Overdose Deaths Analyzed in Medical Setting
Terminations due to medication overdoses (medication poisoning) continue to rise. terminations due to medical analgesics increased due to 4,030 in 1999 to 15,597 in 2009 and 16,651 in 2011. In 2011, nearly 60 percent of all medication misuse terminations (22,134) involved pharmaceutical medications. medical analgesics, such as oxycodone, hydrocodone and methadone, were involved in about 3 of every 4 pharmaceutical misuse terminations, confirming the predominant role medical analgesics play in medication-related mortality (Jones et al. 2013). The following chart (Diagram 1) compares mortality trends in motor vehicle accidents, poisoning overall and overdoses due to medications. Since 2009, the rate of terminations due to overall poisoning and medication overdoses surpassed the rate of terminations due to motor vehicle accidents. In 2011, the rate for overdoses passed 15 percent. Data due to the Centers for Disease Control (CDC) for 2011 indicate the rising trend has continued (Jones et al. 2013). Another recent finding reported by the CDC is a significant increase in medical abuse and misuse terminations among women. Diagram 1. Motor vehicle traffic, poisoning, and medication poisoning (misuse) death rates, United States, 1980-2011 mv_traffic
Source: Warner et al. (2011) updated with 2009 and 2011 mortality data by Jones (2013).
Although fatalities due to motor vehicle accidents are declining, a recent traffic fatality analysis due to the National Highway Transportation Safety Administration (NHTSA) indicates that 33% of drivers killed in such accidents in 2009 tested positive for medications. Among these medications are prescription narcotics, depressants and stimulants, whether used medically or non-medically (Office of National medication Control Policy 2013).
Rates of unintentional medication-related death (overdoses) in the past decade, which are primarily due to the prescription medication epidemic, far outpace those due to the prior heroin and cocaine epidemics of the 1970’s and 1980’s. In 2007, over 27,000 unintentional medication misuse terminations occurred in the United States (Warner et al. 2011). Diagram 2. Rate of unintentional medication misuse terminations in United States, 1970-2005 unintentional_drug
Source: National Vital Statistics System, 2013
Contributing to the rising death rate has been an overall increase in the availability of prescription medications, especially medical analgesics (Diagram 3). The rates of sales for opioids, medical-related terminations and treatment admissions have all increased between 1999 and 2011: Diagram 3. medical sales, medical-related terminations and medical treatment admissions opioid_sales
Source: Warner et al. 2011
terminations due to medical prescription medications continue to outpace terminations due to other medications. As shown in Diagram 4, since 2007 terminations due to opioids have outnumbered those for cocaine and heroin combined: Diagram 4. medication misuse terminations by major medication types in U.S., 1999-2011 opioid_sales
Source: National Vital Statistics System 2012.
Finally, about one half of prescription painkiller deaths involve at least one other drug, including benzodiazepines, cocaine, and heroin. Alcohol is also involved in many drug-related overdose deaths. (Warner et al. 2009).
NEXT: Emergency Room Visits and Treatment Episodes Attributed to Non-Medical Prescription Drug Use
Sources:
Automation of Reports and Consolidated Orders System (ARCOS). Springfield, VA: Drug Enforcement Administration (DEA), U.S. Department of Justice as cited by Jones (2012).
Centers for Disease Control (CDC). Prescription Painkiller Overdoses in the US. CDC Vital Signs November 2011 Atlanta, GA: Centers for Disease Control and Prevention (Last Accessed 4/24/2013)
Jones, Christopher; Karin A. Mack; Leonard J. Paulozzi. Pharmaceutical Overdose Deaths, United States, 2010, Journal of the American Medical Association (JAMA). 2013; 309(7):657-659. Abstract (Last Accessed 4/24/2013):
Jones, Christopher M. (2012) Prescription Drug Abuse and Overdose in United States, presented at Third Party Payer and PDMP Meeting, December 2012.
National Vital Statistics System. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Multiple Cause of Death on CDC WONDER Online Database, released 2012.
Treatment Episode Data Set (TEDS). Rockville, MD: Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Behavioral Health Statistics and Quality, Department of Health and Human Services (DHHS) as cited by Jones (2012).
Warner, Margaret, Liu Hui Chen, Diane M. Makuc. Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006. National Center for Health Statistics. Data brief, no 22. September 2009.
Warner M, Chen LH, Makuc DM, Anderson RN, Miniño AM. Drug poisoning deaths in the United States, 1980–2008. National Center for Health Statistics. Data brief, no 81. Hyattsville, MD: National Center for Health Statistics. November 2011.
Office of National Drug Control Policy. Reducing Drugged Driving and Protecting Public Health and Safety. Washington DC: Office of national Drug Control Policy, Executive Office of the President. December 2012.
