Opioid Deaths Quadruple Since 1999

Transcription

1 THE COUNCIL OF STATE GOVERNMENTS CAPITOL RESEARCH AUGUST 2017 HEALTH POLICY Opioid Deaths Quadruple Since 1999 Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) has quadrupled, accounting for six out of every 10 drug overdose deaths. Current estimates show that 91 Americans die each day from an opioid overdose, according to the Centers for Disease Control and Prevention, or CDC 1. Opioid deaths are increasing at alarming rates across the states. And while state policies to reduce the availability of prescription opioids are working to reduce overdose deaths, heroin and synthetic opioid overdoses are beginning to climb. 2 Fast Facts About the Impact of Opioids in the United States The economic burden of prescription opioid misuse is estimated to be $78.5 billion per year, including health care costs, lost productivity, addiction treatment and criminal justice involvement. 3 Opioid Overdose Deaths Compared to All Drug Overdose Deaths from 1999 to ,000 50,000 ALL DRUG DEATHS 40,000 30,000 OPIOID DEATHS 20,000 10, NOTES: Total opioid overdose deaths reported in the United States exclude opioid deaths in North Dakota in 2012, 2006, and In these years, data are not available for the states due to suppression constraints and are therefore excluded from the U.S. total and the corresponding percentage of all drug overdose deaths. SOURCES: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention, or CDC, National Center for Health Statistics. Compiled from Multiple Causes of Death on CDC WONDER Online Database, released in 2016.

2 About 80 percent of people who use heroin first misused prescription opioids. 4 In 2015, 33,091 people died from an opioid overdose. 5 In 1999, opioid overdose deaths accounted for 48 percent of all drug overdose deaths. In 2015, the percentage of opioid deaths increased to 63 percent. 6 Two million people were diagnosed with prescription opioid use disorder in Opioid Overdose Death Rates in the States Forty-six states and the District of Columbia experienced an increase in total opioid overdose deaths and an increase in the rate of opioid overdose deaths per 100,000 people from 1999 to (No data available in 1999 for Nebraska, North Dakota, South Dakota and Wyoming.) In terms of total opioid overdose deaths, the five states with the highest number of deaths in 2015 were Massachusetts (1,550); Florida (1,838); California (2,018); New York (2,166); and Ohio (2,698). These figures are strongly connected to population, but there are states with higher populations reporting fewer deaths than these states in The five states with the lowest number of opioid overdose deaths in 2015 were South Dakota (27); North Dakota (34); Wyoming (46); Montana (48); and Nebraska (55). Regarding the rate of increase in opioid deaths, some different states are revealed. The five states showing the highest rate increases for opioid deaths from 1999 to 2015 were West Virginia (18.7 times higher rate in 2015); Ohio (16 times higher rate in 2015); Kentucky (15 times higher rate in 2015); Iowa (11.2 times higher rate in 1999 Opioid Overdose Death Rates by State The rates represent the number of opioid overdose deaths per 100,00 people. NO DATA AVAILABLE RATE OF RATE OF RATE OF Opioid Overdose Death Rates by State The rates represent the number of opioid overdose deaths per 100,00 people. RATE OF RATE OF 5.1 TO 10 RATE OF 10.1 TO 15 RATE OF 15.1 TO 20 RATE OF 20.1 TO 25 RATE OF 25.1 TO 30 RATE OF 30.1 TO 34.2 SOURCES: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention, or CDC, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released in NSD stands for No Sufficient Data, with four states having no sufficient data in 1999 for opioid overdose deaths. Rates calculated by The Council of State Governments using the crude number of opioid deaths per 100,000 people for each state based on its mid-year population from the U.S. Census Bureau.

3 2015); and Michigan (10.8 times higher rate in 2015). The five states showing the lowest rate increases for opioid deaths from 1999 to 2015 were California (1.2 times higher rate in 2015); Washington (1.6 times higher rate in 2015); New Mexico (1.6 times higher rate in 2015); Nevada (1.7 times higher rate in 2015); and Hawaii (1.7 times higher rate in 2015). Types of Opioids Causing Overdose Deaths is Changing Over the last 15 years, one emerging trend is the increase in synthetic opioids and heroin as the cause of overdose deaths. For many years, prescription opioids made up a larger percentage of opioid deaths, but heroin and synthetic opioids have overtaken prescription opioids in terms of overdose deaths in recent years. In 1999, heroin or synthetic opioids (other than methadone, which is primarily used to treat opioid addiction), were named in approximately 33 percent of opioid overdose deaths. Fast forward to 2015, synthetic opioids or heroin were identified in approximately 68 percent of all opioid overdose deaths. Data from the CDC show a steep rise in synthetic opioid and heroin overdose deaths in the last few years, just as prescription opioid overdose deaths are starting to level out. In a recent analysis of retail-filled opioid prescriptions, QuintilesIMS showed that retail prescriptions decreased almost 15 percent in the U.S. from 2013 to For the first time ever, drug overdoses are the leading cause of death for Americans under 50 years old, 9 and every year the death toll is climbing, increasing the burden on states. Policymakers are being called upon to offer solutions. Emily McCarthy, Graduate Fellow, emily.mccarthy@csg.org Opioid Overdose Deaths By Type, United States ,000 NATURAL AND SEMISYNTHETIC OPIOIDS (E.G. OXYCODONE, HYDROCODONE) 12,000 9,000 HEROIN 6,000 METHADONE 3,000 SYNTHETIC OPIOIDS, OTHER THAN METHADONE DEFINITIONS: Natural and Semisynthetic Opioids A category of prescription opioids that includes natural opioid analgesics (e.g. morphine and codeine) and semisynthetic opioid analgesics (e.g. drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone). Synthetic Opioids, other than Methadone A category of opioids including drugs such as tramadol and fentanyl. Synthetic opioids are commonly available by prescription. Fentanyl is legally made as a pharmaceutical drug to treat pain, or illegally made as a non-prescription drug and is increasingly used to intensify the effects of other drugs, such as heroin. Methadone a synthetic opioid prescribed to treat moderate to severe pain or to reduce withdrawal symptoms in people addicted to heroin or other narcotic drugs. Heroin an illicit (illegally-made) opioid synthesized from morphine. SOURCES: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention, or CDC, National Center for Health Statistics. Data compiled from Multiple Causes of Death on CDC WONDER Online Database, released in Natural and semisynthetic opioid overdose deaths reported for the United States exclude North Dakota in 2013, 2012, and 2011, and the District of Columbia in 2010 and THE COUNCIL OF STATE GOVERNMENTS 3

