Vital Signs: Overdoses of Prescription Opioid Pain Relievers — U.S., 1999 – 2008 Research Abstract

Background: Overdose deaths involving opioid pain relievers (OPR), also known as opioid analgesics, have increased and now exceed deaths involving heroin and cocaine combined. This report describes the use and abuse of OPR by state.

Methods: CDC analyzed rates of fatal OPR overdoses, nonmedical use, sales, and treatment admissions.

Results: In 2008, drug overdoses in the United States caused 36,450 deaths. OPR were involved in 14,800 deaths (73.8%) of the 20,044 prescription drug overdose deaths. Death rates varied fivefold by state. States with lower death rates had lower rates of nonmedical use of OPR and OPR sales. During 1999–2008, overdose death rates, sales, and substance abuse treatment admissions related to OPR all increased substantially.

By 2010, enough OPR were sold to medicate every American adult with a typical dose of 5 mg of hydrocodone every 4 hours for 1 month. Given that 3% of physicians accounted for 62% of the OPR prescribed in one study, the proliferation of high-volume prescribers can have a large impact on state use of OPR and overdose death rates. Large increases in overdoses involving the types of drugs sold by illegitimate pain clinics (i.e., “pill mills”) have been reported in Florida and Texas. Such clinics provide OPR to large volumes of patients without adequate evaluation or follow-up. Another possible contributor to state disparities is poverty, which was associated with greater increases in state death rates during 1999–2008. Medicaid populations are at greater risk of OPR overdose than non-Medicaid populations.

Source: Centers for Disease Control and Prevention – Morbidity and Mortality Weekly Report (MMWR) – 11/1/11