Opioid-related deaths continue to rise in the United States, with a 16% increase between 2014 and 2015 driven largely by overdoses of illegally manufactured fentanyl and heroin, according to a report released Dec. 16 by the Centers for Disease Control and Prevention.

CDC investigators analyzed drug-related mortality for 2010 through 2015 in a national statistics database for all 50 states and the District of Columbia, as well as drug-related deaths by subcategories of drugs in 28 states for 2014 through 2015. They found that the rapidly evolving opioid epidemic has not only continued but worsened in many ways, across all demographics and geographical regions of the country, said Rose A. Rudd, MSPH, of the CDC’s National Center for Injury Prevention and Control in Atlanta, and her associates ( MMWR. 2016 Dec 16;65:1-8 ).

Among their findings:

• Mortality from drug overdoses rose significantly over the 5-year study period, from 12.3 per 100,000 in 2010 to 16.3 per 100,000 in 2015. It rose in 30 states and in the District of Columbia, stayed stable in 19 states, and initially decreased but then rose again in 2 states (Florida and South Carolina).

• During the last year for which data are complete (2015), deaths from drug overdoses rose by approximately 12%, “signifying a continuing trend since 1999.”

• Sixty-three percent of the 52,404 deaths from drug overdoses in 2015 involved an opioid.

• The age-adjusted opioid-related death rate rose by 16% during the last year, from 9.0 per 100,000 in 2014 to 10.4 per 100,000 in 2015.

• These significant increases were driven by a rise in deaths from synthetic opioids other than methadone – chiefly illicitly manufactured fentanyl and heroin, which rose by 72.2% and 20.6%, respectively.

• In contrast, death rates tied to natural or semisynthetic opioids increased by only 2.6%, while those tied to methadone decreased by 9.1%.

Dr. Rudd and her associates cited several limitations. One is that some drug overdose death certificates did not identify specific drugs. Another is that heroin and morphine are metabolized similarly, which means that some heroin deaths might have been misclassified. Also, it could be problematic to generalize the findings, because the “state-specific analyses of opioid deaths are restricted to 28 states.”

“The ongoing epidemic of opioid deaths requires intense attention and action,” Dr. Rudd and her associates wrote. “Intensifying efforts to distribute naloxone (an antidote to reverse an opioid overdose), enhancing access to treatment … and implementing harm reduction services are urgently needed.”

The study was conducted by the CDC.


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