U.S. Drug overdose deaths are increasing

The second leading cause of accidental death in the US is drug overdose (JAMA 2007). Prescription painkiller overdose deaths (opioid analgesics like OxyContin, Vicodin and methadone) account for nearly half of the 36,450 total fatal overdoses with 15,000 deaths that have claimed a number of celebrity lives including famous actor Heath Ledger (CDC 2011).

With so much concern over illegal drugs, it seems silly not to focus on a problem that is at least as deadly but far more accepted.

Drug overdose deaths increasing quickly

Drug overdoses are normally considered accidental and they're on the riseWe’ve reported on this phenomenon before, so for the regular A3 readers this report might not seem new. But what’s staggering is just how quickly these numbers are moving up.

In 2004 there were 19,838 total accidental overdose deaths, with about 9,000 caused by prescribed drugs, and 8,000 more caused by illegal drugs like cocaine, heroin, and methamphetamines (Paulozzi, LJ, Budnitz 2006). That signals a near doubling in about 7 years, and when you look at numbers from 1999, we’re talking about triple the accidental drug overdose deaths in just over a decade! Fastest growing cause of death in our country ladies and gentlemen.

SAMHSA Reports that use of prescription pain relievers (opioid analgesics) have increased since 2002 from 360,000 to 754,000 people in 2010. That means that people are twice as likely to use these drugs now, which would be fine if 5% of the users weren’t dying every year.  A study I talked about on ABC’s Good Morning America earlier this year (see here) reported that people taking heavy doses are especially likely to die and that this might be at least partially due to additional opioid use over and above the prescribed regimen.Time to get this under control prescribers!!!

This increase in usage opioid analgesics like Oxycontin, Vicodin, and methadone has made them the some of the most deadly drugs in the USA (Paulozzi, LJ, Budnitz 2006). In 1999 to 2004 prescription overdose related to opioid analgesics increased from 2,900 to at least 7,500, this equates to 160% increase in just 5 years (Paulozzi).

A JAMA study conducted between 1999 to 2004 reported that white women showed a relative increase in unintentional drug related deaths of 136.5% followed by young adults aged 15-24 years (113.3%). But the latest report from the CDC suggest that Men and middle aged individuals are most likely to be affected by this growing epidemic. The bottom line is this problem is either moving around or is universal enough affect essentially every major group of Americans. One of the scariest findings from this most recent CDC study may be the conclusion that states are generally unprepared to deal with this growing epidemic.

What can we do about overdose deaths?

First of all, it is seriously time that we had more consistent state and federal computer systems keeping track of prescriptions for heavily controlled drugs in this country. We can keep track of packages moving across state lines with no problem, why is it so damn hard to watch pills that lead to 35,000 deaths? Most states have them in place but they’re not heavily used and there’s nothing at all that looks at cross federal prescription patterns.

Second, we wrote about some harm-reduction methods to reduce overdose deaths, things like intranasal naloxone, safe injection sites, and more. As far as I’m concerned, we need to get off our national moral horse and start acting responsibly when it comes to saving lives. If we have simple solutions that have been shown to reduce deaths while not increasing abuse, I say let’s implement!!! Anything else is simply wrong.

Citations:

Paulozzi, LJ, Budnitz, DS, Xi, Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiology Drug Safety 2006; 15: 618-627. (originally published in 2006 and recently updated)

Addiction stories: Hellish Heroin – Bambi’s heroin addiction story

Opiate Addiction can be a horrible thing whether it's to heroin, hydrocodone, oxycontin, or any one of a number of available opiates. This is only the first in a series of addiction stories we will have on the site.Addiction stories seem to have an impact that objective research can never have. This is another in a series of addiction stories submitted by our readers. I hope that everyone will benefit from learning about others’ experiences. There’s no doubt that Bambi’s experience of escalation in use from what seemed initially innocent is a common one. If you, or someone you know, needs help with their opiate addiction, try our rehab-finder for the best way to get reliable, verified, rehab recommendations.

A harrowing tale of heroin addiction:

When most people hear the word heroin, some things come to mind. Those of you who have never even thought of doing a drug like heroin, would never understand. And for those of you who you know who you are, whether you have found your way out, or are slowly still slipping away… Believe me, if you know who you are, then you know how it is. Realizing you’re addicted to something doesn’t hit you, until you mentally find your way out by accepting what has happened and letting go with only one hell of a memory. Continue reading “Addiction stories: Hellish Heroin – Bambi’s heroin addiction story”

About Addiction: Addiction Recovery, Alcohol, and Drug Legalization

Yes, you’ve got it, it’s your 30 seconds of news about addiction from around the world (wide web). Enjoy the reading – you can claim you learned your “new thing of the day.”

