mortality

Opioid Involvement in Deaths in the US Attributed to Drug Overdose, 2016

According to the Centers for Disease Control, in 2016, there were 63,632 drug overdose deaths in the United States. The CDC further estimates that of those, 42,249 deaths involved any opioid. The CDC further reports that in 2016, 15,469 deaths involved heroin; 14,487 deaths involved natural and semi-synthetic opioids; 3,373 deaths involved methadone; and 19,413 deaths involved synthetic opioids other than methadone, a category which includes fentanyl.

Deaths in 2016 in the US Attributed to Drug Overdose

"• In 2016, there were more than 63,600 drug overdose deaths in the United States.
"• The age-adjusted rate of drug overdose deaths in 2016 (19.8 per 100,000) was 21% higher than the rate in 2015 (16.3).
"• Among persons aged 15 and over, adults aged 25–34, 35–44, and 45–54 had the highest rates of drug overdose deaths in 2016 at around 35 per 100,000.
"• West Virginia (52.0 per 100,000), Ohio (39.1), New Hampshire (39.0), the District of Columbia (38.8), and Pennsylvania (37.9) had the highest observed age-adjusted drug overdose death rates in 2016.

Estimated Economic Impact of Illegal Opioid Use and Opioid-Related Overdose Deaths

The White House Council of Economic Advisers released its analysis of the economic costs of illegal opioid use, related overdoses, and overdose mortality in November 2017. It reported a dramatically higher estimate than previous analyses, largely due to a change in methodology. Previous analyses had used a person's estimated lifetime earnings to place a dollar value on that person's life.

Provisional Counts of Overdose Deaths Can Be Misleading

The federal Centers for Disease Control reported on December 21, 2017, that there had been a total of 63,600 deaths attributed to drug overdose in the US in 2016. Based on data available for analysis on Oct. 1, 2017, the CDC's provisional count of drug overdose deaths in the US for the 12-month period ending in December 2016 had been 71,135. The difference is attributed to data quality: provisional counts are by definition incomplete, which means they can be misleading.

Factors That May Skew Estimates of Overdose Deaths Attributed to Specific Drugs, Particularly Opioids

"First, factors related to death investigation might affect rate estimates involving specific drugs. At autopsy, the substances tested for, and circumstances under which tests are performed to determine which drugs are present, might vary by jurisdiction and over time. Second, the percentage of deaths with specific drugs identified on the death certificate varies by jurisdiction and over time. Nationally, 19% (in 2014) and 17% (in 2015) of drug overdose death certificates did not include the specific types of drugs involved.

Deaths from Drug Overdose in the United States

"During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. There has been progress in preventing methadone deaths, and death rates declined by 9.1%. However, rates of deaths involving other opioids, specifically heroin and synthetic opioids other than methadone (likely driven primarily by illicitly manufactured fentanyl) (2,3), increased sharply overall and across many states."

Alcohol as a Factor in Overdose Deaths Attributed to Other Drugs in the US

"In 2014, alcohols, including ethanol and isopropyl alcohol, were involved in 15% of all drug overdose deaths and 17% of the drug overdose deaths that mentioned involvement of at least one specific drug. Table E shows the frequency of alcohol involvement among drug overdose deaths involving specific drugs.
"• Alcohol involvement was mentioned in 12%–22% of the drug overdose deaths involving fentanyl, heroin, hydrocodone, morphine, oxycodone, alprazolam, diazepam, or cocaine.

Key Factors Underlying Increasing Rates of Heroin Use and Opioid Overdose in the US

"A key factor underlying the recent increases in rates of heroin use and overdose may be the low cost and high purity of heroin.45,46 The price in retail purchases has been lower than $600 per pure gram every year since 2001, with costs of $465 in 2012 and $552 in 2002, as compared with $1237 in 1992 and $2690 in 1982.45 A recent study showed that each $100 decrease in the price per pure gram of heroin resulted in a 2.9% increase in the number of hospitalizations for heroin overdose.46"

Estimated Drug-Induced Mortality in the US, by Gender and Race/Ethnicity

"In 2014, a total of 49,714 persons died of drug-induced causes in the United States (Tables 10, 12, and 13). This category includes deaths from poisoning and medical conditions caused by use of legal or illegal drugs, as well as deaths from poisoning due to medically prescribed and other drugs. It excludes unintentional injuries, homicides, and other causes indirectly related to drug use, as well as newborn deaths due to the mother’s drug use.

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