Analisi spazio-temporale della crisi degli oppioidi in Inghilterra

Starting from the end of the Nineties, in the United States began a phenomenon which turned out to be a real epidemic and a national crisis in less than two decades, affecting public health as well as social and economic welfare. This phenomenon refers to the increasing number of people that make use or even die as a result of extended opioid assumption. Moreover, there is a strong correlation between the irresponsible and sometimes unregulated prescriptions of opioid-based pharmaceuticals and this alarming trend. In the last few years it was noticed a generalised increasing of the opioids also in the rest of the world. In Western and Central Europe, the opiate consumption trend has been increasing since 2013, with the increase being particularly marked in 2016. That is why there is an urgency of understanding if the epidemic of the USA may potentially spread also in other countries. The study focuses on opioid prescriptions between the August 2010 and the December 2017 over the English territory by the General Practices under the National Health Service. Five categories of different opioid-based pharmaceuticals is considered, according to the taxonomy provided by the British National Formulary: analgesics, cough suppressants, anti-motility drugs, anaesthetics and opioids used for dependence. After having computed an estimation of the drug prescription rate over some fixed time periods on spatial units (called Lower Super Output Area, where 1500 people dwell on average), it is made a spatio-temporal analysis by means of time series and the study of the distribution over the English territory of the prescription rates. If from the temporal analysis the overall increasing of the opioid drugs consumption is confirmed, on the other hand - despite the very fine granularity of the spatial units - clear and distinct areas of prescriptions are identified (at least for the most consumed categories of opioid drugs). Such regions are confirmed by introducing spatial autocorrelation in order to detect hotspots and coldspots, highlighting a noticeable difference between different areas. Consumption in the London region is very different from the other industrial big cities, where opioids use seems to be much greater, and there are some large rural areas were the prescriptions rate is considerably higher than the average of the country. In the end, some relationships between socio-economic factors and prescription rates are found. The variables considered which are related to health sphere, living and geographical environment are the most valuable, but also the education level is worth. Moreover, in this kind of considerations, it is seen that, since the territorial clusters of rate values are very defined, influencing prediction with spatiality improves performance of models considerably.