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Cocaine- and opiate-related fatal overdose in New York City, 1990–2000

Kyle T Bernstein1*, Angela Bucciarelli2, Tinka Markham Piper2, Charles Gross3, Ken Tardiff3 and Sandro Galea45

Author Affiliations

1 Department of Emergency Medicine, School of Medicine, New York University. 462 First Ave, 3rd Floor, Room A345, NY, NY 10003. USA

2 Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Ave, NY, NY 10029, USA

3 Department of Psychiatry, Weill Medical College, Cornell University, 525 E. 68th St, NY, NY 10021 USA

4 Department of Epidemiology, School of Public Health, University of Michigan. 1214 South University, Ann Arbor, Michigan, 48104-2548, USA

5 Department of Epidemiology, Columbia University Mailman School of Public Health. 722 168th St, New York, New York 10032, USA

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BMC Public Health 2007, 7:31  doi:10.1186/1471-2458-7-31

Published: 9 March 2007



In New York City (NYC), the annual mortality rate is higher for accidental drug overdoses than for homicides; cocaine and opiates are the drugs most frequently associated with drug overdose deaths. We assessed trends and correlates of cocaine- and opiate-related overdose deaths in NYC during 1990–2000.


Data were collected from the NYC Office of the Chief Medical Examiner (OCME) on all fatal drug overdoses involving cocaine and/or opiates that occurred between 1990–2000 (n = 8,774) and classified into three mutually exclusive groups (cocaine only; opiates-only; cocaine and opiates). Risk factors for accidental overdose were examined in the three groups and compared using multinomial logistic regression.


Overall, among decedents ages 15–64, 2,392 (27.3%) were attributed to cocaine only and 2,825 (32.2%) were attributed to opiates-only. During the interval studied, the percentage of drug overdose deaths attributed to cocaine only fell from 29.2% to 23.6% while the percentage of overdose deaths attributed to opiates-only rose from 30.6% to 40.1%. Compared to New Yorkers who fatally overdosed from opiates-only, fatal overdose attributed to cocaine-only was associated with being male (OR = 0.71, 95% CI 0.62–0.82), Black (OR = 4.73, 95% CI 4.08–5.49) or Hispanic (OR = 1.51, 95% CI 1.29–1.76), an overdose outside of a residence or building (OR = 1.34, 95% CI 1.06–1.68), having alcohol detected at autopsy (OR = 0.50, 95% CI 0.44–0.56) and older age (55–64) (OR = 2.53 95% CI 1.70–3.75)).


As interventions to prevent fatal overdose become more targeted and drug specific, understanding the different populations at risk for different drug-related overdoses will become more critical.