Over­dose deaths rise sharply in 2016

The Denver Post - - FRONT PAGE - The Wash­ing­ton Post By Lenny Bern­stein

Deaths from drug over­doses rose sharply in the first nine months of 2016, the gov­ern­ment re­ported Tues­day, re­leas­ing data that con­firm the widely held be­lief that the opi­oid epi­demic wors­ened last year de­spite in­creased ef­forts by pub­lic health au­thor­i­ties.

The Na­tional Cen­ter for Health Sta­tis­tics re­ported that over­dose deaths reached a record 19.9 per 100,000 pop­u­la­tion in the third quar­ter, a big in­crease over the 16.7 recorded for the same three months in 2015. Sim­i­larly, the first two quar­ters of last year showed death rates of 18.9 and 19.3, far greater than the cor­re­spond­ing pe­ri­ods for 2015. Data for the fourth quar­ter of 2016 are not yet avail­able.

The gov­ern­ment’s an­nual drug death sta­tis­tics typ­i­cally lag by about a year; the lat­est of­fi­cial in­for­ma­tion from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion shows the 2015 drug over­dose rate at 16.3 per 100,000 peo­ple, for a total of 52,404 fa­tal over­doses. Given avail­able state

data and anec­do­tal in­for­ma­tion, many ex­perts are ex­pect­ing a big in­crease in deaths in 2016, driven by the wors­en­ing cri­sis in over­doses from opi­oids, es­pe­cially fen­tanyl and heroin. About six in 10 drug over­dose deaths are caused by opi­oids.

In June, The New York Times pre­dicted that the num­ber of over­dose deaths would ex­ceed 60,000 in 2016, based on data it com­piled from hun­dreds of state health departments and county coro­ners and med­i­cal ex­am­in­ers. If true, that num­ber would mark the sharpest an­nual in­crease ever recorded. The death rate re­leased by the Na­tional Cen­ter for Health Sta­tis­tics for the 12 months ending last Septem­ber would equate to 59,520 deaths.

In Colorado, the age-ad­justed drug over­dose death rate for all of 2016 was 16.1 deaths per 100,000 pop­u­la­tion, ac­cord­ing to fig­ures from the state De­part­ment of Pub­lic Health and En­vi­ron­ment.

That is the high­est the rate has been since at least 1999.

The fig­ure in­cludes drug poi­son­ings that were clas­si­fied as both un­in­ten­tional and as the re­sult of sui­cide, although the for­mer makes up the vast ma­jor­ity of the deaths.

Over­doses from pre­scrip­tion opi­oids in Colorado fell by about 9 per­cent in 2016, com­pared with 2015, from 329 deaths to 300, ac­cord­ing to fi­nal num­bers from the state. But heroin deaths rose sharply — more than 42 per­cent — from 160 deaths in 2015 to 228 deaths in 2016.

That is an even big­ger in­crease than what pre­lim­i­nary num­bers showed five months ago. State health of­fi­cials said the two trends could be the re­sult of a crack­down on opi­oid pre­scrib­ing in Colorado cou­pled with peo­ple who are ad­dicted to the painkillers switch­ing to heroin.

For all of 2016, the death rate specif­i­cally from pre­scrip­tion opi­oid over­doses in Colorado was 5.3 out of 100,000 pop­u­la­tion, the low­est it has been since 2010. The death rate from heroin over­doses, though, was 4.1 per 100,000, sub­stan­tially higher than it has been in any year in over a decade. In 1999, for in­stance, the heroin over­dose death rate in Colorado was 0.9 deaths per 100,000 pop­u­la­tion.

The raw num­bers from the state Health De­part­ment feed into the big­ger re­port from the Na­tional Cen­ter for Health Sta­tis­tics, which usu­ally lags be­hind Colorado in re­leas­ing data. But Colorado health of­fi­cials use pop­u­la­tion es­ti­mates from the state De­part­ment of Lo­cal Af­fairs — not the fed­eral cen­sus, as the NCHS re­port does — which can lead to slight vari­a­tions in the cal­cu­lated death rates.

The na­tional drug over­dose num­bers are part of a re­port that looked at mor­tal­ity rates from lead­ing causes of death. The data show that the over­all U.S. death rate fell slightly in 2016, with top killers such as heart dis­ease and cancer re­main­ing sta­ble. The es­ti­mates in the re­port are ad­justed for age and con­sid­ered “pro­vi­sional,” so they may change slightly as states con­tinue in­ves­ti­gat­ing the causes of a small num­ber of cases.

In a sep­a­rate study re­leased Mon­day, a Univer­sity of Vir­ginia pro­fes­sor of pub­lic pol­icy and eco­nom­ics sug­gested that opi­oid death rates for 2014 may be as much as 24 per­cent greater than pre­vi­ously re­ported to­tals.

The lat­est gov­ern­ment num­bers back up the dire ac­counts of may­ors, gover­nors, first re­spon­ders and coro­ners who are grap­pling with the un­abated cri­sis of over­dose and ad­dic­tion in com­mu­ni­ties across Amer­ica. The re­port “is show­ing the trend that we’re see­ing around the coun­try from var­i­ous data sources,” said Farida Ah­mad, who wrote the fed­eral re­port. “The data doesn’t show any de­clines at this point.”

The in­creases come de­spite more de­ter­mined ef­forts by gov­ern­ment and pri­vate au­thor­i­ties to in­ter­vene in the epi­demic, which claims an av­er­age 142 deaths daily. Last month, the Pres­i­dent’s Com­mis­sion on Com­bat­ing Drug Ad­dic­tion and the Opi­oid Cri­sis urged the White House to de­clare a na­tional emer­gency. The CDC, Food and Drug Ad­min­is­tra­tion, and Congress have all taken steps to ad­dress the cri­sis, as have physi­cian groups and pri­vate in­sur­ance com­pa­nies. Many com­mu­ni­ties have made the over­dose an­ti­dote nalox­one widely avail­able, and oth­ers are try­ing to pro­vide more treat­ment for the es­ti­mated 2.6 mil­lion opi­oid ad­dicts in the United States.

But lit­tle ap­pears to be work­ing. At this point, death rates for peo­ple be­tween age 25 and 44 have risen for vir­tu­ally ev­ery racial and eth­nic group and in al­most all states, ac­cord­ing to a Wash­ing­ton Post anal­y­sis.

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