US Opioid Death Rate Flattens, Heroin Deaths Increase

Richard C. Dart, M.D., Ph.D Denver Health & Hospital Authority Professor, University of Colorado School of Interview with:
Richard C. Dart, M.D., Ph.D

Denver Health & Hospital Authority
Professor, University of Colorado School of Medicine


Medical Research: What is the background for this study? What are the main findings?

Dr. Dart: For the past two decades, prescription opioid medication abuse has increased significantly in the US. An estimated 25 million people initiated nonmedical use of pain relievers between 2002 and 2011.  In 2010 the number of death attributed to prescription opioid medications reached 16,651. The  RADARS® System (Researched Abuse, Diversion and Addiction Related Surveillance) has been monitoring prescription drug abuse and diversion for over 13 years. We use a “mosaic” approach, measuring abuse and diversion from multiple perspectives, to describe this hidden phenomenon as comprehensively as possible.

For the current publication we used 5 separate RADARS® System programs to collect data and the study period was from January 2002 through December 2013. We noticed a substantial increase  of prescription drug abuse from 2002 through 2010, followed by a flattening or decrease in 2010 and, lastly, a decline in 2011 through 2013. We also noticed a similar pattern in opioid-related deaths. Nonmedical use did not change significantly among college students.

Medical Research: What should clinicians and patients take away from your report?

Dr. Dart: The findings suggest that the United States may be making progress in controlling the abuse of opioid analgesics. However, although rates of abuse are encouraging, the rate of heroin deaths was found to be inversely related to the abuse of prescription opioids. Further investigation into this phenomenon will need to be addressed to develop public health policy and guide prevention and treatment initiatives.

It’s important to understand that the US already has a large number of people who abuse or are addicted to prescription opioid analgesics. In addition it restricting the availability of opioids, we also need to provide access to substance-abuse treatment. Currently, the US has insufficient capacity to treat such patients. As availability of prescription opioids decreases, these patients will be tempted to switch to heroin.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Dart: The results of our study suggests a promising trajectory of the abuse and deaths of opioid analgesics in the US, however it is necessary to continue monitoring to ensure that the programs implemented by local, state and federal governments to improve opioid prescribing, reduce doctor-shopping, limit questionable practices by pain clinics and otherwise improve the use of opioid analgesics in the US continues to be effective.

It will also be crucial to continue the monitoring of the heroin-related mortality, ensuring the development of public health policy as well as guiding prevention and treatment initiatives.


Trends in Opioid Analgesic Abuse and Mortality in the United States

Richard C. Dart, M.D., Ph.D., Hilary L. Surratt, Ph.D., Theodore J. Cicero, Ph.D., Mark W. Parrino, M.P.A., S. Geoff Severtson, Ph.D., Becki Bucher-Bartelson, Ph.D., and Jody L. Green, Ph.D.

N Engl J Med 2015; 372:241-248
January 15, 2015 DOI: 10.1056/NEJMsa1406143

[wysija_form id=”1″] Interview with & Richard C. Dart, M.D., Ph.D (2015). US Opioid Death Rate Flattens, Heroin Deaths Increase

Last Updated on November 4, 2015 by Marie Benz MD FAAD