Tag: opioid overdoses

Guns, Germs, and Drugs Are Largely Responsible for the Decline in U.S. Life Expectancy

Mary Pat Campbell

Link: https://reason.com/2024/01/08/guns-germs-and-drugs-are-largely-responsible-for-the-decline-in-u-s-life-expectancy/

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The Post reported that some politicians pointed to the rising death toll from “lethal drug overdoses” as a significant factor in declining U.S. life expectancy. The Post did, however, acknowledge that drug deaths “are not solely responsible for the decline in life expectancy.” It is worth noting that opioid overdose deaths began truly soaring after 2010 when users turned to illicit heroin and fentanyl after the introduction of Food and Drug Administration–approved abuse-deterrent formulations.

So how much do drug overdose deaths contribute to the recent decline in U.S. life expectancy? A 2021 comprehensive review of factors affecting mortality trends in the U.S. between 1999 and 2018 found that average life expectancy would “have been 0.3 years greater were it not for increases in unintentional drug poisoning.” In a 2023 preprint article, two Johns Hopkins University researchers calculated that opioid overdose deaths between 2019 and 2021 reduced U.S. life expectancy by 0.65 years. If politicians and policy makers really want to make increasing life expectancy a priority, one huge step would be to actually end the war on drugs. A cease-fire in the drug war would likely reduce gun deaths too.

Author(s): Ronald Bailey

Publication Date: 8 Jan 2024

Publication Site: Reason

How disadvantage became deadly in America

Mary Pat Campbell

Link: https://www.ft.com/content/6d8bad29-3147-44a2-bc61-70f8ceff6c6f?accessToken=zwAGB5lW9184kc9ti60pMUdEotO8YXD4zv9sbw.MEUCIBrMWnKTNAovwoanjaXAlP0CCkAObuApixHcx7P0kp59AiEA9jdxWJNbfckzoDKgEmmH7uFUtPa-vSeZlmAr7O6ilxc&sharetype=gift&token=d188b24b-de79-4e0e-b16a-9b22a4e17e42

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Much has been made of America’s life expectancy deficit, but focusing on a statistic which is an average for the whole population masks truly staggering disparities at the extremes. For men at the bottom of the US economic ladder, it’s even worse. My calculations suggest the average age of death in that group is just 36 years old, compared with 55 in the Netherlands and 57 in Sweden.

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In most wealthy countries, if you’re desperately unlucky in the longevity stakes, you succumb to cancer before you reach 60. But if you’re unlucky in the US, you die from a drug overdose or gunshot wound by 40. Which brings us again to the most shocking statistic: among the least fortunate 10 per cent of American men, the average age at death is 36.

Looking at different regions within the US paints a similar picture. Conditions such as obesity shorten the lives of rich and poor alike, but the most uniquely American afflictions have steep socio-economic gradients. Wealthy Americans who live in the parts of the country with high opioid use and gun violence live just as long as those who live where fentanyl addiction and gunshot incidents are relatively rare. But poor Americans live far shorter lives if they grow up surrounded by guns and drugs than if they don’t.

Author(s): JOHN BURN-MURDOCH

Publication Date: 13 October 2023

Publication Site: Financial Times

The Shady Statistics Behind the War on Painkillers

Mary Pat Campbell

Link: https://reason.com/video/2023/10/11/the-shady-statistics-behind-the-war-on-painkillers/

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The attack on opioid prescriptions for non-cancer chronic pain began to advance around 2010, and intensified thereafter. The crackdown coincided with—and perhaps caused—a rapid growth in heroin overdose deaths, and later, an explosion in illegal synthetic opioid deaths, primarily fentanyl, an illicitly manufactured substance added to or substituted for heroin to meet the increasing demand for illegal opiates. This pattern of events is illustrated in a graphic put out by the Centers for Disease Control (CDC).

Indeed, overdose deaths from commonly prescribed opiates increased rapidly from 1999 to 2010, but the chart doesn’t tell us how many of the victims legally obtained the opiates. The chosen scale also omits the fact that drug overdose deaths have been increasing at a fairly steady rate since 1979, with no obvious changes associated with the rise and fall of opioid prescriptions for chronic pain. The chart does show how overdose death rates from commonly prescribed opiates did not decline much after 2010, although legal prescriptions went down dramatically. This suggests that these deaths may have involved individuals who bought illegally manufactured opiates, or that the people who lost pain medication as a result of official actions were not the ones liable to overdose.

The increase in deaths of despair obviously merits some policy attention, but labeling it an “opioid crisis,” as is common nowadays, profoundly misstates its nature, timing, and likely causes and solutions. To justify restricting opioids for non-cancer chronic pain patients requires specific evidence that people prescribed opioids for pain are the ones dying of overdoses. There’s quite a bit of negative evidence on this score, but public health officials have seized on a few positive studies to support their claims.

One influential and heavily cited 2011 study published in the Journal of the American Medical Association, “Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths,” uses a classic prohibitionist tactic. The authors use a sample of 750 Veterans Health Administration (VHA) patients who received opioid prescriptions for pain and later died of opioid overdoses, and compare them to a random sample of 155,000 other VHA patients who received opioid prescriptions and did not die of overdoses.

