U.S. Opioid Overdose Epidemic Might Be Worse Than Estimated
According to new research in the journal, Addiction, the number of fatalities attributed to opioid overdoses in the United States could be as much as 28% higher than reported due to incomplete death records. Researchers at the University of Rochester posit that almost 100,000 overdose deaths may not have been counted because the opioid that was involved was not identified.
The discrepancy is pronounced in several states, including Alabama, Indiana, Mississippi, Louisiana, and Pennsylvania, where the actual number of overdoses caused by opioids could be twice as high as those of current estimates.
What Do Experts Think?
Senior Author Elaine Hill, Ph.D., an economist and assistant professor in the University of Rochester Medical Center:
“A substantial share of fatal drug overdoses is missing information on specific drug involvement, leading to underreporting of opioid-related death rates and a misrepresentation of the extent of the opioid crisis. The corrected estimates of opioid-related deaths in this study are not trivial. They show that the human toll has been substantially higher than reported by several thousand lives taken each year.”
Dr. Hill and her cohorts revealed that nearly 72% of unclassified drug overdoses that occurred between 1999-2016 involved prescription or illicit opioids, equating to 99,160 additional opioid-related fatalities.
Investigators discovered the discrepancy while examining the economic, health, and environmental impact of coal mining and oil and gas drilling. Appalachia and other areas of the country hit hardest by the opioid epidemic overlap with regions where coal mining and shale gas development is occurring.
As a part of the research, Dr. Hill attempted to ascertain whether the shale boom improved or worsened the opioid crisis. She found that almost 22% of all drug-related overdoses were unclassified, meaning that drugs potentially involved in the cause of death went unreported.
Research in 2018 from the University of Pittsburgh reached a similar conclusion, estimating that as up to 70,000 opioid-related fatalities were not reported. Medical examiners and coroners in several states often did not specify the drug that was involved in the cause of death.
Critics have long complained that overdose data issued by the Centers for Disease Control and Prevention (CDC) and other federal agencies is flawed, and researchers admitted in 2018 that fatalities attributed to opioid were “significantly inflated” because overdoses involving illicit fentanyl were falsely counted as prescription opioid deaths. Unfortunately, toxicology tests cannot, at this time, distinguish between prescription and illicit fentanyl.
The overdose data is further complicated because polydrug use is involved in nearly half of all drug overdoses.
Poor Overdose Data in Many States
In the study, Dr. Hill and her colleagues gathered overdose death records from the CDC’s National Center for Health Statistics. They correlated information on unclassified overdose fatalities with potential contributing causes, such as prior opioid use and chronic pain conditions.
While the overall percentage of unclassified deaths decreased over time, the number remained high in several states. For example, in Pennsylvania, the official number of opioid-related deaths was 12,374. Experts estimate that the actual number of deaths was 26,586— more than twice the amount.
“The underreporting of opioid-related deaths is very dependent upon location, and this new data alters our perception of the intensity of the problem. Understanding the true extent and geography of the opioid crisis is a critical factor in the national response to the epidemic and the allocation of federal and state resources.”
The CDC recently revealed that drug overdose fatalities dropped 4.1% in 2018—the first decline in nearly 30 years, led by a significant drop in overdoses involving oxycodone, hydrocodone, and other painkillers. But deaths involving illicit fentanyl, meth, and psychostimulants are increasing, thereby threatening to reverse the overall decline in deaths.
Drugs Can Kill in Other Ways
All of this research may miss the mark, however, according to research published in PLOS ONE. This is because they don’t include deaths caused by drunk driving, infectious and cardiovascular disease, and suicide, all of which are affected by substance abuse.
In 2016, more than 63,000 deaths were attributed to drug overdoses, but Preston and colleagues estimate that the actual number of drug-related fatalities was more like 142,000. Drug use reduced close to a year-and-a-half of life for males and three-quarters of a year for females.
Getting Help for Addiction
Opioid addiction or other dependencies on drugs or alcohol can be a devastating, life-long condition that can lead to a myriad of health, emotional, and social problems. If you or someone you know is suffering, we urge you to contact us today to learn about our treatment programs.
Just Believe Recovery is a specialized treatment facility that offers a comprehensive, evidence-based approach to addiction. We are dedicated to helping those who need it most recover from substance abuse and reclaim the healthy lives they deserve!