Understanding the Epidemic
Record Overdose Deaths
Drug overdose deaths in the United States continue to increase in 2016
Drug overdose deaths and opioid-involved deaths continue to increase in the United States. The majority of drug overdose deaths (66%) involve an opioid. In 2016, the number of overdose deaths involving opioids (including prescription opioids and heroin) was 5 times higher than in 1999. From 2000 to 2016, more than 600,000 people died from drug overdoses. On average, 115 Americans die every day from an opioid overdose. 1
We now know that overdoses from prescription opioids are a driving factor in the 16-year increase in opioid overdose deaths. The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010,3,4 yet there had not been an overall change in the amount of pain that Americans reported.5,6 Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.7
Heroin use is trending up
From 2002–2013, past month heroin use, past year heroin use, and heroin addiction have all increased among 18-25 year olds.8 The number of people who started to use heroin in the past year is also trending up. Among new heroin users, approximately three out of four report abusing prescription opioids prior to using heroin.9 The increased availability, lower price, and increased purity of heroin in the US have been identified as possible contributors to rising rates of heroin use.10
Between 2010 and 2016, the rate of heroin-related overdose deaths increased by a factor of 5 – more than 15,469 people died in 2016. The largest increase in overdose deaths from 2015 to 2016 was for those involving synthetic opioids (other than methadone), which rose from 9,580 deaths in 2015 to 19,413 in 2016.2 One of these synthetic opioids, illegally-made fentanyl, is driving the increases.1 Fentanyl is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge.
Preventing Overdose Deaths
What can be done?
We need to improve prescribing of opioids, expand treatment of addiction, and reduce access to illegal opioids.
- Improve opioid prescribing to reduce exposure to opioids, prevent abuse, and stop addiction.
- Expand access to evidence-based substance abuse treatment, such as Medication-Assisted Treatment, for people already struggling with opioid addiction.
- Expand access and use of naloxone—a safe antidote to reverse opioid overdose.
- Promote the use of state prescription drug monitoring programs, which give health care providers information to improve patient safety and prevent abuse.
- Implement and strengthen state strategies that help prevent high-risk prescribing and prevent opioid overdose.
- Improve detection of the trends of illegal opioid use by working with state and local public health agencies, medical examiners and coroners, and law enforcement.
- Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep. ePub: 16 December 2016. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1.
- Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov.
- US Department of Justice. Automation of Reports and Consolidated Orders System (ARCOS). Springfield, VA: US Department of Justice, Drug Enforcement Administration (DEA); 2011.
- Paulozzi LJ, Jones CM, Mack KA, Rudd RA. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999—2008. MMWR 2011; 60(43):1487-1492.
- Chang H, Daubresse M, Kruszewski S, et al. Prevalence and treatment of pain in emergency departments in the United States, 2000 – 2010. Amer J of Emergency Med 2014; 32(5): 421-31.
- Daubresse M, Chang H, Yu Y, Viswanathan S, et al. Ambulatory diagnosis and treatment of nonmalignant pain in the United States, 2000 – 2010. Medical Care 2013; 51(10): 870-878.
- Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov
- Centers for Disease Control and Prevention. Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013. MMWR 2015; 64(26):719-725
- Muhuri PK, Gfroerer JC, Davies C. Associations of nonmedical pain reliever use and initiation of heroin use in the United States. CBHSQ Data Review, 2013.
- Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past fifty years. JAMA Psychiatry 2014;71:821–6.