Contribution of Synthetic Opioids to Drug Overdose Deaths

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Drugs evaluated in this analysis included opioids, methadone, synthetic opioids, and psychostimulants with abuse potential.
Drugs evaluated in this analysis included opioids, methadone, synthetic opioids, and psychostimulants with abuse potential.

Opioids were the leading contributor to drug overdose deaths between 2015 and 2016, according to a Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. Synthetic opioids (excluding methadone) had the largest rate increase in overdose-related deaths compared with the previous year.

Using the International Classification of Diseases, Tenth Revision (ICD-10) and the National Vital Statistics System multiple cause-of-death mortality files, investigators identified drug overdose deaths between the years 2015 and 2016. Drugs evaluated in this analysis included opioids, natural/semisynthetic opioids, methadone, heroin, synthetic opioids other than methadone, and psychostimulants with abuse potential. The mortality analysis was adjusted for age, sex, racial/ethnic group, urbanization level, and state.

In 2016 alone, a total of 63,632 drug-related overdose deaths occurred in the United States. The age-adjusted rate of drug-related overdose deaths increased by 21.5% between 2015 and 2016. The majority of overdose deaths in 2016 were attributed to opioids (66.4%; 13.3 per 100,000 population), a 27.9% increase from rates observed in 2015.

Synthetic opioids were the primary contributor to opioid deaths in 2016. Rates of age-adjusted overdose-related deaths increased for all drugs examined between 2015 and 2016: heroin (19.5%), prescription opioids (10.6%), cocaine (52.4%), and psychostimulants (33.3%).

Men age 25 to 44 years and individuals between the ages of 25 and 34 years experienced the largest absolute rate increases in opioid- and synthetic opioid-related overdose deaths between 2015 and 2016. In a state-level analysis, the highest rates of synthetic opioid-related deaths occurred in New Hampshire (30.3 deaths per 100,000 people), West Virginia (26.3 deaths per 100,000 people), and Massachusetts (23.5 deaths per 100,000 people). The largest rate increases in synthetic opioid deaths occurred in the District of Columbia (392.3%), Illinois (227.3%), and Maryland (206.9%).

Limitations of this analysis include the lack of information on specific drugs involved in some deaths.

“Building on existing resources, more rapidly available and comprehensive surveillance data are needed to track emerging drug threats to guide public action to prevent and respond to the epidemic through increased naloxone availability, harm reduction services, linkage into treatment (including medication-assisted treatment), safe prescribing practices, and supporting law enforcement strategies to reduce the illicit drug supply,” concluded the report authors.

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Reference

Seth P, Scholl L, Rudd RA, Bacon S. Overdose deaths involving opioids, cocaine, and psychostimulants - United States, 2015-2016. MMWR Morb Mortal Wkly Rep. 2018;67(12):349-358.

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