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Fatal Opioid Overdoses: Good News and Bad News

For the first time in more than a decade, fewer Americans died from prescription drug overdoses in 2012 than in 2011, according to a new report from the Centers for Disease Control and Prevention.

While the declining death toll is a bit of welcome news, there’s more to the CDC’s report than initially meets the eye.

Graduating from Pills to Heroin

While it’s true that opiate painkillers caused fewer overdose fatalities in the nation, the CDC report also indicates that heroin deaths more than doubled between 2010 and 2012.

Looking at the numbers, it’s important to note that while prescription painkiller deaths rose to 16,000 in a decade, heroin deaths were far fewer in 2012 (6,000). Plus, some reported deaths may have been attributable to opioids and heroin as well as other substances.

One of the co-writers of the CDC report, Holly Hedegaard, an injury epidemiologist, says, “At the national level, it’s hard to know what’s influencing any change in the rate. You really need three or four points to say, here’s where the trend is going.”

Trends Around the Nation

Twenty eight states confirm the CDCs findings of a decrease in opioid deaths, accompanied by rising heroin fatalities in 2012. Many of those states have worked hard to educate doctors about prescribing opioid painkillers, a fact that may be affecting lower overdose rates.

“There’s been some data that the actual prescribing of opioids has gone down as well. It’s not just the overdoses, it’s prescribing,” says Cindy Reilly director of the prescription drug abuse project at the Pew Charitable Trusts.

There’s been some data that the actual prescribing of opioids has gone down as well. It’s not just the overdoses, it’s prescribing.-Cindy Reilly

Driven to a Deadly Alternative?

Dr. Michael H. Lowenstein, medical director for the Waismann Method treatment for opiate dependence, says he’s seen a dramatic increase in the number of heroin patients as they report “graduating” from opioids to heroin.

The CDC reports that three out of four heroin users previously abused prescription painkillers. However, with limited access to refills, these addicts eventually moved on to a cheaper alternative. And that alternative is heroin.

With the exception of American Indians/Alaskan Natives, every region of the country, ethnic group and age group showed an increase in heroin death rates. Men overdosed from heroin at nearly four times the rate of women and the age group most affects was the 25- to 34-year-olds group.

Dr. Lowenstein suggests a three-pronged approach to prevention and treatment strategies: patient education, physician education and closer patient supervision.

Additional Reading: A Majority of ER Visits Traced Back to One Culprit

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