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Drug overdose deaths have quadrupled in the past 20 years

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Published Sep. 13, 2023, 11:18 a.m. ET

The US is now experiencing its greatest overall rates of death in more than a century — and it’s being fueled by a sharp rise in drug overdoses.

Experts from Florida Atlantic University analyzed trends in US drug overdose deaths, and discovered that the rates of those deaths spiked 4.4 times from 1999 to 2020.

In 1999, there were 6.9 overdose deaths per 100,000 deaths. That number jumped to 30 overdose deaths per 100,000 — more than quadrupling — by 2020.

“Death is inevitable, but premature death is not,” Dr. Charles H. Hennekens of the FAU Schmidt College of Medicine said in a news release.

“Public health authorities should … treat patients who have drug use disorders in the same way as patients who have a serious chronic disease to avoid premature death,” Hennekens added.

The researchers point to a 1986 World Health Organization statement that pain treatment is a universal right. Following that, pain treatment guidelines for diseases like cancer were developed to include the use of opioids.

And soon thereafter, OxyContin — oxycodone hydrochloride, a highly addictive opioid — was approved for the management of pain, paving the way for widespread prescription and abuse of opioids.

Overdose deaths in the US spiked after the introduction of OxyContin, a highly addictive opioid.
Overdose deaths in the US spiked after the introduction of OxyContin, a highly addictive opioid. Helayne Seidman

Purdue Pharma, the makers of OxyContin, has been hit with massive fines and a tsunami of lawsuits for allegedly misleading the public and government officials on the addictive nature of OxyContin. The company is currently in Chapter 11 bankruptcy.

When analyzing their data, gleaned from the Centers for Disease Control and Prevention, FAU researchers identified several trends.

White Americans, Alaskan Natives and Native Americans have experienced the greatest increases in overdose deaths by race. And the Midwest and rural areas have been affected more than other regions.

From 1999 to 2004, Appalachia — particularly West Virginia — and the Southwest had the highest death rates from opioids.

Over the next several years, mortality rates in these regions increased further, while new hot spots emerged in states such as Florida. From 2011 to 2016, hot spots expanded in Appalachia and the Southwest, but disappeared in Florida due to that state’s restrictions on opioid prescriptions.

Fentanyl is now a major cause of drug overdose, especially in its illegal "street" forms.
The synthetic opioid fentanyl — which is 50 times stronger than heroin, according to the Centers for Disease Control and Prevention— is now a major cause of drug overdose, especially in its illegal “street” forms. J.C. Rice

The study, published in the American Journal of Medicine, also revealed that from 2014 to 2018, fentanyl deaths increased throughout the US.

Fentanyl has more than 50 times the potency of heroin and 100 times that of morphine. A synthetic opioid, the drug is now a major cause of drug overdose, especially in its illegal “street” forms.

“To reduce risks of overdose, addiction care should be integrated into the practice of all health care providers regardless of specialty, and training in this area should be further incorporated into medical education,” said study co-author Dr. Allison Ferris.

“We believe that guidelines are necessary … however, health care providers should make individual clinical decisions for each patient and policy makers for the health of the general public,” Ferris added.