Opioids: Responsible For More Deaths Than Thought

Over 70,000 Americans died in 2017 as a result of a drug overdose, close to 68% of those deaths involved opioids, and this number is greater than six times higher than it was in 1999. Opioids can induce euphoria and become addicting, these types of drugs include prescription drugs such as pain relievers and illegal drugs such as heroin. 

The question has been brought to discussion if whether drug records that focus on death by overdose and drug related mental/behavioral disorders are a true reflection of the actual death toll arising from this drug epidemic, and could it be higher as well as be behind the negative trends in American life expectancy. 

A study published in PLOS ONE had the goal to address such questions, and investigated broader drug related deaths in Americans between the ages of 15-64 years old; in the subset of the population 9% of deaths were drug related based on the overdose rates, a figure which has increased over 4% in less than two decades. 

“Increasing mortality among working age Americans was not limited to drug overdose, and we believed that the rapid increase in drug use and abuse was likely to be implicated in mortality from other causes of death,” said co-author Prof. Samuel Preston of the University of Pennsylvania in Philadelphia.

This study suggests that drugs can kill people in multiple ways beyond that of drug overdose, such as infectious diseases like hepatitis and HIV as well as circulatory illnesses and accidents that can occur as a result of impaired judgement and suicide. 

“People who are perpetual drug users have much higher mortality in general,” says Prof. Preston.

Data was analyzed from the National Center for Health Statistics which included over 44 million deaths among those in the age group of 15-64 across the nation over an 18 year period. Recorded drug coded deaths attributing to overdose and drug mental/behavioral disorders were found to only reflect half of all drug associated deaths. 

“The most important causes of death accounting for the impact of drugs, in addition to those deaths coded to drugs on death certificates, were cardiovascular diseases and, for working age men, external causes of death,” said Prof. Preston.

For instance in 2016 the total number of drug related deaths was found to be 142,000. However, this number was 2.25 times more than the actual recorded number of 63,000 drug related deaths which were mostly attributed to overdose. 

After reaching the age of 15 life expectancy for those using drugs was found to decrease on average by 1.4 years for men and 0.7 years for women; while these numbers may not appear to be much the researchers believe that this is enough to affect American life expectancy and account for the recent reversal of life expectancy trends. 

“We estimate that the impact of drugs is responsible for the reduction in U.S. life expectancy at age 15 since 2010,” said Prof. Samuel Preston. “If one were to eliminate those deaths we estimate to have been caused by drug use and abuse, we estimate that life expectancy at age 15 in 2016 would increase by 1.4 years for men and 0.7 years for women,” Prof. Preston added.

Some regions were found to be affected more than others in the decrease of life expectancy such as in West Virginia where the drug epidemic has hit harder; here the rate has more than doubled, among those aged 15-64 drug associated deaths represented 27% of female deaths and 39% of male deaths. 

Other areas that have been hit hard by the epidemic include Ohio, Maryland, Massachusetts, and Pennsylvania. Nebraska is the state with the lowest drug related deaths among both genders. 

While this study was able to more accurately recalculate the actual extent of the American drug epidemic, it was not able to shine light on the root causes. “For now, this research aims to paint a broad picture and get at the true extent of the drug epidemic in the United States,” says Prof. Preston.