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Deaths from opioids continue to rise

Published: Tuesday, Feb. 26, 2013 7:30 a.m. CDT

MILWAUKEE — Continuing a trend that began more than a decade ago, 16,651 people died of overdoses involving prescription narcotic painkillers in 2010, the most recent year that data were available, according to researchers with the U.S. Centers for Disease Control and Prevention.

In 1999, there were 4,030 such deaths involving opioids.

“This analysis confirms the predominant role opioid analgesics play in pharmaceutical overdose deaths, either alone or in combination with other drugs,” CDC researchers wrote in a report in JAMA, the Journal of the American Medical Association.

Given the growing number of patients with chronic pain who are getting opioids, the increasing number of overdose deaths is not surprising, said Stephen Abram, a pain specialist at the Medical College of Wisconsin.

Abram said there are a variety of reasons for the deaths, including prescribing doses that are too high; patients taking more than is prescribed; recreational use of illicitly obtained drugs; and a mixture of opioids and other prescription drugs.

People have been misinformed about the safety and effectiveness of opioids for treating chronic pain, said Michael Von Korff, a Seattle health researcher and member of Physicians for Responsible Opioid Prescribing.

“We won’t see a turnaround in the appalling rates of prescription opioid overdose and addiction until prescribing becomes much more selective and cautious,” Von Korff said.

The CDC analysis indicated that 82 percent of the 2010 opioid deaths were unintentional. Another 8 percent were undetermined and 9 percent were suicides.

In addition to the overdose deaths, there were 425,000 emergency department visits for misuse or abuse of opioids, including overdoses, up from 166,338 in 2004, said Chris Jones, a CDC researcher and lead author of the paper.

The deaths and emergency room visits follow a fourfold increase in opioid sales since 1999, Jones noted.

The new report also provided a more detailed analysis of the role of other prescription drugs that were used along with opioids.

For instance, among the opioid deaths, 30 percent of the users also had taken a sedative known as benzodiazepine and 13 percent had taken an antidepressant.

Jones noted that drugs such as benzodiazepines often are co-prescribed to opioid users, especially by clinics known as pill mills.

“They certainly have synergistic effects in terms of the high they give people,” he said.

He said pain and depression often occur together, which is why many people who die of an opioid overdose also had been taking an antidepressant.

 

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