Dr. Paulozzi, MD, MPH, states, “The mortality rates from unintentional drug overdose have risen steadily since the early 1970s.” Since 2000, these rates have reached historic highs.
As of 2008, overdose death rates were between four and five times higher than those of the “black tar” heroin epidemic in the mid 1970s. Overdose death rates were also two times greater than the number of deaths that occurred from crack cocaine use in the early 1990s.
The Center for Disease Control and Prevention (CDC) confirms that drug overdose rates have dramatically increased since 1970. In 2007, 27,658 unintentional drug overdose deaths occurred in the United States.
The CDC further reports that drug overdose deaths were second only to motor vehicle crash deaths among leading causes of unintentional injury death in 2007 in the US. “Among deaths attributed to drugs, the most common drug categories are cocaine, heroin and a type of prescription drug called opioid painkillers,” states the CDC.
Explaining the Death Rate Increases
The CDC explains that opioids are synthetic versions of opium. Examples of opioids include oxycodone, hydrocone and methadone. While they are routinely prescribed to reduce pain, opioids can also suppress breathing to a fatal degree if taken in excess. The CDC reports a 10-fold increase has occurred in the medical use of opioid painkillers since 1990. This has resulted from a movement toward more aggressive pain management.
In 1997, two panels in the US introduced medical guidelines for the management of chronic pain. Doctors were thus encouraged to expand the use of opioid pain medications after alternative treatments proved insufficient. Since the guidelines were published, per capita retail purchases of the pain relievers oxycodone, hydrocodone and methadone have increased dramatically. In conjunction, rates of emergency room visits and deaths attributable to opioid overdoses have also increased.
The CDC has conducted analysis of overdose death rates in the US. The organization discovered in 2007 that the number of deaths involving opioid analgesics was 1.93 times the number involving cocaine and 5.38 times the number involving heroin. While deaths related to heroin use have remained mostly steady since 1999, those relative to opioid use have increased dramatically. Cocaine overdoses have also risen, but not at the staggering rate of opioid overdoses.
Opioids in Legal and Illegal Markets
A government-funded study revealed that patients who receive prescriptions for such drugs as OxyContin, Vicodin and methadone need to be regularly evaluated. Prescriptions for methadone have increased by more than 800 percent in the US since 1999, and deaths related to this medication have risen more than seven-fold.
Many researchers and healthcare professionals believe that opioid-related overdoses often occur among people who obtain the drugs by “doctor shopping.” This means they illegally receive prescriptions from multiple providers. The other end of this spectrum is the many people who purchase opioids illegally on the street. The CDC reports that opioids cause feelings of euphoria, and they are now widely available in illicit markets throughout the US.
The authors of a West Virginia study that reviewed unintentional overdose deaths provide this succinct message: “Clinicians have a critical role to play in preventing the diversion of prescription drugs. Clinicians and pharmacists need to counsel patients who are prescribed opioids, not only about the risk of overdose to themselves, but also about the risk to others with whom they might share their medication.”