The Massachusetts Health Policy Commission (HPC) tracks the impact of opioid use on the use of health care services in the Commonwealth, complementing regular data collection by the Massachusetts Department of Public Health (DPH) and federal agencies that enable analysis of pertinent epidemiological trends. Like many states across the country, Massachusetts continues to experience high rates of opioid-related morbidity and mortality. This issue of HPC DataPoints examines the variation in opioid-related emergency department (ED) utilization in Massachusetts by zip code, as an accompaniment to the HPC’s recently released chartpack, Opioid-Related Acute Hospital Utilization in Massachusetts. The HPC highlighted the increase in opioid-related hospital (ED and inpatient) discharges in Massachusetts between 2011 and 2015 in a previous DataPoints issue. This latest issue incorporates data through 2017.
The maps below reflect opioid-related ED utilization in the years 2012, 2016, and 2017 by the primary care service area (PCSA) of patients’ home zip codes.  The color-coding in the map indicates the range of the rate of opioid-related ED visits per 100,000 in the PCSA in that year. Hover over an area on the map to view the actual rate per 100,000 and the percent change across years. 
Figure 1 below shows considerable geographic variation in the rate of opioid-related ED utilization in 2017.
As shown in Figure 1 above, in 2017, ten PCSAs in Massachusetts had at least 750 opioid-related ED visits per 100,000 people. In contrast, there were no such areas in 2012, as shown in Figure 2 below.
Despite the trend toward higher rates of opioid-related ED visits from 2012 (Figure 2) to 2017 (Figure 1) in most service areas of the Commonwealth, the rate of opioid-related ED visits declined across many geographic areas between 2016 (rates shown in Figure 3 below) and 2017. From 2016 to 2017, 28 service areas experienced a decrease of more than 20% in the rate of opioid-related ED visits, while only two service areas saw an increase of more than 20%.
The source of data for this analysis is the Massachusetts Center for Health Information and Analysis Emergency Department Discharge Database for the years 2012, 2016, and 2017. For purposes of this analysis, opioid-related ED visits are only those visits for which either the primary or secondary diagnosis was opioid-related and did not result in hospitalization at that facility. A complete description of the methodology, including the codes used to identify opioid-related discharges, can be found in Opioid-Related Acute Hospital Utilization in Massachusetts.