Opioid Overdose Triples in the United States, CDC Report Shows

Caroline Cassels

September 30, 2009

September 30, 2009 — Fatal overdoses in the United States involving opioid analgesics has more than tripled since 1999, with higher rates among men, individuals aged 35 to 54 years, and non-Hispanic whites.

A new report from the Centers for Disease Control and Prevention (CDC) shows that the number of fatal poisonings caused by opioid overdose increased from 4000 in 1999 to 13,800 in 2006. Furthermore, the report by Diane M. Makuc, DrPH, and colleagues from the CDC's National Center for Health Statistics, indicates that opioid analgesics were involved in almost 40% of all poisoning deaths in 2006, up from about 20% in 1999.

Poisoning is the second leading cause of injury death overall and the leading cause of injury death for individuals aged 35 to 54 years. It surpasses firearm-related and motor vehicle–related death in this age group.

"Throughout the period 1999-2006, people aged 35-54 years had higher poisoning death rates involving opioid analgesics than those in other age groups," Dr. Makuc and colleagues write.

According to the report, drug poisonings are the largest portion of the poisoning burden, and opioid analgesic–related deaths are among the fastest increasing drug poisoning deaths.

Among opioid analgesic–related deaths, those involving methadone increased the most during the study period.

"Methadone is a long-acting opioid and requires a complex dosing schedule. Methadone relieves pain for 4 to 8 hours but remains in the body for up to 59 hours. A lack of knowledge about the unique properties of methadone was identified as contributing to some deaths," the authors write.

In addition, the researchers found that the number of poisoning deaths involving methadone increased nearly 7-fold from 790 in 1999 to 5420 in 2006.

The report also shows that in about 50% of deaths involving opioid overdose, more than 1 type of drug contributed to the death. Involved in 17% of deaths, a combination of benzodiazepines and opioids was specified most frequently. This was followed by cocaine or heroin in 15% of deaths and benzodiazepines with cocaine or heroin in 3% of deaths.

"The involvement of benzodiazepines — sedatives used to treat anxiety, insomnia and seizures — is particularly troubling as previous studies have shown that people who were prescribed both methadone and benzodiazepines were at greater risk of overdose than those prescribed only 1 of these drugs," the authors write.

Increase in Fatal Poisonings Involving Opioid Analgesics in the United States, 1999–2006.

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