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Which Drug Causes the Most Deaths Each Year?

Drugs cause deaths every day across America. Both prescription and illicit drugs are involved in the deaths across the country. Drugs containing oxycodone, hydrocodone and methadone are responsible for most prescription deaths.

Consider these facts:

  • In 2015, about 91 Americans died per day from an opioid overdose. An annual mortality count of more than 33,000 deaths.
  • Every day, more than 1,000 people are treated in emergency departments for prescription opioids.
  • Prescription drugs deaths actually outnumbered heroin deaths.
  • Since 1999, the number of prescription opioids sold in the U.S. nearly quadrupled. During the same timeframe, overdose deaths involving prescription opioids and heroin quadrupled.
  • As a point of comparison, 12,982 people lost their lives to heroin overdoses in 2015.1,2
  • In 2015, an estimated 276,000 adolescents, 829,000 young adults , and 2.7 million adults misused prescription pain relievers in the past month.
  • Oxycodone caused 5,417 deaths versus 3,274 deaths from hydrocodone in 2014.

What Is Oxycodone?

Purdue Pharma came up with OxyContin as the latest and greatest “miracle pill.” He was looking for a non-addictive alternative to treating pain.

Drug users discovered that crushing tablets gave them a much larger dose of the opioid. It also created a more powerful high than traditional narcotic medications. In 2010, in an attempt to decrease epidemic levels of abuse, Purdue reformulated OxyContin. He wanted make it harder to crush, snort or inject. About 25% of users claimed they figured out how to defeat the deterrent. Addiction experts relate the rise of addictive prescription drugs to the recent heroin epidemic.

  • An analysis of people discharged from emergency showed oxycodone was the most widely prescribed pain reliever. There were 52.3% total dispensed drugs. Of those, 97.9% were for the 5-mg pill.6,7,8

What Is Hydrocodone?

Hydrocodone is in the same drug family as morphine and oxycodone. The drug is a semi-synthetic opioid synthesized from codeine.

  • Several variants available in the U.S. also contain acetaminophen.
  • Hydrocodone has a high potential for dependency and addiction.
  • The number of prescriptions for opioids increased from 76 million in 1991 to nearly 207 million in 2013. The United States is responsible for nearly 100% of the world’s consumption of hydrocodone.
  • The recent introduction of hydrocodone has raised questions about general safety and need for opioid medications. These concerns came from their potential for misuse, abuse, diversion and addiction.
  • From 2007 to 2009, data from poison control centers showed hydrocodone more intentionally used by adolescents than any other prescription opioid. 9

What Is Methadone?

Methadone is used for moderate to severe pain and for opioid addiction treatment.

  • Researchers believe fatal cardiovascular side effects are responsible for methadone deaths.
  • Studies show cardiovascular disease is a factor in death for recovering methadone addicts. 10
  • In 2006, the U.S. Food and Drug Administration issued warnings about methadone. They warned about respiratory depression, cardiac arrhythmias, and unintentional overdoses.
  • Methadone prescriptions account for 0.85% in the insured population and 1.1% in the Medicaid population.
  • Despite the low number of prescriptions, methadone deaths accounted for 22.9% of all opioid-related deaths. There were3,400 people who lost their lives to the drug in 2014. 11

An Emerging Killer: Fentanyl

Initially used as a general anesthetic during surgery, fentanyl is a powerful synthetic opioid. Fentanyl is 50 to 100 times stronger than morphine and 50 times more potent than heroin. An amount the size of three grains of sugar is lethal to an adult.

The majority of fentanyl overdoses in the U.S. are illegal and produced in Mexico. Yet some are linked to legal prescriptions. It is hard to know how many fentanyl deaths are caused by prescription fentanyl. Most medical examiners are unable to tell the difference between pharmaceutical and illicit versions. 12,13

  • Of 351 people who suffered fatal opioid overdoses in New Hampshire, fentanyl was a factor in 253 of those deaths. 11
  • Most experts blame fentanyl for the 72.2% increase in synthetic opioid deaths from 2014 to 2015. They point the finger at illegally manufactured versions for causing overdose numbers to triple in just two years. (3,105 in 2013 to 9,580 in 2015)
  • It is common for people using fentanyl to have demographic similarities with heroin users.
  • Fentanyl is often sold in counterfeit pills that are designed to look like common prescription opioids.
  • Fentanyl is also added to heroin or other drugs, which is a contributing factor in many deaths.

Contributing Factors to Prescription Opioid Overdoses

A huge push has been made to warn the public of the dangers of prescription opioids. What gets lost in the message: the issue of polysubstance abuse.

If the coroner found drugs in a person’s system, each drug would be listed separately under their overdose categories.

Nearly 30% of fatal opioid overdoses also involve benzodiazepines. These are often used concurrently with opioids. It is possible the increase in opioid-related deaths is related to the simultaneous use of benzodiazepine/opioid. The number of people using both classes of drugs increased from 9% in 2001 to 17% in 2013.15

A recent study found 30% of individuals who were prescribed opioids also received benzodiazepines. This study found co-prescribing was associated with a higher risk of death. Benzodiazepines increase the respiratory depressant effect of opioids. This can be fatal.

Concurrent use of opioids and benzodiazepines, Increases the risk of for opioid overdose. Elimination of concurrent benzodiazepine/opioid use could reduce the risk of emergency room visits. 15

Posted on June 1, 2017 and modified on May 3, 2019

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