms among different subgroups of the population. During the active implementation period, 72.4% of the pairwise comparisons demonstrated a significant difference in death rate from Ohio. Collectively, the Northeastern states yielded the greatest proportion of insignificant results during the active implementation period (27.6%). During the inactive implementation period, 76.4% of the pairwise comparisons demonstrated a significant difference from Ohio, with the greatest proportion of such being seen in other Midwestern states. 67.3% of all significant results indicated the death rate was higher in Ohio than its compared state for a given year in the nine-year period. The results suggest that the drug reforms may not have been implemented as timely or effectively in Ohio as other states within the Midwest and other regions in the country. The relatively high yield of significant differences of death rates during both the active and inactive reform periods may be indicative of regional disparities that prevented the policy from being implemented everywhere to the same extent. Further research needs to be conducted to understand the state-level barriers that prevented drug abuse mitigation in Ohio during the study period.
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Biostatistics, Drug Overdose, National Drug Control Strategy, Obama, R Statistical Software, Statistics