Addiction recovery- Inpatient and Outpatient treatment plans

Addiction Recovery-Recovering from addiction is hard, no matter what type of addiction it is. In order to complete a successful recovery from addiction, a positive attitude helps. Holding a positive attitude increases the chances that the recovery attempt will be a successful one. We’ve written often about addiction treatment and tips to increase sucess.

Recovery Now– What are the stages to inpatient addiction treatment? According to Recovery Now, the stages of inpatient treatment include:  intake, detox, stabilization, and long term recovery. Though I don’t necessarily agree with every aspect of this article, it contains some good information about addiction treatment that every reader should know. This additional piece from Recovery Now discusses the appropriateness of inpatient versus outpatient addiction treatment for specific patients.

Alcohol use

Science Daily– We’ve talked about the link that has been found between family history of alcoholism and an individual’s obesity risk.  In this study a family history of alcoholism produced an increased risk for obesity, though the environment also played a large role in this link. Environmental factors include the types of foods that are eaten- foods that are typically high in calories from sugars, salt and fat.

Desert News– Everyone knows at least one person whose life has been affected by alcohol abuse in some form or another. Here is a story of how alcohol negatively affected a woman’s life and how it overtook her life ultimately leading to her death.

The Sydney Morning Herald– Drunk Driving is not just a problem in the United States, driving under the influence of alcohol appears to be a problem in other countries as well.  In Australia almost 1,400 people were arrested for alcohol-related offenses.

AOL Health-There is a multitude of information found on billboards and in TV commercials which explains the risks of drunk and drugged driving. Despite this information 30 million Americans are driving drunk each year and 10 million are driving while they are under the influence of drugs. This problem is very serious and is most problematic among drivers who are aged 16-25. Although there has been a drop in the overall number of individuals who are driving while they are under the influence, one in three car accidents still occur from drunk driving.

Drugs- The dangers of legal drugs, Marijuana, Adderall, and Methadone

Belfast TelegraphAlcohol and legal drugs are okay in small doses and can even be helpful in medical settings and for overall health. However it is important to note that there have been many more alcohol related deaths than deaths from illegal substances such as heroin and crystal meth. By far alcohol is the greatest perpetrator followed by prescription drugs including amphetamines, benzodiazepines and antidepressants. In Ireland in 2009 alone there were 283 alcohol-related deaths were registered in the north and 276 the previous year.

NIH News- There has been a recent increase in marijuana use among 8th graders according to NIDA’s monitoring the future survey. It was reported that the rate of eighth-graders who are using illicit drugs is 16 percent, a 2.5 increase from the previous year’s use of 14.5 percent. Among high school seniors cigarette use has declined but marijuana, ecstasy and prescription drug use has increased. Marijuana use among adolescents is so problematic because it affects the brains development as well as a person’s learning, judgment, and motor skills. Additionally 1 in 6 people who start using it as adolescents become addicted. The spike in the drug use may be attributed to the debate on legalization which may give a false impression that the drug has no negative effects or consequences.

‘WisconsinWatch.org– Use of Adderall, a medication for ADHD, is on the rise and in demand on many college campuses. Adderall is increasing in popularity and is easily accessible on college campuses because it helps individuals study.  The drug is particularly popular in the University of Wisconsin and many students are taking it despite the negative side effects it may bring. School officials are not educating the university population of the ill effects of Adderall so it continues to be used as a study aid. At least part of the worry has to do with the potential for such students to move on to even stronger versions of amphetamines such as crystal meth, so maybe the efforts should focus on teaching students about addiction to amphetamines and the associated risks.

Scotsman NewsMethadone a drug which is used to prevent withdrawal symptoms in individuals who were addicted to opiate drugs (and as a replacement medication in heroin addiction treatment) is going to be in high demand after nearly £2 million worth of the heroin was discovered on a raid in Scotland.  Police hope that by working with healthcare professionals they can help these drug users seek addiction treatment. Anyone who was effected by the drug raid are offered the support and care they need

Victimization and Drug Legalization

Physorg.com– A potential link has been found between victimization (and hence trauma) and the prevalence of substance use disorders. This was most evident for homosexual and bisexual men and women than it was for heterosexual men and women. Both gay men and women reported high prevalence rates of victimization some point in their lifetime with lesbian women twice as likely to report victimization experiences. Men and women who reported two or more victimization experiences were found to have higher odds of alcohol and other drug dependence.

