Opioid-Involved Overdose Vulnerability in Wyoming: Measuring Risk in a Rural Environment

Abstract

Background

Between 2009 and 2019 opioid-involved fatal overdose rates increased by 45% and the average opioid dispensing rate in Wyoming was higher than the national average. The opioid crisis is shaped by a complex set of socioeconomic, geopolitical, and health-related variables. We conducted a vulnerability assessment to identify Wyoming counties at higher risk of opioid-related harm, factors associated with this risk, and areas in need of overdose treatment access to inform priority responses.

Methods

We compiled 2016 to 2018 county-level aggregated and de-identified data. We created risk maps and ran spatial analyses in a geographic information system to depict the spatial distribution of overdose-related measures. We used addresses of opioid treatment programs and buprenorphine providers to develop drive-time maps and ran 2-step floating catchment area analyses to measure accessibility to treatment. We used a straightforward and replicable weighted ranks approach to calculate final county vulnerability scores and rankings from most to least vulnerable.

Findings

We found Hot Springs, Carbon, Natrona, Fremont, and Sweetwater Counties to be most vulnerable to opioid-involved overdose fatalities. Opioid prescribing rates were highest in Hot Springs County (97 per 100 persons), almost two times the national average (51 per 100 persons). Statewide, there were over 90 buprenorphine-waivered providers, however accessibility to these clinicians was limited to urban centers. Most individuals lived further than a four-hour round-trip drive to the nearest methadone treatment program.

Conclusions

Identifying Wyoming counties with high opioid overdose vulnerabilities and limited access to overdose treatment can inform public health and harm reduction responses.

Keywords:

• Opioids
• substance use
• Wyoming
• vulnerability
• spatial epidemiology

Acknowledgments

The authors wish to acknowledge Debi Anderson, CPM, Wyoming Department of Health, for her assistance with this assessment.

Financial disclosure statement

The Council of State and Territorial Epidemiologists (CSTE) provided technical assistance to this Wyoming Opioid Overdose Vulnerability Assessment through Tufts University. This project is funded through the Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control (NCIPC) and supported by Cooperative Agreement number CDC-RFA-OT18-1804: Technical Assistance for Response to Public Health or Healthcare Crises.

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

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