In the USA, between 2016 and 2017, there were 2,217 people who died of drug overdoses, compared to 1,775 the year before. And between July 1, 2015, and September 30, 2017, there were 66,108 overdose deaths — 22,643 of which were fatal. The increase in fatalities from the epidemic is more than 5,000 since 2016.
The study, published in JAMA Internal Medicine, included a review of death certificates and deaths reported to authorities (as opposed to overdose statistics in the health media, as is the case in the USA, elsewhere in the world, and perhaps elsewhere in the world in years past). The researchers used these figures to estimate the number of people who died of an overdose.
Overall, more than half of the opioid overdoses had been committed by a legal prescription. But the majority were self-inflicted, and more than 40 percent of overdose deaths involved a prescription drug such as fentanyl (found in heroin and prescription painkillers), opioids (which are also found in some of the illicit drugs), sedatives (found in drugs like Xanax, Valium, Klonopin, and others) and depressants (found in codeine, the cause of 98 percent of accidental poisoning deaths.
The most common overdose products were heroin, oxycodone, fentanyl, cocaine, and methamphetamine.
“Contrary to the public health narrative that largely attributes mortality due to illicit opioids in the USA to the use of illicit fentanyl, poisoning from prescription opioids is responsible for many more drug overdose deaths, and overdoses of non-narcotic drugs are increasing,” the researchers write. “Thus, physicians should examine their prescribing practices, prescribing codes and practices and safety plans, including safety monitoring, when prescribing the three most common types of opioid pain medications: benzodiazepines, opioids, and sedatives.”
Overall, an overwhelming majority of those who died of a prescription opioid overdose were men.
“There is a significant risk that opioids and other prescription pain medications are misused or abused in men,” the study notes. “Some interventions may be proposed that address the relationship between risk for misuse and gender. This could be accomplished by reducing commercial messaging and, in particular, informing physicians that opioids should not be prescribed to men or by men.”
The researchers also stress that not all fatal overdoses are attributable to prescription opioids, saying that not every fatal overdose involves fentanyl, a drug that, on its own, may not be lethal. They also note that many fatal overdoses involved fentanyl combined with other substances.
“In Canada,” they write, “the overdose death rate from illicit fentanyl did not reach epidemic levels until 2016. The size of this epidemic has been amplified by the deadly derivative fentanyl spray, naloxone and opioid emergency departments. . . . While Canada has introduced action to reduce overdoses, it is still far from containing the fentanyl scourge, which has been primarily drug-related and predominantly in men and users of large non-user populations.
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