By R Carter
As progress is continually made on the collection and reporting of drug overdose deaths, those improvements are reflected in the data reported by the CDC. The graphs below represent provisional overdose deaths as of November 2018 and are more than 90% accurate, with about 9% awaiting completion of investigations and 1% of records still pending data entry.
Each line represents a specific category of drugs, see the legend, but it should be noted that 90% of drug overdose deaths include multiple drugs. The four most often identified in combination are heroin, cocaine, alcohol and fentanyl. Also about 10% of overdose deaths for each drug category include non-narcotic substances or substances which not considered abusable drugs or substances.
What is the data telling us?
Opioid overdose deaths have plateaued despite continued attempts to restrict access to prescription opioids for first time patients and forced tapering or termination for chronic pain patients. Fewer prescription are being written but overdose deaths continue to climb in some states and overall across the US are down by only 4.4% compared to an overdose death rate which has climbed in some state as much as 30% because of illegal Fentanyl.
In some states where the opioid overdose death rate has declined the most, there’s been a corresponding rise in overdose deaths from psychostimulants such as Cocaine and Methamphetamine. Some are interpreting this as a strong indicator that the so called prescription drug crisis has, all along, been an illegal opioid crisis due to the porous borders in the US and the sophistication of these drug sources to produce products identical to medical grade pharmaceuticals here in the US. Consequently, efforts are underway to better identify specific markers in these substances to differentiate them from legal medical grade substance produced here in the US.
With this growing evidence, many public health officials have stopped labeling the opiate crisis as a prescription drug crisis, al-be-it they still believe the crisis began as a result of over prescribing. No doubt there is some truth in this but simple explanations for drug abuse have rarely, if ever, produced insights that lead to effective means for combating the problem.