State of the State in outcomes: Prescription drug overdoses

Karin A. Mack, PhDSenior Behavioral Scientist

Prescription Drug Overdose Team

National Center for Injury Prevention and Control

Division of Unintentional Injury Prevention

2000 2002 2004 2006 2008 20100

2

4

6

8

10

12

14

16

MV Traffic

Firearm

Poisoning

Fall

SOURCE: National Vital Statistics System-Mortality (NVSS-M), CDC/NCHS.

Injury Deaths by Cause, 1999-2010 - USAge adjusted rate per 100,000

Drug Poisoning

<11.0 11.0 - 13.9 >14.0

Age-adjusted rate per 100,000 population

10.0

9.6

7.8

8.6

10.6

6.3

3.4

6.7

7.3

14.0

11.8

11.4

9.6

14.4

13.2

15.0

23.8

11.8

10.9

11.4

19.4

10.7

6.812.7

23.6

10.9

12.9

16.9

14.6

16.1

13.0

16.9

15.3

28.9

13.1

17.5

10.4

16.4

17.0

20.7

11.6

VT 9.7NJ 9.8CT 10.1MA 11.0MD 11.0NH 11.8DC 12.9RI 15.5DE 16.6

12.5

Death Rates for Drug Overdose by State, 2010

Data: WONDER multiple causes mortality files, age-adjusted death rates for 2010. Deaths whose underlying cause was coded to unintentional (X40-44), intentional (X60-64, X85), or undetermined intent (Y10-14) drug poisoning.

Number of deaths by selected drugs involved,

US, 1999-2010

CDC/NCHS National Vital Statistics System, CDC Wonder.

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

Opioids HeroinCocaine Benzodiazepines

Year

Num

ber

of

Death

s

Specific Drug Involvement in Pharmaceutical Overdose Deaths, United States, 2010

Jones et al Pharmaceutical overdose deaths, United States, 2010. JAMA 2013 and CDC/NCHS NVSS MCOD 2010.

Rx Opioids

Benzo

diazep

ines

Cocaine

Antidepressa

nts

Heroin

Other

unspec

ified narc

otics

Illicit

stimulan

ts

Antiepileptic a

nd antipark

insonism

drugs

Syste

mic and hem

atologic

al dru

gs

Antipsych

otic and neu

rolep

tic dru

gs

Acetaminophen

Respira

tory

drugs

Cardiova

scular d

rugs

Barbitu

rates

Autonomic n

ervous s

ystem

drugs

NSAID

s

Anesth

etics

and therap

eutic g

ases

Cannibas

Hormones

, insu

lins,

gluco

corti

coids

Anti-infec

tives

Diuretics an

d other

drugs

Topica

l dru

gs

Other

psych

otropic d

rugs

Muscl

e rela

xants

Other

analgesic

s

Gastro

intestinal

drugs

LSD and oth

er psy

chodys

leptics0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

Drug or Drug Class

Num

ber

of D

eath

s

Deaths are the tip of the iceberg.For every opioid overdose death in 2010,

there were

SAMHSA NSDUH, DAWN, TEDS data setsCoalition Against Insurance Fraud. Prescription for Peril. http://www.insurancefraud.org/downloads/drugDiversion.pdf 2007.

Substance abuse treatment admissions 15

Emergency department visits 26

People who meet abuse or dependence criteria 115

Past year nonmedical users 733

Percent change 2000-2010Treatment admissions for Opioids*

>500

300-500<300

TEDS – Treatment episode data set ICPRS/SAMDHA*This category includes admissions for non-prescription use of methadone, codeine, morphine, oxycodone, hydromorphone, meperidine, opium, and other drugs with morphine-like effects.

National Estimates of Misuse/Abuse Drug-related Emergency Department Visits, US 2004

- 2011

Drug Abuse Warning Network http://www.samhsa.gov/data/dawn.aspx#DAWN National Tables

2004 2005 2006 2007 2008 2009 2010 20110

100,000

200,000

300,000

400,000

500,000

600,000

CocaineHeroinAntidepressantsOpiates/opioids

Rates of opioid overdose deaths, sales and treatment admissions, US, 1999-2010

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

1

2

3

4

5

6

7

8

Opioid Sales KG/10,000 Opioid Deaths/100,000Opioid Treatment Admissions/10,000

Year

Rate

Paulozzi, et al. 2011. Vital Signs: Overdoses of Prescription Opioid Pain Relievers --- United States, 1999--2008

Preliminary data

Preliminary data

<1700 1700-2400 >2400

Number of oxycodone scripts per 10,000 persons, US, 2011

Preliminary Data: IMS. Retail.

Preliminary data

Preliminary data

Oxycodone web searches

1. Tampa2. Seattle3. Orlando4. Portland5. Boston6. Phoenix7. Philadelphia8. Miami9. New York10. Atlanta

Thank You

The findings and conclusions in this report are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.