Author(s): Aaron Brown

Publication Date: 11 Oct 2023

Publication Site: Reason

Overdoses soared even as prescription pain pills plunged/Highest death rates hit counties where doses of pain pills per person had been top in nation

Mary Pat Campbell

Link: https://www.washingtonpost.com/investigations/2023/09/12/us-overdose-deaths-opioid-crisis/

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The number of prescription opioid pain pills shipped in the United States plummeted nearly 45 percent between 2011 and 2019, new federal data shows, even as fatal overdoses rose to record levels as users increasingly used heroin, and then illegal fentanyl.

The data confirms what’s long been known about the arc of the nation’s addiction crisis: Users first got hooked by pain pills saturating the nation, then turned to cheaper and more readily available street drugs after law enforcement crackdowns, public outcry and changes in how the medical community views prescribing opioids to treat pain.

The drug industry transaction data, collected by the Drug Enforcement Administration and released Tuesday by attorneys involved in the massive litigation against opioid industry players, reveals that the number of prescription hydrocodone and oxycodone pills peaked in 2011 at 12.8 billion pills, and dropped to fewer than 7.1 billion by 2019. Shipments of potent 80-milligram oxycodone pills dropped 92 percent in 2019 from their peak a decade earlier.

Many of the counties with the highest fentanyl death rates — in hard-hit states such as West Virginia, Kentucky and Ohio — started out with alarmingly high doses of prescription pills per capita, according to a Washington Post analysis of the DEA data and federal death records.

Counties with the highest average doses of legal pain pills per person from 2006 to 2013 suffered the highest death rates in the nation over the subsequent six years.

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Annual overall overdose deaths reached a grim milestone in 2021, surpassing 100,000 for the first time in U.S. history. More than 110,000 people died of drug overdoses in 2022, two-thirds of whom succumbed to synthetic opioids such as fentanyl, according to estimates by the Centers for Disease Control and Prevention.

Author(s): Rich, Steven; Ovalle, David

Publication Date: 12 Sep 2023

Publication Site: Washington Post

The economic impact of the opioid epidemic

Mary Pat Campbell

Link: https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2023/04/17/the-economic-impact-of-the-opioid-epidemic/

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While the opioid epidemic has had significant impacts across the labor market, its effects have been particularly pronounced in specific occupations and industries. A CDC analysis of mortality data from 21 states concluded that unintentional and undetermined overdose deaths accounted for a disproportionate share of all deaths in the following six occupational groups: construction, extraction (e.g., mining), food preparation and serving, health care practitioners, health care support, and personal care and service. These fatalities are particularly concentrated in construction and extraction: an analysis by the Massachusetts Department of Public Health found that individuals employed in construction and extraction accounted for over 24% of all overdose deaths in the state’s working population.

Notably, the jobs with the highest rates of opioid overdose fatalities generally have high occupational injury rates and low access to paid sick leave. Figure 1 demonstrates that the industries with the highest rates of overdose fatalities in the workplace have elevated occupational injury rates for fractures and musculoskeletal disorders, both of which are significant risk factors for long-term opioid use.

Author(s): Julia Paris, Caitlin Rowley, and Richard G. Frank

Publication Date: 17 April 2023

Publication Site: Brookings

Drug-Overdose Deaths Reached a Record in 2021, Fueled by Fentanyl

Mary Pat Campbell

Link: https://www.wsj.com/articles/drug-overdose-deaths-reached-a-record-in-2021-fueled-by-fentanyl-11652277600

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Drug-overdose deaths in 2021 topped 100,000 for the first time in a calendar year, federal data showed, a record high fueled by the spread of illicit forms of fentanyl throughout the country.

More than 107,000 people in the U.S. died from drug overdoses last year, preliminary Centers for Disease Control and Prevention data released Wednesday showed, roughly a 15% increase from 2020. The proliferation of the potent synthetic opioid fentanyl has been compounded by the destabilizing effects of the Covid-19 pandemic on users and people in recovery, according to health authorities and treatment providers.

The U.S. has recorded more than one million overdose deaths since 2000, and more than half of those came in the past seven years.

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The agency has counted about 103,600 overdoses for 2021 but believes the number is several thousand higher due to suspected overdoses that haven’t yet been confirmed by local death investigators, Dr. Anderson said.

Author(s): Jon Kamp

Publication Date: 11 May 2022

Publication Site: WSJ

Provisional Drug Overdose Death Counts

Mary Pat Campbell

Link:https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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This data visualization presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation (see Technical notes) resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts (see Technical notes).

Author(s): Ahmad FB, Rossen LM, Sutton P

Publication Date: accessed 5 Feb 2022

Publication Site: CDC

More than 1 million have died in the overdose crisis, but still the response is scandalously inadequate

Mary Pat Campbell

Link:https://www.washingtonpost.com/opinions/2022/01/24/dopesick-author-on-opioid-crisis/

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These are measures taken by people desperately fighting, largely on their own, against a drug-overdose death toll that historically has killed more Americans than the coronavirus pandemic. Since 1996, the year OxyContin launched and the United States’ health-care system fell prey to the lie that opioid painkillers were safe for virtually everything from headaches to wisdom-tooth surgery, more than 1 million Americans have died of overdoses; the coronavirus pandemic has claimed about 850,000. During the first year of the pandemic, the Centers for Disease Control and Prevention reported a record 100,000 annual overdose deaths.

