How the CDC Misclassifies Opioid Overdoses

How the CDC Misclassifies Opioid Overdoses | Pain News Network | by Denise Molohon,

Denise explains how incorrect and biased the numbers are after the CDC admits “some heroin overdose deaths were counted twice”. 

I think the minute anyone without bias or personal agenda began reading through the CDC’s proposed guidelines for opioid prescribing, they must seriously question many things.

Chief among them, the highly suspect “low to very low quality” evidence being presented to support their “strong recommendations,” but also their dangerously skewed data; which ultimately could leave millions of chronic pain sufferers critically ill, without sound medical treatments, and with little to no quality of life.

In a recent CDC Morbidity and Mortality Weekly Report (MMWR) on drug and opioid overdose deaths, I found myself doing the exact same thing — seriously questioning the data. In 2014, the report found that 28,647 people died of drug overdoses involving opioids, including heroin, a 9 percent increase over the previous year. 

However, the CDC admits in the MMWR, that “some overdose deaths may have been misclassified and the data has limitations.” I wondered how much was misclassified? Exactly what data has limitations and why?

I believe the American people have a right to transparency and full disclosure, not flawed data that is often presented in a confusing manner

If heroin deaths are being misclassified as morphine, which results in the “underreporting” of heroin overdose deaths, then wouldn’t the opposite also hold true? That there is “over-reporting” of morphine deaths, which are then misclassified as prescription opioid deaths?

According to the Washington Post, CDC Director Tom Frieden admitted some heroin overdose deaths were counted twice!

All opioid pain reliever deaths are counted as “prescription” opioid overdoses. Why?

The DEA reported last year in its National Heroin Threat Assessment Summary that, “Many medical examiners are reluctant to characterize a death as heroin-related without the presence of 6-monoaceytlmorphine (6-MAM), a metabolite unique to heroin, but which quickly metabolizes into morphine.  Thus many heroin deaths are reported as morphine-related deaths.”

Because most medical examiners and coroners did not routinely test for fentanyl in 2014, many illicit fentanyl/heroin overdose deaths were also probably counted as prescription opioid overdoses.

Why is the data about opioid overdoses so flawed and what is the government doing about it?

A federal agency called the Substance Abuse and Medical Health Services Administration (SAMHSA) brought together groups of experts four times in 2003, 2007, 2010, and again in 2013. All agreed uniform standards and definitions were needed for classifying opioid-related deaths. Guidelines were developed in July 2013 by SAMHSA to provide uniform standard procedures for medical examiners, coroners and other practitioners.

According to the DEA’s National Heroin Threat Assessment Summary, the overwhelming number of fentanyl overdose deaths are not attributable to pharmaceutical fentanyl but rather illicit fentanyl.

Note that the DEA is making a critical distinction between an illegal drug and a legal prescription drug. Why isn’t the CDC doing this?

In my opinion, for the CDC to lump all opioids together as “prescription” opioids or as “pain relievers” shows a highly dangerous bias, an unwillingness to address the soaring number of heroin and fentanyl overdoses, and a lack of competence in taking a responsible leadership role.

If the CDC can’t be counted on to clearly report on the data, sources and causes of overdose deaths, how can we trust their opioid prescribing guidelines?

I noticed the same problems in a previous post, but assumed I was something something. I believed the government would not post data that was so blatantly biased. But Denise gives evidence that they would, and they did.

Denise is a strong supporter and patient advocate for ASAP, the Arachnoiditis Society for Awareness & Prevention. She and her family live in Indiana.  

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One thought on “How the CDC Misclassifies Opioid Overdoses

  1. Payne Hertz

    There is also the fact a large percentage of coroner sin the US are not trained pathologists, but often local sheriffs or other government employees with no medical training doubling as the county coroner. I suspect this phenomenon is more common in poor rural counties than major cities, which may be why the “opioid-related” death rate in rural counties is allegedly so much higher than in cities, despite the fact that legal and illegal drugs are generally easier to come by in cities than out in the boonies. The local sheriff takes a blood test, it comes back positive for opioids and he rules the death as due to opioids. If he thinks the death was a suicide he might want to rule it an OD so the family can get the insurance. This is the politically and perhaps the morally correct thing to do,

    A trained pathologist, on the other hand, might look for something other than 10mg of Vicodin as the cause of death and come to a different conclusion…or not. But 10mg of Vicodin can qualify as an “opiate-related” death as readily as 1000mg and a bottle of Jack Daniels in CDC lala land. so we also have the CDC claiming “overdoses” from what are normally considered to be trivial amounts of opioids.

    Poor quality science, poor quality ethics and regulatory capture are not the basis of sound policy.

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