Magazine article Clinical Psychiatry News

Opioid Overdoses Quadrupled over Last Decade

Magazine article Clinical Psychiatry News

Opioid Overdoses Quadrupled over Last Decade

Article excerpt


Overdose deaths involving opioid pain relievers now exceed deaths from heroin and cocaine combined, according to a report from the Centers for Disease Control and Prevention.

Prescription drug overdoses have been increasing in the United States over the last decade, and by 2008 had reached 36,450 deaths - almost as many as from motor vehicle crashes (39,973). Opioid pain reliever (OPR) sales have also increased, "despite numerous warnings and recommendations over the past decade for voluntary education of providers about more cautious use of OPR[s]," said Dr. Leonard J. Paulozzi and his associates at the CDC's division of unintentional injury prevention.

During 1999-2008, overdose death rates, sales, and substance abuse treatment admissions related to OPRs increased in parallel, with the overdose death rate in 2008 nearly four times the rate in 1999. Sales of OPRs in 2010 were four times those in 1999. The substance abuse treatment admission rate in 2009 was almost six times the rate in 1999. By 2010, enough OPRs were sold each year to medicate every American adult with 5 mg of hydrocodone every 4 hours for 1 month, the researchers said.

The report used death rates based on the National Vital Statistics System multiple cause of death files, age adjusted to the 2000 U.S. Census population. Deaths were attributed to drug overdose in 2008 at a rate of 11,9/100,000 population. Among those, a particular drug was specified for 74.5%. Of those 27,153 deaths, prescription drugs were a factor in 73.8%. And of those 20,044, OPRs were involved in 73.8% (14,800). Drug overdose death rates were 6.5/100,000 population for all prescription drugs and 4.8/100,000 for OPRs, compared with 2.8/100,000 for illicit drugs, including heroin, cocaine, hallucinogens, and stimulants (MMWR 2011;60:1-6).

Overdose resulted in 830,652 years of potential life lost, a number comparable to that of motor vehicle crashes. Overdose deaths varied fivefold by state, ranging from 5.5/100,000 population in Nebraska to 27.0/100,000 in New Mexico.

Middle-aged whites were more likely to die of an OPR overdose, compared with other races and age groups. Deaths rates involving OPRs among non-Hispanic whites and Native Americans /Alaska Natives were three times higher than the rates for blacks and Hispanic whites. …

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