CDC Addresses Opioid Death Prevention on Overdose Awareness Day

Opioid related overdoses made up 66.4% of the 63,632 overdose deaths in the United States in 2016, prompting the CDC to gather data on fatal opioid overdoses and a prevention plan.

The CDC used data from 11 states to determine the substances and circumstances typically involved in opioid deaths and concluded that overdose deaths can be prevented by increasing access to naloxone, creating more resources and support for those who have experienced nonfatal overdoses, and expanding treatment within institutional settings and upon discharge, according to a recent report.

The CDC examined death certificates, medical examiner data, coroner data, toxicology results, on opioid deaths between July 2016 and June 2017. Among 11,884 opioid deaths during this period, 2066 involved prescription opioids, 6975 were from illicit opioids only, and 2194 were caused by both prescription and illicit opioids, according to the report. Overdose deaths related to prescription opioid use only was highest in the West, while deaths related to illicit opioid use only was highest in the Northeast and Midwest, and fatal overdoses as a result of both prescription and illicit opioids were highest in Kentucky.

While the median age of those who had suffered a prescription opioid overdose was 47, the median age of those who experienced illicit overdoses was 36. Among prescription opioid deaths, 51% occurred in women and 86.2% occurred in non-Hispanic whites, while 73% of illicit opioid deaths occurred in men and 83.6% occurred in non-Hispanic whites, according to the report.

The CDC found that the use of other drugs was frequent in opioid deaths. Of those who died from a prescription opioid overdose, 51.6% were found to have benzodiazepines in their system and 21.6% had gabapentin in their system. Toxicology reports show that cocaine was detected in 34.9% of illicit opioid deaths and benzodiazepines were found in 24% of deaths. Among those who died from a combination of prescription and illicit opioids, benzodiazepines were found in 44.5% and cocaine in 34.8%

Approximately 10% of opioid deaths occurred in those who had been recently released from an institutional setting, such as a including jail, prison, and detention facility in the case of illicit opioid deaths, and hospitals when prescription opioid deaths occurred, according to the report. The CDC determined that offering treatment resources in institutions and upon release may help prevent these deaths.

Prior nonfatal overdoses occurred in 15.1% of illicit opioid-only deaths, 13.5% of deaths caused by illicit and prescription opioids, and 9.3% of prescription opioid-only deaths. Therefore, access to treatment, resources, and support among those who have experienced nonfatal overdoses has become an increasingly important prevention measure, according to the report.

Bystanders were reportedly present in 44% of all opioid deaths, but naloxone use was only reported in 4% of illicit opioid deaths, and 0.8% of prescription opioid deaths, according to the report.

The CDC concluded that, while illicit opioids largely contribute to overdose deaths, prescription opioids also play a significant role and should not be ignored. While the most effective prevention methods may include increased access to naloxone and resources for those who have previously overdosed and those in institutional settings, other public health strategies such as syringe distribution should be utilized.

Reference

Opportunities to Prevent Overdose Deaths Involving Prescription and Illicit Opioids, 11 States, July 2016—June 2017. CDC’s Website. August 31, 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6734a2.htm?s_cid=mm6734a2_w.