Opioid Overdose Deaths Hit Record High

More people died from drug overdoses in the United States in 2014 than during any previous year on record, with increases in opioid overdose deaths the driving factor, according to new statistics released today by the US Centers for Disease Control and Prevention (CDC).

In 2014, opioid overdose deaths, including deaths from the use of opioid painkillers and heroin, hit record levels, with an “alarming” 14% increase, the CDC said.

The death rate from the most commonly prescribed opioid pain relievers (natural and semisynthetic opioids) rose 9%, the death rate from heroin jumped 26%, and the death rate from synthetic opioids, a category that includes illicitly manufactured fentanyl and synthetic opioid pain relievers other than methadone, spiked 80%.

“Nearly every aspect of the opioid overdose death epidemic worsened in 2014,” the CDC said.

Their analysis of National Vital Statistics data was reported December 18 in the Morbidity and Mortality Weekly Report.

During 2014, a total of 47,055 drug overdose deaths occurred in the United States, representing a 1-year increase of 6.5%, from 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014. Rates of opioid overdose deaths jumped significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000 in 2014, a 14% increase.

In 2014, opioids were involved in 28,647 deaths, or 61% of all drug overdose deaths; the rate of opioid overdoses has tripled since 2000, the CDC said.

“Increases in prescription opioid pain reliever and heroin deaths are the biggest driver of the drug overdose epidemic. Deaths from heroin increased in 2014, continuing a sharp rise that has seen heroin overdoses triple since 2010. Deaths involving illicitly made fentanyl, a potent opioid often added to or sold as heroin, also are on the upswing,” the CDC notes in a news release.

Drug overdose deaths have increased in both men and women, in non-Hispanic whites and blacks, and in adults of nearly all ages, the CDC said. Rates of drug overdose deaths were highest in West Virginia, New Mexico, New Hampshire, Kentucky, and Ohio.

Intertwined Drivers

The CDC says two distinct but intertwined trends are driving the overdose epidemic in the United States: a 15-year increase in deaths from prescription opioid pain reliever overdoses as a result of misuse and abuse, and a recent surge in illicit drug overdoses driven mainly by heroin overdoses. Both of these trends worsened in 2014.

The agency reports that more than 6 of 10 drug overdose deaths in 2014 involved opioids, including opioid pain relievers and heroin. The largest increase in opioid overdose deaths involved synthetic opioids (not including methadone), which were involved in 5500 deaths in 2014, nearly twice as many as in 2013.

Heroin-related death rates jumped 26% from 2013 to 2014, totaling 10,574 deaths in 2014. “Past misuse of prescription opioids is the strongest risk factor for heroin initiation and use — especially among people who became dependent upon or abused prescription opioids in the past year. The increased availability of heroin, its relatively low price (compared to prescription opioids), and high purity appear to be major drivers of the upward trend in heroin use, overdoses, and deaths,” the CDC notes.

Call to Action

“The increasing number of deaths from opioid overdose is alarming,” CDC Director Tom Frieden, MD, MPH, said in a statement. “The opioid epidemic is devastating American families and communities. To curb these trends and save lives, we must help prevent addiction and provide support and treatment to those who suffer from opioid use disorders. This report also shows how important it is that law enforcement intensify efforts to reduce the availability of heroin, illegal fentanyl, and other illegal opioids.”

The CDC said the new data point to four ways that overdose deaths may be prevented:

• Limit initiation into opioid misuse and addiction through education of healthcare providers;
• Expand access to evidence-based treatment of substance use disorder, including medication-assisted treatment, for people with opioid use disorder;
• Protect people who have opioid use disorder by expanding access to and use of naloxone;
• Get state and local public health agencies, medical examiners and coroners, and law enforcement agencies to work together to improve detection of and response to illicit opioid overdose outbreaks.

Earlier this year, US Health and Human Services Secretary Sylvia Burwell announced a targeted initiative aimed at reducing prescription opioid- and heroin-related overdose, death, and dependence. The evidence-based approach focuses on three areas: informing opioid prescribing practices, increasing the use of naloxone, and using medication- assisted treatment to cure people of opioid addiction.