Opioid Mortality –Where is the Opioid Epidemic Now?

Updated: Feb 17

ZACHARY HERMAN, BS

ASIF ILYAS, MD, MBA, FACS


SUMMARY POINTS

  • Opioid mortality is defined as a death related to opioid use, be it prescription or illicit use.

  • Opioid related death rates are increasing most quickly among adults aged 25 to 44 years in the United States, and is the most common cause of accidental death in that age group.

  • In 2018, the states with the highest rates of death due to drug overdose were West Virginia (51.5 per 100,000), Delaware (43.8 per 100,000), Maryland (37.2 per 100,000), Pennsylvania (36.1 per 100,000), Ohio (35.9 per 100,000), and New Hampshire (35.8 per 100,000).

  • In 2019, drug overdose deaths in the United States rose 4.6% to 70,980, including 50,704 which were opioid specific.


ANALYSIS


Opioid mortality, or opioid-related death, is defined as any death in which a prescription or illicit opioid use contributed substantially to an individual's cause of death as determined by death certificates. Increased rates of opioid prescribing and the associated negative health consequences have emerged as leading public health problems in North America, particularly among young and middle-aged adults. The United States has emerged as one of the highest per capita opioid consuming countries in the world, and deaths related to opioid use have increased dramatically throughout the country. Importantly, opioid-related death rates are increasing most quickly among adults aged 25 to 44 years in the United States.


In 2018, Gomes et al. published a study on the burden of opioid related deaths in the United States. They found that between 2001 and 2016, the number of opioid-related deaths in the United States increased by 345%, from 9,489 to 42,245 deaths. By 2016, men accounted for 67.5% of all opioid-related deaths, and the median age at death was 40 years. The percentage of deaths attributable to opioids increased in a similar fashion. In 2001, 0.4% of deaths (1 in 255) were opioid-related, rising to 1.5% of deaths (1 in 65) by 2016, an increase of 292%. This burden was highest among adults aged 24 to 35 years. Figure 1 depicts the percentage of deaths contributed to opioid use by age group from the years 2001-2016. Overall, opioid- related deaths resulted in 1,681,359 years of life lost in the United States in 2016. Adults aged 25 to 34 years had 12.9 years of life lost and those aged 35 to 44 years had 9.9 years of life lost.


More recently, data has been published on opioid mortality in the years 2018 and 2019. In 2018, 67,367 drug overdose deaths occurred in the United States. The rate of overdose deaths decreased by 4.6% from 2017 (21.7 per 100,000) to 2018 (20.7 per 100,000). Opioids are currently the main driver of drug overdose deaths. Opioids were involved in 46,802 overdose deaths in 2018 (69.5% of all drug overdose deaths). Two out of three (67.0%) opioid-involved overdose deaths involve synthetic opioids. In 2018, the states with the highest rates of death due to drug overdose were West Virginia (51.5 per 100,000), Delaware (43.8 per 100,000), Maryland (37.2 per 100,000), Pennsylvania (36.1 per 100,000), Ohio (35.9 per 100,000), and New Hampshire (35.8 per 100,000).

According to recent data released in July of 2020 on drug overdose and opioid related deaths in 2019, drug overdose deaths in the United States rose 4.6% in 2019 to 70,980, including 50,704 involving opioids. Figure 2 shows the 12-month provisional number of drug opioid deaths by all opioids: natural, synthetic, semi-synthetic opioids, heroine, and methadone. Provisional counts for the 12-month ending periods are the number of deaths received and processed for the 12-month period ending in the month indicated. Thus, the amount of deaths related to all opioids increased in the year 2019 (50,704) by roughly 3,700 compared to the year 2018 (46,996).

As the data shows, mortality related to opioid use is still problematic and imposes an enormous health burden across the United States. Health care practitioners must continue to make efforts to control the opioid prescribing rate in attempt to decrease the mortality associated with the drug class.


REFERENCES


1. Gomes, T., Tadrous, M., Mamdani, M., Paterson, J. and Juurlink, D., 2018. The Burden of Opioid- Related Mortality in the United States. JAMA Network Open, 1(2), p.e180-e217.

2. 2018 Drug Overdose Death Rates | drug overdose | CDC injury center. Cdc.gov. https://www.cdc.gov/drugoverdose/data/statedeaths/drug-overdose-death-2018.html. Published May 27, 2020. Accessed August 31, 2020.

3. CDC: Drug overdose deaths up 4.6% in 2019 | AHA News. Aha.org. https://www.aha.org/news/headline/2020-07-16-cdc-drug-overdose-deaths-46-2019. Accessed August 31, 2020.






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