Opioid Pain Meds Culprits in Majority of Overdose Deaths

Caroline Cassels

February 19, 2013

Opioid analgesics are the primary culprits in the vast majority of US overdose deaths, new research shows.

An analysis conducted by investigators at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, showed that 75.2% of pharmaceutical deaths involved opioids, either alone or in combination with other drugs.

"Data recently released by the National Center for Health Statistics show drug overdose deaths increased for the 11th consecutive year in 2010. Pharmaceuticals, especially opioid analgesics, have driven this increase. Other pharmaceuticals are involved in opioid overdose deaths, but their involvement is less well characterized," write Christopher M. Jones, PharmD, and colleagues from the CDC.

The findings are published as a Research Letter in the February 20 issue of JAMA.

The investigators used data from the National Vital Statistics System multiple cause-of-death file to examine the specific drugs involved in pharmaceutical and opioid-related overdose deaths.

The data show that in 2010, there were 38,329 drug overdose deaths in the United States. Of these, 57.7% (22,134) involved pharmaceuticals, and 24.6% (9429) involved only unspecified drugs.

Of the pharmaceutical-related overdose deaths, 74.3% (16,451) were unintentional, 17.1% (3780) were suicides, and 8.4% (1868) were of undetermined intent.

Opioids (75.2%), benzodiazepines (29.4%), antidepressants (17.6%), and antiepileptic and antiparkinsonism drugs (7.8%) were the pharmaceuticals (alone or in combination with other drugs) most commonly involved in pharmaceutical overdose deaths, the investigators report.

According to the authors, the analysis not only confirms the predominant role opioid analgesics play in pharmaceutical overdose deaths but also highlights "the frequent involvement of drugs typically prescribed for mental health conditions such as benzodiazepines, antidepressants, and antipsychotics in overdose deaths."

They also note that individuals with mental illness "are at increased risk for heavy therapeutic use, nonmedical use, and overdose of opioids."

As such, they emphasize that "screening, identification, and appropriate management of such disorders is an important part of both behavioral health and chronic pain management. Tools such as prescription drug monitoring programs and electronic health records can help clinicians to identify risky medication use and inform treatment decisions, especially for opioids and benzodiazepines."

The authors have disclosed no relevant financial relationships.

JAMA. 2013;309:657-659. Abstract