Posted by & filed under Noah's Notes.

In December the CDC released updated data on trends in deaths from drug overdose between 1999 and 2016 and, as you might imagine, there is nothing good about it.

Anyone paying attention knows it is getting worse, but this data from the National Vital Statistics System also gives us insights into specific groups, geography and types of drugs.  All of this is important to understand if we wish to have an appropriate medical response and effective public policy.

Here are the “low-lights”:

  • In 2016 there were 63,600 drug overdose deaths in the US, up 21% from 2015.
  • Deaths from drugs like fentanyl and tramadol doubled between 2015 and 2016.
  • Drug overdose death rates increased by 10% per year between 1999 and 2006, by 3%per year between 2006 and 2014 and by 18% per year between 2014 and 2016 (probably due to the introduction of potent synthetic opioids).
  • Overdose rates are rising in all; age groups.
  • For people 55 to 64 drug overdose deaths have been rising steeply in the last 2 years (@ 17%).
  • The highest rates are in people aged 25-54.
  • Males have higher rates of overdose deaths than females.
  • 22 states (including Maine) and the District of Columbia have rates higher than the national average, 23 states had rates lower than the national average, and 5 states are at the national average.
  • The 5 worse states are West Virginia, Ohio, New Hampshire and Pennsylvania.
  • The 5 best states are Iowa, North Dakota, Texas and South Dakota.

To put all of this in perspective, the number of people dying from overdose each year is higher than the number of people who died in the Viet Nam war, higher than number who died from AIDS at the peak of that epidemic, and higher than the number who died in car crashes before safety changes to cars.

It is evident that the health care system is not doing its job, our political leaders are not doing their job and our society is not doing its job.  We must address the stigma associated with addiction, spread understanding of substance use disorders as chronic disease, expand access to medication assisted recovery, improve governmental and private payer support for these programs, make naloxone (the overdose antidote) widely available in our communities, and confront the poverty and emotional trauma that are the major causes of these challenges.

Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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