New CDC Overdose Study Reduces Role of Pain Meds – Dec 26, 2016 By Pat Anson, Editor
The Centers for Disease Control and Prevention has quietly released a new report showing that illegal drugs like heroin, cocaine and fentanyl are responsible for more drug overdose deaths in the United States than opioid pain medication.
The report not only underscores the changing nature of the nation’s overdose epidemic, but undermines some of the rationale behind federal efforts to limit the prescribing of pain medication and public statements used to justify them.
In 2010, for example, the study found that oxycodone was the top drug involved in overdose deaths. But by 2014, the painkiller was ranked third, behind heroin and cocaine
Deaths linked to oxycodone and other prescription pain medications – although still significant, at about 16,000 a year — remained relatively stable, even as the total number of drug overdoses increased by 23 percent, from 38,329 deaths in 2010 to 47,055 in 2014.
One of the CDC’s stated reasons for releasing its opioid prescribing guidelines earlier this year was that “the death rate associated with opioid pain medication has increased markedly,” a statement that now appears to be factually wrong
This statement on a CDC analysis of overdoses also appears incorrect, in light of the new study:
“Prescription opioids continue to be involved in more overdose deaths than any other drug.”
Both statements came from the CDC’s National Center for Injury Prevention and Control. It was a different part of the agency, the CDC’s National Center for Health Statistics that arrived at this new evidence, after collaborating with the FDA in developing an enhanced method to study overdose deaths that allowed them to identify specific drugs
The old method used by the CDC relies on death certificate codes, known as ICD codes, which can broadly categorize an overdose as “opioid related” without ever determining what the drug was, if it was legal, or even if it was the cause of death.
Using new software, researchers scanned the actual text in hundreds of thousands of death certificates, including notes written by coroners about the cause of death and other significant factors involved in an overdose.
Over three-quarters of the deaths involving oxycodone and hydrocodone, for example, involved other substances.
Alcohol was involved in 15 percent of all drug overdoses.
While the textual analysis of death certificates is an improvement over previous methods, researchers admit it still has flaws.
- It cannot distinguish between prescription fentanyl and illicit fentanyl;
- some deaths that refer to morphine may actually involve heroin; and
- some deaths classified as “unintentional” may have actually been suicides.
Oddly, the CDC released this new study just a week after releasing its annual report on drug overdose deaths, which used the older, flawed method of analyzing overdoses.
Further adding to the confusion and questionable use of statistics, the White House Office of National Drug Control Policy and the CDC released three different estimates of the number of Americans that died of drug overdoses in 2015 (see “Opioid Overdose Statistics: As Clear as Mud”).