The Effect of Disasters on Drug-Related Mortality in the U.S., 2000-2023

Michael Vuolo , The Ohio State University
Taylor Jun, The Ohio State University
Smitha Rao, The Ohio State University
Alan Davis, The Ohio State University
Brian Kelly, Indiana University

Drug-related morbidity, mortality, and dependence have increased exponentially in the U.S. over the past four decades. Over the same period, the occurrence of disasters and extreme weather events also increased. Guided by a Big Events theoretical perspective, we examined the degree to which these two increasing trends, drug-related mortality and disasters, are related to identify how drug mortality may be exacerbated in communities that experience disasters. We used monthly death counts from 2000-2023 at the county level from the CDC’s restricted access mortality files, combined with a novel Federal Emergency Management Agency (FEMA) Disaster Declaration dataset that contains all officially declared disasters. We examined outcomes for drug overdose mortality, mortality from specific drug classes, and psychotropic drug-implicated deaths (drugs as a contributing cause, but not main cause). We analyzed counts using negative binomial models that include a year fixed effect, a population exposure offset, and adjustments for repeated measures and consider separate models for both population-average effects and within-county fixed effects. For the latter, in a given county, compared to months within no disaster declaration, deaths were 3.9%, 10.0%, and 4.9% higher for opioids, cocaine, and psychostimulants, respectively, in months with a disaster declaration (p<.001). Drug-implicated deaths were 4.6% higher (p<.001). We find considerable evidence that disasters affect drug-related mortality, measured from both overdoses and psychotropic drug-implicated deaths. Thus, disasters appear to contribute to an escalation in drug-related mortality, and there is a need to enhance resources and support for people who use drugs when disasters occur.

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 Presented in Session P6. Health, Mortality, and Ageing 2