London Evening Standard– Should drugs be legalized? That is the question that is popping up in many states across the United States.  Is marijuana safer if it is regulated by the state?  The argument for legalizing drugs goes a little something like this: Despite drugs being illegal there will always be a demand for them so if drugs are legalized then governments will be able to control drug quality before they are sold on the streets. Tax income from drug sales can then to educate individuals about drugs and to aid individuals who need addiction treatment

North West Evening Mail– Paul Brown, the director of Cumbria Alcohol and Drug Advisory Service spoke out after former drugs policy minister Bob Ainsworth and he called for the decriminalization of all banned substances. Brown informed attendees that only Portugal has decriminalized drugs and since that occurred crime rates have fallen and more individuals are willing to seek treatment for drug problems. Many substances that are legal such as alcohol and tobacco are bigger killers than drugs that are criminalized. Alcohol and tobacco kill an average 40,000 people a year this is 10 times more than any illegal drug.

Alcohol, benzos, and opiates – Withdrawal that might kill you

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it.

Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceded by a medical detox period lasting anywhere from 2 days to a week or more.

Which withdrawals can actually kill?

  1. Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, extreme nausea, diarrhea, or DT (delirium tremens), they need to be rushed to see a doctor as soon as possible. In fact, alcohol withdrawal after heavy, chronic use is best managed under the care of a doctor or a professional medical detox unit. By using medications that relieve withdrawal symptoms, these professionals can essentially eliminate any of these risks.
  2. Benzodiazepines – Benzos were introduced as a replacement to barbiturates that were causing common overdose cases, many of which resulted in death. Nevertheless, withdrawal from extended use of benzodiaepines can kill. Whether Xanax (alprazolam), Ativan (lorazepam), Valium (diazepam) or other variations, long term use of Benzodiazepines requires medical supervision to be completed successfully with minimal side-effects and risk to the patient. Normally, the withdrawal process is managed by slowly reducing the dose and transferring the patient from a slow acting, to a long acting, form of the drug. Still, full resolution of benzodiazepine withdrawal syndrome can take up to 6 months (or even longer).
  3. Opiates – Many people are surprised to learn that in most cases, withdrawal from many opiates is not deadly. Still there are some very important exceptions. Methadone, a long-acting opiate often prescribed as a replacement for heroin can cause death during withdrawal if it’s consumed in high enough doses for a long enough period. The debate of whether the state should be prescribing something like this should be saved for a later date. It is one of the better ways of getting people off of heroin, though obviously, all it does is replace dependence on one substance with another, more manageable one. Also, some of the recently popular methods of rapid-detox from heroin addiction can themselves cause death, and many other negative side-effects. Overall, I would recommend checking in with a physician and conducting opiate withdrawal in a controlled setting. Withdrawal under Suboxone or Subutex can be far less horrific.

Much of the danger in withdrawal from all of these drugs has to do with the body’s response to the extreme changes in the chemical processes going on in the brain and the rest of the body. Alcohol, Benzos, and Opiates interference with the GABA system, the body’s most common downregulator.

Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater – It won’t always lead to disaster, but it’s a bad idea.

The withdrawal danger summary

That’s pretty much it. “Cold Turkey” withdrawal from cocaine, marijuana, crystal meth, ecstasy, GHB (never mix GHB with alcohol though!!!), and many other recreationally used drugs will not lead to death in the vast majority of cases. While it may make you uncomfortable, and you may feel moody, constipated, dehydrated, hungry or nauseous, and a whole slew of other symptoms, the chances of someone actually dying from withdrawal are very small.

If you have any more specific questions regarding your case though, don’t shy from asking me!

About addiction: Prescription overdose, legalization, methadone, and the brain.

Here are this week’s must reads posts about addiction. Don’t forget to click the title for our related posts!

From the other allaboutaddiction (.net) Overdose deaths due to prescription medication

From Addiction InboxThe economics of drug legalization

From Addiction TomorrowA great balanced post about methadone

From PhysorgThe neurological consequences of early meth exposure

That’s it for this week. Enjoy!