Table 3

Multilevel models of patient and county-level main effects predicting overdose outcomes

Conditional effectsB (SE)Repeat non-fatal overdose
n=24 031		Drug-related death
n=23 463		Any death
n=24 031
ORCIP valueB (SE)ORCIP valueB (SE)ORCIP value
Between-patient (L1)           
 Race (White)−0.30 (0.09)0.74(0.54 to 1.00)0.001−0.37 (0.20)0.69(0.36 to 1.34)0.066−0.21 (0.12)0.81(0.55 to 1.19)0.072
 Sex (male)−0.15 (0.04)0.86(0.75 to 1.00)<0.001−0.14 (0.09)0.86(0.64 to 1.16)0.104−0.09 (0.06)0.92(0.76 to 1.11)0.128
 25–34 (15–24)0.01 (0.06)1.01(0.84 to 1.22)0.8310.18 (0.13)1.20(0.79 to 1.83)0.1490.24 (0.12)1.27(0.84 to 1.90)0.054
 35–44 (15–24)−0.28 (0.07)0.75(0.60 to 0.94)<0.001−0.002 (0.14)1.00(0.62 to 1.60)0.9890.40 (0.13)1.49(0.97 to 2.29)0.002
 45–54 (15–24)−0.51 (0.08)0.60(0.46 to 0.77)<0.0010.14 (0.15)1.15(0.70 to 1.91)0.3571.28 (0.13)3.62(2.39 to 5.47)<0.001
 55–64 (15–24)−0.56 (0.09)0.60(0.43 to 0.76)<0.001−0.54 (0.19)0.58(0.31 to 1.10)0.0051.66 (0.12)5.24(3.47 to 7.92)<0.001
 65–74 (15–24)−1.30 (0.15)0.27(0.17 to 0.44)<0.001−2.94 (0.71)0.05(<0.01 to 0.54)<0.0012.15 (0.13)8.62(5.54 to 13.41)<0.001
 75–84 (15–24)−1.55 (0.21)0.21(0.11 to 0.42)<0.001−2.23 (0.58)0.11(0.02 to 0.73)<0.0012.64 (0.14)13.97(8.72 to 22.37)<0.001
 85 plus (15–24)−2.13 (0.34)0.12(0.04 to 0.36)<0.001––––3.08 (0.16)21.69(12.97 to 36.26)<0.001
 Time at risk<0.01 (<0.01)1.00(1.00 to 1.00)<0.001−0.003 (<0.001)1.00(1.00 to 1.00)<0.001−0.003 (<0.01)1.00(1.00 to 1.00)<0.001
 Repeat non-fatal overdose (no)–   1.30 (0.10)3.68(2.62 to 5.17)<0.0011.03 (0.09)2.81(2.11 to 3.73)<0.001
Between-county (L2)           
 Opioid prescribing rate−0.01 (0.08)0.99(0.84 to 1.16)0.8600.08 (0.09)1.08(0.91 to 1.30)0.375−0.08 (0.08)0.92(0.79 to 1.09)0.338
 Medical doctor rate−0.07 (0.09)0.93(0.77 to 1.12)0.467−0.05 (0.11)0.95(0.77 to 1.17)0.626−0.05 (0.09)0.95(0.79 to 1.14)0.593
 Rural (urban)0.02 (0.18)1.02(0.72 to 1.45)0.9190.21 (0.22)1.24(0.80 to 1.91)0.3320.14 (0.17)1.15(0.82 to 1.61)0.415
 Percentage Black0.07 (0.09)1.06(0.88 to 1.27)0.5490.10 (0.10)1.11(0.91 to 1.35)0.292−0.03 (0.09)0.98(0.82 to 1.16)0.790
 Percentage Hispanic−0.06 (0.09)0.94(0.79 to 1.12)0.486−0.10 (0.10)0.91(0.74 to 1.11)0.343−0.01 (0.08)0.99(0.84 to 1.17)0.790
 Percentage male−0.10 (0.08)0.90(0.77 to 1.06)0.207−0.07 (0.10)0.94(0.77 to 1.14)0.519−0.05 (0.08)0.95(0.82 to 1.11)0.538
 Percentage over 65−0.03 (0.10)0.97(0.80 to 1.17)0.735−0.03 (0.11)0.97(0.77 to 1.21)0.7580.08 (0.09)1.09(0.90 to 1.31)0.375
 Poverty rate−0.16 (0.10)0.86(0.71 to 1.03)0.108−0.27 (0.11)0.76(0.62 to 0.95)0.0160.08 (0.09)1.09(0.91 to 1.30)0.360
 Percentage < high school education−0.01 (0.09)0.99(0.83 to 1.18)0.918−0.09 (0.11)0.91(0.72 to 1.14)0.4030.11 (0.08)1.12(0.95 to 1.32)0.168
 Unemployment0.15 (0.11)1.16(0.93 to 1.44)0.1750.19 (0.13)1.21(0.93 to 1.58)0.159−0.17 (0.10)0.84(0.68 to 1.03)0.092
 Halfway house provider rate0.17 (0.08)1.18(1.01 to 1.38)0.0360.25 (0.08)1.28(1.10 to 1.49)0.0020.21 (0.07)1.23(1.06 to 1.42)0.006
 Buprenorphine provider rate−0.03 (0.09)0.97(0.81 to 1.16)0.708−0.18 (0.10)0.83(0.68 to 1.02)0.077−0.20 (0.09)0.82(0.68 to 0.97)0.024
 Naltrexone provider rate0.07 (0.08)1.07(0.91 to 1.26)0.3820.25 (0.09)1.28(1.07 to 1.54)0.0090.18 (0.08)1.20(1.03 to 1.39)0.021
Random effects           
 Between-county residual variability0.30 (0.06)––<0.0010.20 (0.08)––0.0070.25 (0.06)––<0.001
 Between-patient residual variability0.97 (0.01)––<0.0010.97 (0.01)––<0.0011.16 (0.01)––<0.001

  • CI refers to 99.9% confidence interval for L1 effects and 95% confidence interval for L2 effects. To facilitate cross-variable comparison, L2 coefficients are standardised. For categorical variables, reference categories are listed in parentheses. For fatal overdose, adults aged 85 plus were removed from final model due to no instances of fatal overdose in that age group

  • L1, level 1; L2, level 2.