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Ohio, like most of the United States, is in the midst of an opioid overdose epidemic. This dashboard presents a snapshot of how drug overdose, primarily due to abuse of opioid drugs, are impacting Butler County, Ohio.
In order to estimate the size of this impact, Hamilton County Public Health has developed this data tool to provide information on ED visits and 911 dispatches due to overdose. Overdoses here are defined as medical emergency due to the use of drugs of abuse, primarily opioids. Not all overdoses presented here involve opioids (the majority do) and not all overdoses result in death (the majority don't). ED visits here are defined as overdoses among Butler County residents treated in any Ohio hospital or certain hospital systems outside Ohio such as St. Elizabeth's in Kentucky. 911 dispatches are defined as dispatches to a location within Butler County due to an overdose incident.
ED Visits & 911 Dispatches Due to Overdose; Daily Counts with Alert Threshold
The following graphs depict the daily number of ED visits and 911 dispatches due to overdose over the past 30 days for Butler County, OH.
If the blue line (the count) equals or surpasses the red line (the threshold), Butler County is experiencing a statistically significant increase in overdoses. The threshold line is designed to detect sudden and sharp increases in overdose activity; more gradual increases may not be identified as statistically significant but are no less likely to represent a true increase in overdose activity.
Methods for calculating the threshold are detailed in the Data Notes section at the end of this report.
911 dispatch data is provided by the City of Middletown Police, West Chester Township Police, the City of Monroe, and the Butler County Sheriff (it does not include the City of Fairfield).
911 dispatches are updated on the report if available by 10 a.m. on the report date. Estimates are subject to change, especially in recent days.
Suspected Overdose Deaths
Below is the number of suspected overdose deaths occurring in Butler County, by week, so far in 2019. These numbers provided by the Butler County Coroner's Office are preliminary and may change when final death data are reported. In 2017, the Butler County Coroner's Office reported 232 overdose deaths. In 2018, a total of 164 overdose deaths were reported. The year-to-date (YTD) death charts are updated Mondays, on a weekly basis.
Data presented in this section includes individuals who report living in Butler County, Ohio over the date range specified (below) :
(Note: Default is the past 30 days)
The above figures reflect the number of individuals from Butler County that were seen in the Emergency Department (ED) and where they were seen.
Below is a map showing the number of ED visits among those living in Butler County by home ZIP code over the time period specified.
The demographic breakdown of the ED patients is as follows:
Data presented in this section includes individuals who were seen at a Butler County hospital, regardless of where the patient resided, over the date range specified (top of home location section):
(Note: Default is the past 30 days)
The above figures reflect the number of individuals who were seen at a Butler County hospital for overdose and where they reported living.
Below is a map showing the home ZIP code of patients to Butler County hospitals over the specified time period.
The demographic breakdown for patients seen at Butler County hospitals is as follows:
‘Overdose’ on this report refers to unintentional overdose of drugs of abuse, where an overdose is defined as a medical emergency due to an over-consumption of drugs. The term 'overdose' here does not necessarily imply death.
ED visit data are retrieved from the state's EpiCenter surveillance tool. Initially, all ED visits indicating 'drugs' as a reason for visit among Butler County residents or patients to Butler County hospitals are queried. Cases were included in analysis if the case notes for the patient included the term "overdose" or "OD." Where specified, traumatic injuries due to drugs caused by suicide attempts, adverse reactions to normal medications, or accidental overdose of over-the-counter or common drugs such as Tylenol or insulin were excluded from analysis. Instances where alcohol and/or marijuana were the sole drugs referenced are omitted as well. ZIP codes refer to the ZIP code of residence of the patient visiting the ED. Dates are defined as 6 a.m. of a day to 6 a.m. of the following day, which more accurately reflects drug use patterns than standard day intervals. For example, January 1st refers to the period of 6 a.m. on January 1st to 6 a.m. on January 2nd.
Data from the EpiCenter surveillance tool is subject to at least 2 limitations. First, case notes in the EpiCenter tool are limited and often do not include full details of ED visit, such as drug used or intent of use. As such, overdose estimates will include not just opioids, but potentially any drug. Second, case notes are recorded at patient intake and may change from a patient's initial examination to their final diagnosis.
911 dispatches refer to fire/EMS and law enforcement responses to 911 emergency calls related to drug overdose, in which a unit was dispatched. Call notes are reviewed and included/excluded using the same criteria as EpiCenter, adapted for the format of 911 dispatch call logs.
Deaths that are suspected to be due to overdose by the Butler County Coroner are counted in this report as suspected overdose deaths. The overdose classification is preliminary and estimates are subject to change as death data are processed and reported.
Alert thresholds are calculated as the 99th percentile of outcomes in a Poisson Distribution model where the past week's average of the relevant measure is used as the Poisson average.