4 Opioid Deaths in the States Growth from 1999 to 2015 STATE OPIOID DEATHS, 1999 ALL DRUG DEATHS, THE COUNCIL OF STATE GOVERNMENTS PERCENT OF ALL DRUG DEATHS DUE TO OPIOIDS IN 1999 OPIOID DEATHS PER 100,000 PEOPLE IN 1999 OPIOID DEATHS, 2015 ALL DRUG DEATHS, 2015 PERCENT OF ALL DRUG DEATHS DUE TO OPIOIDS IN 2015 OPIOID DEATHS PER 100,000 PEOPLE IN 2015 ALABAMA % % 5.8 ALASKA % % 11.7 ARIZONA % ,274 53% 9.8 ARKANSAS % % 6.8 CALIFORNIA 1,474 2,662 55% 4.4 2,018 4,659 43% 5.2 COLORADO % % 9.1 CONNECTICUT % % 19.1 DELAWARE % % 14.1 D.C % % 14.6 FLORIDA % 2.7 1,838 3,228 57% 9.1 GEORGIA % ,302 66% 8.4 HAWAII % % 4.4 IDAHO % % 5.4 ILLINOIS % 4.0 1,381 1,835 75% 10.8 INDIANA % ,245 43% 8.1 IOWA % % 5.4 KANSAS % % 5.2 KENTUCKY % ,273 70% 20.0 LOUISIANA % % 6.1 MAINE % % 17.9 MARYLAND % 9.4 1,087 1,285 85% 18.1 MASSACHUSETTS % 5.3 1,550 1,724 90% 22.8 MICHIGAN % 1.2 1,309 1,980 66% 13.2 MINNESOTA % % 6.2 MISSISSIPPI % % 5.0 MISSOURI % ,066 65% 11.4 MONTANA % % 4.7 NEBRASKA NSD* 39 NSD* NSD* % 2.9 NEVADA % % 14.5 NEW HAMPSHIRE % % 28.6 NEW JERSEY % ,454 59% 9.6 NEW MEXICO % % 16.9 NEW YORK % 3.4 2,166 2,754 79% 11.0 NORTH CAROLINA % 2.1 1,171 1,567 75% 11.7 NORTH DAKOTA NSD* 12 NSD* NSD* % 4.5 OHIO % 1.5 2,698 3,310 82% 23.2 OKLAHOMA % % 10.9 OREGON % % 8.2 PENNSYLVANIA % 2.7 1,362 3,264 42% 10.6 RHODE ISLAND % % 24.1 SOUTH CAROLINA % % 11.3 SOUTH DAKOTA NSD* 17 NSD* NSD* % 3.1 TENNESSEE % 1.6 1,038 1,457 71% 15.7 TEXAS 351 1,087 32% 1.8 1,287 2,588 50% 4.7 UTAH % % 15.0 VERMONT % % 12.6 VIRGINIA % ,039 79% 9.8 WASHINGTON % ,094 63% 9.7 WEST VIRGINIA % % 34.2 WISCONSIN % % 10.8 WYOMING NSD* 20 NSD* NSD* % 7.8 UNITED STATES 8,050 16,849 48% ,091 52,404 63% 10.3

5 Table SOURCES: Kaiser Family Foundation analysis of Centers for Disease Control and Prevention, or CDC, National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released in NSD stands for No Sufficient Data, with four states having no sufficient data in 1999 for opioid overdose deaths. Rates calculated by The Council of State Governments using the crude number of opioid deaths per 100,000 people for each state based on its mid-year population from the U.S. Census Bureau. REFERENCES 1 Understanding the Epidemic. (2016, December 16). Retrieved July 26, 2017, from 2 Opioid Overdose. (2017, February 09). Retrieved July 26, 2017, from 3 Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, Med Care. 2016;54(10): doi: / MLR Carlson RG, Nahhas RW, Martins SS, Daniulaityte R. Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study. Drug Alcohol Depend. 2016;160: doi: /j.drugalcdep Kaiser Family Foundation analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. Multiple Cause of Death on CDC WONDER Online Database, released Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. 6 Ibid 7 SAMHSA Center for Behavioral Health Statistics and Quality. (n.d.) National Survey on Drug Use and Health METHODOLOGICAL SUMMARY AND DEFINITIONS. Retrieved July 26, 2017, from 8 Source: Xponent, QuintilesIMS, Danbury, CT, Copyright Katz, J. (2017, June 05). Drug Deaths in America Are Rising Faster Than Ever. Retrieved July 26, 2017, from THE COUNCIL OF STATE GOVERNMENTS 5