New Data: Illegally obtained opioids is the “driving force” behind epidemic
The data analytics approach was used to understand the link between opioid overdose deaths and the legal use of prescribed opioids
http://wwlp.com/2016/07/26/new-data-illegally-obtained-opioids-is-the-driving-force-behind-epidemic/
BOSTON (STATE HOUSE NEWS SERVICE) – Authorized by a law signed last year to collect information from health care agencies, law enforcement departments, the court system and other state agencies, the Department of Public Health is working to demystify the data and identify previously unseen trends in the state’s opioid crisis.
In a preliminary report filed with the Legislature this month, DPH Commissioner Monica Bharel wrote that other states have already called Massachusetts to learn more about its approach to using data analytics to inform the state’s response to the scourge of opioid misuse and overdose.
“The ability to look as broadly and as deeply at public health data has been a unique challenge, but one that has given us a much greater understanding of the current opioid epidemic,” Bharel wrote. The approach “has enabled Massachusetts to serve as a national example for the possibilities of public health’s ability to leverage data warehousing to respond to pressing policy and health concerns by allowing existing data to be used in new and innovative ways to support policy and decision making.”
Working with the Center for Health Information and Analysis, MassIT, the Office of the Chief Medical Examiner, MassHealth, the Department of Correction and others, DPH has developed a model that allows for “simultaneous analysis of 10 data sets with information relevant to opioid deaths.”
The collaborative effort to link data sets has allowed DPH to dig into questions like, “Does an abnormally high number of prescribing physicians increase a patient’s risk of fatal overdose?”
The preliminary answer, DPH reported, is yes. The agency reported that the risk of a fatal opioid overdoses is seven times greater for individuals who use three or more prescribers within three months. DPH also reported that the concurrent use of opioids and benzodiazepines is associated with a four-fold increase in risk of a fatal opioid overdose.
The data analytics approach was also used to better understand the link between opioid overdose deaths and the legal use of prescribed opioids. DPH reported that “at least” two out of every three people who died of an opioid overdose had been prescribed an opioid between 2011 and 2014.
But just 8.3 percent of those decedents had an active opioid prescription in the same month as their death, DPH said, and in 83 percent of opioid overdose deaths that had a toxicology report completed the person who died had “illegally-obtained or likely illegally-obtained substances” in their system at their time of death.
In its report, DPH points to the information on illegally-obtained substances as “evidence to support an emerging hypothesis that illegally-obtained substances are the driving force behind” the state’s epidemic.
Since 2000, Massachusetts has seen a 350 percent increase in opioid-related deaths — from 338 in 2000 to an estimated 1,526 in 2015 — including record-setting numbers of deaths in each of the last four years, according to DPH.
Filed under: General Problems
Yes! Finally someone began to ask the right questions and actually use available data to differentiate between chronic pain patients with active opioid prescriptions.
Most pain doctors require an MRI that shows some structural damage to the spine in order to have something in the file to support prescribing opioids. We all know that a person can have an MRI showing structural damage and not be experiencing pain. And the opposite is also true. A person can have severe back pain without an MRI showing structual damage.
The article stated: “DPH reported that “at least” two out of every three people who died of an opioid overdose had been prescribed an opioid between 2011 and 2014.”
This statement is misleading. The article is implying that the prescribing of opioids led to addiction and ultimately overdose deaths in 66% of the cases.
This is the old question of what came first: the chicken or the egg. In order to support their assertion that 66% of overdose deaths were a result of being prescribed opioids, they would need to assert that the people who died were not already addicted to opiates prior to the legally obtained prescription written between 2011 and 2014. That data would need to be parsed out further. It would be difficult if not impossible to find out whether or not they were addicted to opioids prior to 2011. It would be very interesting to study a population of opioid naive patients who were prescribed pain medication that led them down the road to addiction and ultimately an overdose death. That is the real question and I suspect the number of people in that category is very small.
At least Massachusetts is attempting to dig deeper and and analyze the data they have rather than take the easy way out and regurgitate statistics provided by the CDC or organizations with a conflict of interest such as PROP. This is an encouraging development.
Thank you Massachusetts for doing the epidemiology necessary to elucidate the cause of this epidemic: illegally obtained opioids.
The CDC could take a cue from you.
And one more idea: let’s put a marker on every pill that manufacture legitimately in America.
We follow lot numbers and Vin numbers and DEA numbers.
We track bullets broccoli and balogna.
We can then track this substance back to its source:
Doctor
Pharmacy
Patient
Thief
Should be pretty simple to tell who got what where.
Then will really know that these drugs are not coming, for the most part, from physicians.
And we can turn our attention to the source.
Bravo Dr. Mark. Exactly!