The opioid epidemic may be even deadlier than we think; it already kills more than guns or cars

April 26, 2017 —  The opioid epidemic has led to the deadliest drug crisis in US history — deadlier than the crack epidemic of the 1980s and 1990s. Drug overdoses now cause more deaths than gun violence and car crashes. They even caused more deaths in 2015 than HIV/AIDS did at the height of the epidemic in 1995. A new study, however, suggests that we may be in fact opiodsunderestimating the death toll of the opioid epidemic and current drug crisis. And we don’t even know by how much, according to VOX.com.

The study, conducted by researchers at the Centers for Disease Control and Prevention, looked at 1,676 deaths in Minnesota’s Unexplained Death surveillance system (UNEX) from 2006 to 2015. This system is meant to refer cases with no clear cause of death to further testing and analysis.

In total, 59 of the UNEX deaths, or about 3.5 percent, were linked to opioids. But more than half of these opioid-linked deaths didn’t show up in Minnesota’s official total for opioid overdose deaths.

Given that this is just one death surveillance system in a state that only had a bit more than 300 reported opioid overdose deaths in 2015, it’s possible that these dozens of deaths speak to a much bigger problem of undercounting the opioid epidemic nationwide. It’s unclear just how widespread of a problem this is in other death surveillance systems and other states, but the study’s findings suggest that the numbers we have so far for opioid overdose deaths are at best a minimum.

In other words, the US’s deadliest drug overdose crisis in history is likely even deadlier than we think.

Typically, deaths are marked by local coroners or medical examiners through a system made up of codes from the International Classification of Diseases, 10th Edition (ICD-10). If a medical examiner marks a death as immediately caused by an opioid overdose through the proper ICD-10 codes, that death is eventually added to the US’s total for opioid overdose deaths.

But there’s no national standard for what counts as an opioid overdose, so it’s left to local medical officials to decide whether a death was caused by an overdose or not. This can get surprisingly tricky — particularly in cases involving multiple conditions or for cases in which someone’s death seemed to be immediately caused by one condition but that condition had a separate underlying medical issue behind it.

For instance, opioids are believed to increase the risk of pneumonia. But if a medical examiner sees that a person died of pneumonia, they might mark the death as caused by pneumonia, even if opioids were the underlying cause for the death. (This would be a bit like blaming a lifetime smoker’s death on lung cancer without acknowledging the cigarettes’ contribution.)

In 2015, more Americans died of drug overdoses than any other year on record — more than 52,000 deaths in just one year. That’s higher than the more than 38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.   This latest drug epidemic, however, is not solely about illegal drugs. It began, in fact, with a legal drug.

As a result, opioid overdose deaths trended up — sometimes involving opioids alone, other times involving drugs like alcohol and benzodiazepines (typically prescribed to relieve anxiety). By 2015, opioid overdose deaths totaled more than 33,000 — close to two-thirds of all drug overdose deaths.

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Travis County Youth Substance Abuse Prevention Coalition
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