The Opioid Epidemic: Overdose Rates

Many addicts don’t seek help on time due to the shame of revealing their addiction to their family, the inability to find treatment facilities nearby and because they lack the funds needed to pay for treatment. Due to their pharmacological effects, high doses of opioids can lead to respiratory depression and/or death.One can identify an opioid overdose if the patient has pinpoint pupils, is unconscious and is suffering from respiratory depression. Combining opioids with alcohol and other sedatives such as benzodiazepines increases the chance of suffering from an opioid overdose. Naloxone is a non-expensive drug can reverse the effects of opioid overdose and prevent deaths due to opioid overdose. It’s previously been suggested that naloxone be readily available to relatives of patients that suffer from opioid addiction.

The irresponsible prescription and non-prescription opioid abuse has been increasing since 2003. From 2002 to 2012, statistics from the rate of death from opioid analgesic and heroin poisonings has quadrupled, despite efforts from the government to appease the epidemic. There were an estimated 27 million people who suffered from opioid addiction in 2016, the majority being dependent on heroin, but an increasing proportion using prescription opioids. In Figure 1, the increment of drug-related deaths in the United States from 1999 to 2016 is shown. From these deaths, prescription opioids account for approximately 70% of fatal prescription drug overdoses. In the United States on 2016, there were about 63,632 deaths caused by drug overdose, a 21% increase from previous years.

Figure 1: Scale of drug-related deaths in the United States from 1999 to 2016

A retrospective statistical analysis designed by Pfister et.al. sought to characterize epidemiologic features from patients with prescription and non-prescription  opioid abuse treated at an intensive care unit (ICU) for opioid overdose. The median age was 41, 60% of the patients being female. The most frequent comorbidities identified were tobacco smoking (48.2%), chronic pain (44.6%), and alcoholism (39.3%). The psychological profile of these patients was also studied, finding that the most common mental health issue amongst these patients was depression (28.9%), followed by anxiety disorder (14.8%). 44.63% of the patients admitted used the drugs because of chronic pain. The most frequent opioids abused by these patients were oxycodone (31.4%), hydrocodone (27.5%) and heroin (16.23%). When overdosing, 62.9% of patients ingested other drugs, benzodiazepines being the most common (39.32%) followed by amphetamines (13.48%). Out of the 178 subjects studied, 18 died in the hospital, 17 of them having multiple-organ dysfunction syndrome. Out of the 18 patients that died, 9 had taken other drugs besides opioids when overdosing. The most common cause of death was hypoxic brain injury (50%).