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But with an even more lethal overdose crisis — and that’s not counting all the addiction-related deaths from hepatitis, endocarditis and suicide — the nation’s leadership appears capable of only minor tweaks.

Some blue-leaning states and cities now offer evidence-backed practices such as supplying drug users with clean needles and fentanyl test strips, and even offering medically supervised spaces to inject illicit drugs — all of which foster important connections to professional care and wraparound services. But in much of the world’s richest nation, where a few million Americans suffer with opioid use disorder, these measures remain anathema.

The pandemic-prompted loosening of federal regulations for the telehealth prescribing of buprenorphine, the lifesaving addiction medication, has been a bright spot, particularly for rural people who have long struggled with transportation issues. But that policy change remains temporary and the treatment gap (with an estimated 10 to 12 percent of addicted people receiving treatment in an average year) has barely budged.

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Epidemiologists predict that by 2029, U.S. overdose deaths will have doubled to nearly 2 million. Until we stop arresting and abandoning people who use drugs and start meeting them where they are with treatment and compassion, rare will be the family that remains untouched.

Author(s): Beth Macy

Publication Date: 24 Jan 2022

Publication Site: Washington Post

Opioids and the Unattached Male

Mary Pat Campbell

Link: https://www.city-journal.org/opioids-and-the-unattached-male

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From 2010 to 2019, the drug-related death rate among never-married prime-age white men increased some 125 percent: from 52 deaths per 100,000 to 117 (including 2020 would show an even steeper rise, but the pandemic affected Census data collection). If single and divorced prime-age white men had seen opioid deaths rise by only the same rate as those deaths rose among their married counterparts, the U.S. would have seen 38,800 fewer deaths from drug-related causes over the past decade just among this demographic group.

A marriage certificate is no prophylactic against the scourge of drug overdoses, of course. Marital status is correlated with income, race, and age; while death certificates don’t report income, we know that married decedents are more likely to be white, older, and better-educated. Controlling for those factors still shows single men to be at greater risk of dying from drug-related causes than married ones.

Author(s): Patrick T. Brown

Publication Date: 14 Jan 2022

Publication Site: City Journal

Opioid deaths in America reached new highs in the pandemic

Mary Pat Campbell

Link: https://www.economist.com/graphic-detail/2021/03/30/opioid-deaths-in-america-reached-new-highs-in-the-pandemic

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LAST YEAR was a woeful time for people suffering from a drug addiction. Government shutdowns brought job losses and social isolation—conditions that make a transportive high all the more enticing. Those who had previously used drugs with others did so alone; if they overdosed, no one was around to call for help or administer naloxone, a medication that reverses opioid overdoses.

Fatal overdoses were marching upwards before the pandemic. But they leapt in the first part of last year as states locked down, according to provisional data from the Centres for Disease Control and Prevention. Deaths from synthetic opioids—the biggest killer—were up by 52% year-on-year in the 12 months to August, the last month for which data are available. Those drugs killed nearly 52,000 Americans during the period; cocaine and heroin killed about 16,000 and 14,000, respectively (see chart). Once fatalities are fully tallied for 2020, in a few months’ time, it is likely to be the deadliest year yet in America’s opioid epidemic.

Publication Date: 30 March 2021

Publication Site: The Economist

County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access

Mary Pat Campbell

Link: https://www.sciencedirect.com/science/article/pii/S2352340921000639

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The dataset summarized in this article is a combination of several of U.S. federal data resources for the years 2006-2013, containing county-level variables for opioid pill volumes, demographics (e.g. age, race, ethnicity, income), insurance coverage, healthcare demand (e.g. inpatient and outpatient service utilization), healthcare infrastructure (e.g. number of hospital beds or hospices), and the supply of various types of healthcare providers (e.g. medical doctors, specialists, dentists, or nurse practitioners). We also include indicators for states which permitted opioid prescribing by nurse practitioners. This dataset was originally created to assist researchers in identifying which factors predict per capita opioid pill volume (PCPV) in a county, whether early state Medicaid expansions increased PCPV, and PCPV’s association with opioid-related mortality. Missing data were imputed using regression analysis and hot deck imputation. Non-imputed values are also reported.

Taken together, our data provide a new level of precision that may be leveraged by scholars, policymakers, or data journalists who are interested in studying the opioid epidemic. Researchers may use this dataset to identify patterns in opioid distribution over time and characteristics of counties or states which were disproportionately impacted by the epidemic. These data may also be joined with other sources to facilitate studies on the relationships between opioid pill volume and a wide variety of health, economic, and social outcomes.

Author(s): Kevin N. Griffith, Yevgeniy Feyman, Samantha G. Auty, Erika L. Crable, Timothy W. Levengood

Publication Date: April 2021

Publication Site: Data in Brief