Suicides and overdoses doubled in the last two decades – driven by opioids, new study claims

America’s opioid crisis is behind the double in accidental drug overdoses and suicides over the last two decades, a new study says.

Researchers from Michigan Medicine at the University of Michigan analyzed government figures and found that the total number of deaths from both causes rose from 41,000 in 2000 to nearly 111,000 in 2017. 

In the same time period, suicides and overdoses specifically linked to opioids have increased by nearly 25 percent.

The team says more research is needed to identify those most at risk and is calling on lawmakers to invest in programs that treat both opioid addiction and provide mental health care.

A new study has found that opioid-caused suicides and accidental overdoses increased from 17 percent in 2000 to 41 percent in 2017 (file image)

For the study, published in the New England Journal of Medicine, the researchers looked at data from the Centers for Disease Control and Prevention (CDC). 

On a population level, they found the rate rose from 14.7 deaths per 100,000 Americans to 33.7 deaths in the same period – a 129 percent increase.

‘Unlike other common causes of death, overdose and suicide deaths have increased over the last 15 years in the United States,’ said co-author Dr Amy Bohnert, an associate professor of psychiatry at Michigan Medicine.

‘This pattern, along with overlap in the factors that increase risk for each, support the idea that they are related problems and the increases are due to shared fundamental causes.’ 

When the team looked at opioid-caused suicides and overdoses, it found the drugs were responsible for 41 percent of deaths in 2017, an increase from 17 percent in 2000. 

The researchers identified several risk factors for both. 

Men were twice more likely than women to die of either an overdose or to commit suicide.

White men below age of 40 were the most likely to die from an accidental overdose and were tied with Native American men in the same age range for most likely to commit suicide.

But in middle and old age, black men were more likely to overdose than white or Native American men.  

Among women, overdosing was a more likely cause of death than suicide for all racial and ethnic groups below age 65. 

OPIOIDS IN AMERICA: BY THE NUMBERS

Opioid prescriptions are going down across the US, but overdoses are not.

In 2017, the rate of opioid overdose deaths hit a record high, with around 200 Americans dying every day, according to new figures published by the DEA.

US Health and Human Services Secretary Alex Azar insists the tide has turned.  

However, doctors warn the boom in prescriptions flooded the market with unused pills, some of which may have made it onto the black market.

An in-depth analysis of 2016 US drug overdose data shows that America’s overdose epidemic is spreading geographically and increasing across demographic groups.

Drug overdoses killed 63,632 Americans in 2016 and increased to 70,237 in 2017.

Nearly two-thirds of these deaths involved a prescription or illicit opioid. Overdose deaths increased in all categories of drugs examined for men and women, people ages 15 and older, all races and ethnicities, and across all levels of urbanization. 

Source: Centers for Disease Control and Prevention 

The increase in death rates from overdose and suicides seems to parallel the increase in prescription opioids, then heroin and now fentanyl.

CDC figures released last year reveal that fentanyl, the synthetic opioid 100 times stronger than morphine, was the driving culprit of the 45 percent increase in overdose deaths from 2016 to 2017. 

The researchers suggest several interventions could bring down both overdose and suicide death rates.  

One suggestion is reducing the amount of opioids prescribed per appointment, as well as cutting the doses. 

The overall national opioid prescribing rate has been declining since 2012 and, in 2017, the prescribing rate had fallen to the lowest it had been in more than 10 years.

Another way to drive down death rates is to treat overdoses and suicides in a similar manner – meaning investing in programs that both treat opioid addiction and provide mental health care.

‘Individuals with chronic pain are at clear elevated risk for both unintentional overdose and suicide,’ said co-author Dr Mark Ilgen, a professor of psychiatry at Michigan Medicine.

‘To date, many system-level approaches to address overdose and suicide have addressed these as if they are unrelated outcomes.’

They also suggest that those with an opioid use disorder undergo medication-assisted treatment (MAT) – including using methadone and buprenorphine – coupled with counseling.   

A July 2009 study, led by the London School of Hygiene and Tropical Medicine, found patients had a greater adherence to treatment with MAT compared to non-drug approaches. 

‘Medication-assisted treatment for opioid use disorders have been repeatedly proven to reduce overdose deaths relative to no treatment or non-medication treatment,’ said Dr Bohnert. 

‘Reducing the severity of opioid use disorder through medications will also improve mental health. Reducing barriers to use of these medications is essential to addressing both overdose and suicide.’

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