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National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009.
Drug Alcohol Depend. 2013 Aug 01; 131(3):263-70.DA

Abstract

BACKGROUND

Pharmaceutical opioid related deaths have increased. This study aimed to place pharmaceutical opioid overdose deaths within the context of heroin, cocaine, psychostimulants, and pharmaceutical sedative hypnotics examine demographic trends, and describe common combinations of substances involved in opioid related deaths.

METHODS

We reviewed deaths among 15-64 year olds in the US from 1999-2009 using death certificate data available through the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Database. We identified International Classification of Disease-10 codes describing accidental overdose deaths, including poisonings related to stimulants, pharmaceutical drugs, and heroin. We used crude and age adjusted death rates (deaths/100,000 person years [p-y] and 95% confidence interval [CI] and multivariable Poisson regression models, yielding incident rate ratios; IRRs), for analysis.

RESULTS

The age adjusted death rate related to pharmaceutical opioids increased almost 4-fold from 1999 to 2009 (1.54/100,000 p-y [95% CI 1.49-1.60] to 6.05/100,000 p-y [95% CI 5.95-6.16; p<0.001). From 1999 to 2009, pharmaceutical opioids were responsible for the highest relative increase in overdose death rates (IRR 4.22, 95% CI 3.03-5.87) followed by sedative hypnotics (IRR 3.53, 95% CI 2.11-5.90). Heroin related overdose death rates increased from 2007 to 2009 (1.05/100,000 persons [95% CI 1.00-1.09] to 1.43/100,000 persons [95% CI 1.38-1.48; p<0.001). From 2005-2009 the combination of pharmaceutical opioids and benzodiazepines was the most common cause of polysubstance overdose deaths (1.27/100,000 p-y (95% CI 1.25-1.30).

CONCLUSION

Strategies, such as wider implementation of naloxone, expanded access to treatment, and development of new interventions are needed to curb the pharmaceutical opioid overdose epidemic.

Authors+Show Affiliations

Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, United States. Susan.Calcaterra@ucdenver.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23294765

Citation

Calcaterra, Susan, et al. "National Trends in Pharmaceutical Opioid Related Overdose Deaths Compared to Other Substance Related Overdose Deaths: 1999-2009." Drug and Alcohol Dependence, vol. 131, no. 3, 2013, pp. 263-70.
Calcaterra S, Glanz J, Binswanger IA. National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. Drug Alcohol Depend. 2013;131(3):263-70.
Calcaterra, S., Glanz, J., & Binswanger, I. A. (2013). National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. Drug and Alcohol Dependence, 131(3), 263-70. https://doi.org/10.1016/j.drugalcdep.2012.11.018
Calcaterra S, Glanz J, Binswanger IA. National Trends in Pharmaceutical Opioid Related Overdose Deaths Compared to Other Substance Related Overdose Deaths: 1999-2009. Drug Alcohol Depend. 2013 Aug 1;131(3):263-70. PubMed PMID: 23294765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. AU - Calcaterra,Susan, AU - Glanz,Jason, AU - Binswanger,Ingrid A, Y1 - 2013/01/05/ PY - 2012/07/23/received PY - 2012/11/16/revised PY - 2012/11/21/accepted PY - 2013/1/9/entrez PY - 2013/1/9/pubmed PY - 2013/11/19/medline KW - Heroin KW - Mortality KW - Overdose KW - Pharmaceutical opioids KW - Poisoning KW - Stimulants SP - 263 EP - 70 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 131 IS - 3 N2 - BACKGROUND: Pharmaceutical opioid related deaths have increased. This study aimed to place pharmaceutical opioid overdose deaths within the context of heroin, cocaine, psychostimulants, and pharmaceutical sedative hypnotics examine demographic trends, and describe common combinations of substances involved in opioid related deaths. METHODS: We reviewed deaths among 15-64 year olds in the US from 1999-2009 using death certificate data available through the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Database. We identified International Classification of Disease-10 codes describing accidental overdose deaths, including poisonings related to stimulants, pharmaceutical drugs, and heroin. We used crude and age adjusted death rates (deaths/100,000 person years [p-y] and 95% confidence interval [CI] and multivariable Poisson regression models, yielding incident rate ratios; IRRs), for analysis. RESULTS: The age adjusted death rate related to pharmaceutical opioids increased almost 4-fold from 1999 to 2009 (1.54/100,000 p-y [95% CI 1.49-1.60] to 6.05/100,000 p-y [95% CI 5.95-6.16; p<0.001). From 1999 to 2009, pharmaceutical opioids were responsible for the highest relative increase in overdose death rates (IRR 4.22, 95% CI 3.03-5.87) followed by sedative hypnotics (IRR 3.53, 95% CI 2.11-5.90). Heroin related overdose death rates increased from 2007 to 2009 (1.05/100,000 persons [95% CI 1.00-1.09] to 1.43/100,000 persons [95% CI 1.38-1.48; p<0.001). From 2005-2009 the combination of pharmaceutical opioids and benzodiazepines was the most common cause of polysubstance overdose deaths (1.27/100,000 p-y (95% CI 1.25-1.30). CONCLUSION: Strategies, such as wider implementation of naloxone, expanded access to treatment, and development of new interventions are needed to curb the pharmaceutical opioid overdose epidemic. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/23294765/National_trends_in_pharmaceutical_opioid_related_overdose_deaths_compared_to_other_substance_related_overdose_deaths:_1999_2009_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(12)00459-0 DB - PRIME DP - Unbound Medicine ER -