Revised March 2019
Opioid-Related Overdose Deaths
In 2017, there were 1,176 reported opioid-involved deaths in Indiana—a rate of 18.8 deaths per 100,000 persons, compared to the average national rate of 14.6 deaths per 100,000 persons.
From 1999 through 2012, prescription opioids were the underlying cause of drug overdose deaths. By 2017, the main contributor of opioid-involved deaths shifted to synthetic opioids other than methadone (mainly fentanyl) with 649 reported cases–a nearly twentyfold increase from the 34 deaths reported in 2013 (Figure 1). The number of opioid deaths involving heroin doubled in the same 4-year period from 160 deaths to 327 deaths. Deaths involving prescription opioids also rose from 141 deaths in 2013 to 425 deaths in 2017.
Opioid Pain Reliever Prescriptions
In 2017, Indiana providers wrote 74.2 opioid prescriptions for every 100 persons (Figure 2) compared to the average U.S. rate of 58.7 prescriptions (CDC). Only nine states had a higher opioid prescribing rate than Indiana. However, the 2017 prescribing rate represents more than a 31 percent decrease from a peak of 107.1 opioid prescriptions per 100 persons in 2010.
Despite this decrease, the rate of overdose deaths involving opioid prescriptions tripled from 2.2 deaths per 100,000 persons from 1999 to 6.6 deaths per 100,000 persons in 2017 (Figure 2).
Neonatal Abstinence Syndrome (NAS)
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOWS births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).
To date, there is no standard in NAS/NOWS provider and hospital coding practices (CDC). As a result, the trends and rates reported by states varies. In 2017, Indiana expanded a NAS/NOWS program in which nearly 3,000 babies were tested (via umbilical cords) across 21 hospitals. More than 425 babies, an estimated 14 percent, tested positive for opioids and 20 percent of all tests confirmed the presence of multiple substances (Indiana State Department of Health).
HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)
- U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among males, 6.3 percent (2,530) of new cases were transmitted via IDU or male-to-male contact and IDU. Among females, 2.3 percent (950) were transmitted via IDU (CDC).
- U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,4661) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
- State Incidence: Of the new HIV cases in 2016, 483 occurred in Indiana. Among males, 12.3 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 15.7 percent of new HIV cases were attributed to IDU (Figure 4) (AIDSVu).
- State Prevalence: In 2015, an estimated 10,741 persons were living with a diagnosed HIV infection in Indiana—a rate of 195 cases per 100,000 persons. Of those, 14.7 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 18.3 percent were living with HIV attributed to IDU (AIDSVu).
Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use1
- U.S. Incidence: In 2016, there were an estimated 41,200 new cases of acute HCV2 (CDC). Among case reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
- U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
- State Incidence: There were approximately 146 new cases of acute HCV (2.2 per 100,000 persons) reported in Indiana in 2016 (CDC).
- State Prevalence: In Indiana, there are an estimated 40,900 persons living with Hepatitis C (2013-2016 annual average), a rate of 820 cases per 100,000 persons (HepVu).
- Indiana State Department of Health, Overdose Prevention
- Centers for Disease Control and Prevention, Opioid Overdose
- Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
- Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.
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