Statcast Number 15 Transcript

Margaret Warner, Injury Epidemiologist with the CDC’s National Center for Health Statistics, discusses her new report, “Increase in Fatal Poisonings Involving Opioid Analgesics in the United States, 1999-2006”

Announcer: Margaret Warner is an Injury Epidemiologist with the CDC’s National Center for Health Statistics. Margaret is the lead author on a new report documenting the alarming surge in poisoning fatalities linked to opioid painkillers in the U.S. Margaret, what is the biggest finding in your new Data Brief on Fatal Poisonings?

Warner: In this study we found the number of poisoning deaths from opioid analgesics nearly tripled in the period from 1999 to 2006 and this is quite a large increase from about 4,000 deaths to about 13,800 deaths. So it’s quite a rapid increase in terms of actual fatalities from poisonings.

Announcer: How statistically dramatic has this increase been?

Warner: This increase has been quite dramatic – we don’t often see the number of fatalities tripling in this short a period of time, so we’re watching and using our surveillance to try and figure out what is causing the increase.

Announcer: Why are these fatal poisonings becoming so rampant?

Warner: Our data don’t show why the deaths are becoming so rampant… there are factors outside that we can look at, such as the increase in the prescriptions and the distribution of opioid analgesics largely to treat pain. But we don’t know, for these deaths, where the people got the drugs, what they were taking them for… this is not included in our data. But by using these data we can show the dramatic increase and people can take notice and that’s our goal.

Announcer: Is there any indication how these deaths are broken down according to which are
through recreational use of opioid painkillers and which are through a misuse of
drugs that were prescribed for treatment of a specific condition?

Warner: No we don’t know from these data how many of these people are using these drugs recreationally and how many are using them for prescriptions. We can look at national studies to determine the breakdown of those who are using prescribed opioid analgesics vs. the illicit use, but that doesn’t necessarily relate to the number of deaths, so now people are going back, researchers are going back to more carefully look at the medical records to try to determine whether they can figure out whether they were taking them recreationally

Announcer: Why is the problem appear to be worse in places like West Virginia?

Warner: The states do vary widely in the rates of death from opioid analgesics and we’re trying to figure out why that is. It could be the population that lives there, it could be the distribution of the drugs that are there, and states do vary widely on their prescription laws and ways of dealing with drugs in general.

Announcer: Other western states have high poisoning fatality rates too. Places like Utah,
Nevada, New Mexico and Oklahoma. Any clues as to why this is?

Warner: People are spending a lot of time looking at the regional variations and it’s actually in a way a good thing because it could lead to some prevention efforts and that’s the way researchers are look at this – to try to figure out what it is that’s different about those states and to try to target prevention efforts towards what they feel is working in those states with lower rates.

Announcer: Is there any one drug in particular that is driving this increase?

Warner: We can’t tell specific drug names… we know what class of drug it is but we’re not sure whether it’s Fentanyl or Propoxyphene.

Announcer: What are the reasons why methadone is proving to be so dangerous?

Warner: Methadone is a long-acting opioid analgesic, and so it stays in your body longer than the other opioids. So you may have some relief from the pain for a short period of time and then you may feel pain again and then you take another Methadone tablet. And because it’s a long-acting opioid, the previous tablet in your body will still be there, or part of it – the drug is still retained…. So over a period of a week or two weeks you can accumulate a toxic dose in your body – it’s a buildup and it’s really important that with Methadone, to take it properly… It’s important with all drugs to take them properly – some drugs can stay in your body longer than other drugs, and Methadone is one of those.

Announcer: Any other topics you’d like to cover?

Warner: Showing the number of fatalities is really just the tip of the iceberg… we know that there are emergency department visits, hospitalizations related to these drugs, and also other non-health consequences of drug use that are not measured

Announcer: Our thanks to Margaret Warner for joining us on this edition of Statcast… Statcast is a production of the Public Affairs Office of the National Center for Health Statistics.