Drug overdose deaths higher among U.S. visitors to Florida than rest of U.S., researchers say

U.S. visitors who died in Florida to the state were 63% more likely to have died of a drug overdose than visitors from all other states during the first two decades of the 2000s, researchers found. They published their findings in the journal Injury prevention.

“Our research findings highlight a health risk not only to Florida but to Americans in general and the need for more legislation at the state and federal levels to address this problem,” said Ilan Shrira, author principal of the study and social psychologist. the psychology department at Penn State.

Shrira and study co-author Joshua Foster, a psychology professor at the University of South Alabama, examined more than 47 million death certificates of U.S. permanent residents who died between 2003 and 2020. The certificates were anonymized and indicated the county of residence. , county of death, and cause of death, allowing researchers to determine the number of drug poisoning deaths at the county level across the United States.

They used the data to calculate proportional mortality ratios, a measure traditionally used to determine whether a certain occupation has a higher proportion of deaths from a specific cause compared to the rest of the population. For example, federal data shows that firefighters are at greater risk of dying from cancer than the general population.

In this case, researchers looked at the proportion of drug overdose deaths among visitors to Florida compared to drug overdose deaths among visitors from all other states. They also studied Florida residents who died in the state, both inside and outside their home county.

Researchers found that compared to the rest of the country, visitors to Florida were on average 63 percent more likely to die from a drug overdose over an 18-year period. From 2014 to 2020, in Palm Beach County alone, this figure increased to 214% compared to all other counties in the United States.

Florida residents had a slightly elevated overdose death rate compared to the rest of the country over the 18-year period. Residents who died in their home county were 6.7% more likely to have died of a drug overdose, while those who died within the state but in a different county were 13% more likely to have died from a drug overdose. a drug overdose, according to researchers.

“About 15 to 20 percent of Americans die outside their home country,” Shrira said.

“Fewer Americans are dying outside their home state. Our methodology allowed us to look at people who resided outside of Florida but died in the state and narrow the cause of death to poisoning drug. And when you compare visitors to Florida and visitors from any other country. In another state, the proportion of deaths due to overdoses is much higher – 63% higher – among visitors to Florida per compared to all other people in the United States who died outside their home state.

Researchers identified two issues that may explain the high proportion of drug overdose deaths among visitors to the state. During the first decade of the 2000s, the state saw a rise in “pill mills,” or pain management clinics, that overprescribed opioid painkillers and circumvented regulations by operating as a commercial enterprise instead of accepting health insurance. Death rates peaked around that time before state legislation in 2010 and 2011 put an end to pill mills, Shrira said.

The second problem emerged in the second half of the 2010s, after the passage of the Affordable Care Act, which required insurance companies to cover drug treatment to combat the opioid epidemic, according to Shrira. Florida has had a thriving drug recovery community since the 1960s. However, recent expansion of insurance law has attracted some unscrupulous treatment providers into the industry, who have taken advantage of lucrative insurance reimbursements, but with little motivation to provide high-quality patient care, he said.

The number of treatment facilities in Florida increased from 617 in 2011 to 725 in 2019. Many of these centers, Shrira said, targeted out-of-state patients because their insurance plans had fewer restrictions that insurance plans available to Florida residents.

The exploitative practices kept patients in a treatment loop known as the “Florida Shuffle,” in which patients received treatment, entered a sober living home, and then relapsed, sending them back to the treatment center. The greater concentration of treatment centers in Palm Beach County could explain the high overdose death rates in those years, Shrira said.

“People seeking help for substance use disorder have been lured to Florida by deceptive marketing from people who may have no interest in helping them, exposing many “among them at increased risk of fatal overdose,” he said.

“Authorities have cracked down on some of these practices and made some high-profile arrests and prosecutions, but there are widespread reports that this continues to happen. Anyone in the United States who is considering traveling to enter a treatment clinic away from home should be very careful about the type of location they are actually going to and have an easy way to get home if necessary.