Opioids Tied to Many Medication Poisoning Deaths

Deaths from opioid overdose rose dramatically from 1999 to 2006, then slowed

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Medication poisoning deaths have increased in recent years. But they appear to have risen the most with one type of medication.

Opioids, which have a chemical formula similar to morphine, have been a major cause of medication deaths in the last decade, reports the Centers for Disease Control and Prevention (CDC).

"Ask your pharmacist how much medication you can safely take."

Li-Hui Chen, PhD, and colleagues at the CDC wrote the report.

“Multiple factors were involved in the increase,” said Leonard Paulozzi, MD, a medical epidemiologist with the CDC’s National Center for Injury Prevention and Control, in an interview with dailyRx News. "For one, sales of three types of opioid analgesics [hydrocodone, morphine, and oxycodone] shown in the report increased markedly during that interval. This reflects a progressive increase in the number of patients being treated with opioids and a progressive increase in the number of people who were heavy 'nonmedical' users of these drugs.”

The report authors found that there were 1.4 deaths due to opioids per 100,000 people in 1999. That rate jumped to 5.4 per 100,000 in 2011.

The death rate increased at a faster pace from 1999 through 2006, with an 18 percent increase each year. From 2006 through 2011, the increase slowed to 3 percent per year.

Opioid analgesics are used for pain and include medicines like morphine (brand names Avinza, Kadian, MS Contin, others). Other types of opioids include hydrocodone and oxycodone (brand names Vicodin and Oxycontin, respectively).

Deaths from benzodiazepines also increased, the CDC reports. These are medicines used for sedation or to treat anxiety, such as lorazepam (brand name Ativan).

The authors of the CDC report noted that they did not know how many poisonings were accidental and how many were intentional.

What they were able to report was that the greatest increase in people dying from these medications was in white patients and those who were between 55 and 64 years old.

The overall poisoning death rate for adults in this age group increased more than sixfold — from 1 per 100,000 in 1999 to 6.3 per 100,000 in 2011.

While 4.5 times more whites died from opioid analgesics from 1999 to 2011, the rate also doubled for blacks.

“As a practicing community pharmacist, I believe the increase in drug poisoning is in direct relation to the increase in narcotic prescribing that has occurred over the past 20 years," said Steve Leuck, PharmD, and founder of AudibleRx. “From 1991 to 2009, prescriptions for opiate pain medications increased almost threefold, to over 200 million per year.”

He told dailyRx News that “it is imperative for patients and health care providers alike to take the time to understand that increasing the dose of opiate therapy is not always the answer, and quite often may lead to significant negative effects on the patient and their family.

“Providing an opioid-sparing (non narcotic options) treatment plan for a patient’s pain control is currently the most reliable alternative to decreasing the potential for development of opiate tolerance. Decreasing opiate tolerance will decrease the total number of prescription narcotics prescribed and decrease the potential availability for drug poisoning."

The authors of the report used data from the National Vital Statistics System.

The authors did not disclose any funding sources or conflicts of interest.

Review Date: 
September 18, 2014
Last Updated:
September 19, 2014