Opioids are in the news quite often as of late as the ongoing opioid epidemic worsens. Each day, dozens of opiate users in America lose their lives due to intentional and inadvertent overdoses. Many more are hospitalized for near-fatal overdoses.
As harrowing as the opioid epidemic might be, researchers do not want all of the attention to fall upon prescription and illegal opioids. Indeed, studies show drug overdose deaths for essentially all major narcotics — cocaine, heroin, amphetamines, etc. — have been rising dramatically across the last four decades. While it is true that some drug overdose deaths have declined, like methadone, the overall statistic when all possible narcotics are considered has sharply risen.
What is noteworthy is that methadone overdoses fell after Medicaid took it off its “prescribed drug” lists for patients. On the other hand, prescription opioids have fallen behind synthetic “street” opioids like fentanyl in terms of causing the most deaths. This can be interpreted as a positive sign, as the campaign to curb prescription opioids seems to be working.
Sub-Epidemics Spread Across the Country
University of Pittsburgh Graduate School of Public Health researchers noticed a trend of “sub-epidemics” seemingly traveling from region to region, state to state. According to their findings, a pocket of overdose deaths will appear in one area, caused mainly by one type of drug. The use in that area will go down in a few short years, but a similar event will occur elsewhere, sometimes in a predictable path. This indicates that drug trafficking may be shifting in search of adjacent markets. Or, sub-epidemics may be so extreme that all users in a region are passing away, or hospitalized or entering rehabilitation centers due to “close calls.”
However, the authors of the research paper admitted that the situation and its dynamics are “very complicated.” At a cursory glance, the data is interesting, but to be truly useful, further studies using more variables will be needed.
Example of variables and demographics studied and cataloged:
- Men aged in their late 30s were the most likely to die due to heroin overdose, and exhibited a fatality rate about 300% the same age group among women.
- Men and women are about as equally likely to die due to prescription opioid overdose, with only a marginal increase in men aged between 20 and 40.
- Fatal heroin overdoses are more likely to occur in urban environments, but prescription opioid overdose deaths were more likely to occur in rural areas.
- From 2003 to 2017, cocaine overdose deaths rose, declined, and rose again, mirroring the amount of acreage in Columbia dedicated to coca cultivation.
(For more information about drug overdose death patterns and recent studies, you can click here to view a full article from The Wall Street Journal. You may need a subscription to view.)
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Dr. Greg Gale has been practicing and providing leadership in the field of psychiatry, substance use, and integrated care in the Phoenix metropolitan area for over 11 years. He joins us from his role as a national medical director overseeing behavioral health, substance use, and integrated care services for Humana Behavioral Health. Previously, he was CMO and VP of Clinical Services at Partners in Recovery, a not-for-profit behavioral health and substance use service organization, which operates five clinics throughout Maricopa County.