Opioid overdose death toll continues upward trend

By Dr. Ananya Mandal, MDAug 8 2017

Numbers rise from 2015

According to the National Center for Health Statistics report, the overdose deaths among the persons with drug abusers in 2016 is on an upward rise that has not stopped. These rising numbers are disheartening because the intensified efforts to curb these numbers are thus seemingly not working.

The report says that the numbers of these overdose deaths for the first nine months of 2016 were much higher than the first nine months of 2015 which was already an all-time high at 52,404! Of these fifty two thousand odd deaths, over 33,000 overdose deaths were due to use of opioid drugs. Opioids estimated to kill in overdose included not only illicit street drugs such as heroin and street fentanyl but also legal prescription drugs such as painkillers, the report finds.

The report broke down 2016 into three quarters and found that all the peak numbers of drug overdose deaths were 19.9 for every 100,000 people. In 2015 the highest such number was 16.7 in the same period. Comparing two years, the numbers were –

• 16.3 deaths for every 100,000 people in the first quarter of 2015 to 18.9 in the first quarter of 2016, and
• 16.2 deaths in the second quarter of 2015 to 19.3 in the second quarter of 2016.

US Centers for Disease Control and Prevention CDC report noted that the numbers were not significantly different in the first two quarters of both the years. CDC however makes its reports a year later.

Significant underestimation of the overdose epidemic

This latest report was substantiated by another report that was published earlier this week in the journal American Journal of Preventive Medicine. That report looked at overdose deaths due to opioids between 2008 and 2014. Reported death rates were directly calculated from death certificates and this was compared with the corrected rates that showed involvement of drugs. The analysis took place during 2016–2017.

The authors write that the epidemic of opioid overdose deaths has been underestimated by 24%. The underestimation is by 22% when heroin alone is considered, the researchers note. Researchers explain that this rise in the numbers is due to the increasing popularity of synthetic street opioids such as street fentanyl. Most of the overdose deaths due to these street drugs are missed as cause of death by medical examiners on the death certificates. Illicit fentanyl and other designer opioids like U-4770 – known as Pink, have risen in popularity over heroin and other standard opioids of abuse and have increased the numbers.

Largest underestimations were from Pennsylvania, Indiana, and Louisiana. Heroin mortality was understated in most states, with most from Pennsylvania, Indiana, New Jersey, Louisiana, and Alabama. This study is the first to quantify such underestimation of deaths due to opioids.

President Trump advised by the Opioid commission to begin action

With the alarming reports of rise in the overdose epidemic and the hitherto underestimated status of the numbers, President Trump's commission on the opioid epidemic has called for a declaration of national emergency last week. The commission is chaired by New Jersey Gov. Chris Christie who called for bold actions against this rising menace. Approximately 142 citizens die every day of this epidemic making it a major public health problem says the interim report. President Trump was set to meet with Health and Human Services Secretary Tom Price to discuss this opioid epidemic.