Drug Overdose Epidemic Has Been Growing Exponentially For Decades
https://www.news-line.com/PH_news27263_enews
Death rates from drug overdoses in the U.S. have been on an exponential growth curve that began at least 15 years before the mid-1990s surge in opioid prescribing
suggesting that overdose death rates may continue along this same historical growth trajectory for years to come, according to a University of Pittsburgh Graduate School of Public Health analysis published today in Science.
The type of drug and the demographics of those who die from overdoses has fluctuated over the years. When the use of one drug waned, a new drug filled in, attracting new populations from different geographic regions at faster rates. These findings suggest that, to be successful, prevention efforts must extend beyond control of specific drugs to address deeper factors driving the epidemic.
“The current epidemic of overdose deaths due to prescription opioids, heroin and fentanyl appears to be the most recent manifestation of a more fundamental, longer-term process,” said senior author Donald S. Burke, M.D., Pitt Public Health dean and UPMC-Jonas Salk Chair of Global Health. “Understanding the forces holding these multiple individual drug epidemics together in a tight upward exponential trajectory will be important in revealing the root causes of the epidemic, and this understanding could be crucial to prevention and intervention strategies.”
Burke and his team collected all the accidental drug poisoning – overdose – deaths reported through the U.S. National Vital Statistics System since 1979, when drug overdoses began to be reported in their own category. In the past nearly four decades, the drug overdoses plot as a near-perfect curve, with each yearly data point falling almost exactly on the smooth upward exponential curve.
“This remarkably smooth, long-term epidemic growth pattern really caught our attention,” Burke said. “If we can figure it out, we should be able to bend that curve downward.”
The team then examined overdose death rates for individual drug types, such as cocaine, heroin and prescription opioids, which began to be reported in 1999. What they found was far from perfect.
“There is no regular or predictable pattern to the overdose rates for any of these drugs. Cocaine overdose death rates curved down and up and down and back up over the past 20 years. Methadone deaths have been on a downturn since the mid-2000s. Prescription opioids have been on a fairly steady, steep climb. Heroin deaths shot up in 2010, followed in 2013 by synthetic opioids, such as fentanyl.
Methamphetamine appears to be on the verge of its own dramatic climb,” said lead author Hawre Jalal, M.D., Ph.D., assistant professor of health policy and management at Pitt Public Health. “Nonetheless, when we plot the annual sum of all drug overdoses, we get a remarkably smooth, inexorable exponential curve.”
The team also explored the underlying demographics – age, race, gender and geographic location – of the people who died of drug overdoses. Again, they found great variability depending on the type of drug. Heroin and cocaine impact urban populations, whereas prescription opioids and methamphetamine skew a bit more rural. Cocaine has higher death rates in black men than other populations. When it comes to heroin, younger whites and older blacks have higher death rates.
But, when the overall demographics are combined for all types of drugs, a clear picture emerges of growing death rates spreading across people ages 20 through 65 as the years tick by.
When overdoses are plotted on a U.S. map, certain drugs dominate different areas.
But, when taken as a whole, almost every region in the country is a hotspot for overdose deaths from one or more drugs, with the exception of the north central states.
None of these analyses suggest an obvious mechanism as to how multiple, drug-specific sub-epidemics have merged into a single, tight, exponential curve. However, the researchers believe that improved communications and supply chains, efficiencies in drug manufacturing, expanding drug markets and lower prices could all be making illicit drugs more available, while sociological and psychological forces, such as loss of purpose, dissolution of communities and despair, could be accelerating demand.
“This is a paradox – inexorable growth in the aggregate, composed of variable sub-epidemics,” said Burke. “But it should be solvable. Evidence-based public health responses have contained past epidemics. If we understand and address these root causes at the same time that we take on the opioid crisis, we should be able to curb the epidemic for good.”
Co-authors of this research are Jeanine M. Buchanich, Ph.D., and Mark S. Roberts, M.D., both of Pitt Public Health; Lauren C. Balmert, Ph.D., of Pitt Public Health and Northwestern University; and Kun Zhang, Ph.D., of the U.S. Centers for Disease Control and Prevention (CDC).
This research was supported in part by CDC grant IPA1605230, National Institutes of Health grant 1KL2TR0001856 and Robert Wood Johnson Foundation grant 72858.
Filed under: General Problems
I want the users of opiates for reasons OTHER than as medicine to live, …but this is OFFICIALLY messed up now. I personally know 5 people that are REALLY dying from secondary issues to untreated pain. It is about 5 people that died accidentally from THEIR OWN Prescription MEDICINE all of 2017 in the whole country!
And we know an average of 20 will suicide TODAY because of issues including untreated physical, clinically identifiable pain or DIRECTLY because of untreated physical, clinically identifiable pain. This is like watching a cartoon where the coyote gets smashed every 10 seconds now. I am so ashamed of my Government.
I can only speak personally that low spine surgery, “fusion” surgeries did in fact accomplish the desired end and were a success however, the pain I suppose from the very invasive nature is simply overwhelming in recovery and tissue time heal but the never ending pain from my surgeries are still so never ending, so overwhelming, and so difficult to manage that it took every ounce of “will power”, physical therapy emotional support, and determination to recover but without adequate opiate medication I could have never continued working for 23 years after the last surgery. I knew what I was doing. I trusted my doctor. I did not nor could not sit down and retire with two sons in college, a home and two vehicles to pay for. With the help of opiate medication we, my wife and I managed to accomplish what we HAD to do. I NEVER felt like my life was in jeopardy using the prescribed medication and the proper use and responsibility required of me was ALWAYS monitored with drug screenings and medication “pill counts”. I followed my doctors instructions because to “get high” was never the goal. The goal was to continue to “pay my way” through life without harming my health. The medication was necessary and the use of it indeed required the use of personal responsibility. I understand that if all prescribed opiate medication was removed from society…..PERIOD, something either made here in the US or some type opiate/opioid would find its way to the available market. HOW and why does a very significant amount of substance find it’s way into this country and even if it did not……something WOULD take the place of the preferred illicit substance as apparently time and study shows. Please stop the war on unwanted pain. We are not “partying”!!! Write, call any agency relative to the “opioid epidemic” and state that we are not fueling a “crisis”.
Still more overwhelming evidence that it’s NOT the prescription drugs. Yet I seriously doubt any evidence,no matter how overwhelming, will divert the hysteria or slow the attacks on prescription meds…after all, they’re the only thing the “War on Drugs” can possibly succeed against. Go after doctors & innocent patients who’ve never abused anything; they’re easy to get at.
And are we talking rates or raw numbers here? If just numbers, could it be that a certain percentage of the population is just determined to get high, & since the population is growing, the number of those out to get high is growing? Because there is certainly a certain # of people who are going to get high no matter what.