Journal Article

Quantifying the Epidemic of Prescription Opioid Overdose Deaths

Seth, Puja, Haegerich, Tamara M., Rudd, Rose A., Noonan, Rita K.

2018

Overview

The increases were strongly correlated with increases in synthetic opioid deaths but not with pharmaceutical fentanyl prescribing rates, suggesting that the increases were largely due to IMF.3 In a recent report, fentanyl was detected in at least half of the opioid overdose deaths from July to December 2016 in 7 of the 10 states examined.4 Traditionally, the Centers for Disease Control and Prevention (CDC) and others have included synthetic opioid deaths in estimates of \"prescription\" opioid deaths. Only 4.9% bought opioids from a drug dealer or stranger, and 5.6% reported obtaining them by stealing from a doctor's office, clinic, hospital, or pharmacy or in some other way.5 The National Vital Statistics System (NVSS) multiple causeof-death mortality files record drug overdose deaths, which are identified with the International Classification of Diseases, 10th Revision (1CD-10; Geneva, Switzerland: World Health Organization; 1992), according to the underlying cause-of-death codes X40 to X44 (unintentional), X60 to X64 (suicide), X85 (homicide), or Y10 to Y14 (undetermined intent). Death rates under both measures remain alarmingly high. Because of the increasing evidence that deaths involving synthetic opioids are likely a result of IMF, this more conservative approach likely provides a relatively more accurate number of prescription opioid- involved deaths, even though it excludes synthetic opioids that may have been pharmaceutically manufactured and prescribed. Advances in surveillance, such as the CDC National Center for Injury Prevention and Control's State Unintentional Drug Overdose Reporting System, which currently funds 32 states and Washington, DC, allow for data abstraction from preliminary death certificates and medical examiner or coroner reports on unintentional and undetermined opioid overdose deaths, with detailed data from death scene investigations and toxicology testing.

• Publisher: American Public Health Association
• Subject: AJPH Surveillance / Classification / Death certificates / Deaths / Disease control / Disease prevention / Drug overdose / Drug Overdose - mortality / Drugs / Editorials / Epidemics / Epidemics - statistics & numerical data / Epidemiology / Fentanyl / Government / Heroin / Homicide / Humans / Injury prevention / Law enforcement / Methadone / Mortality / Mortality rates / Narcotics / Opioid-Related Disorders - mortality / Opioids / Overdose / Pharmaceuticals / Pharmacists / Prescription Drug Misuse - mortality / Prescription drugs / Prevention / Public health / Suicide / Surveillance / Toxicology / United States - epidemiology / Vital statistics