Problems with CDC’s Fentanyl Reporting

Here are two more articles about the CDC’s latest numbers of opioid overdoses:

CDC Blames Fentanyl for Spike in Overdose Deaths — Pain News Network – March 29, 2018/ Pat Anson

The Centers for Disease Control and Prevention released a new report today estimating that 63,632 Americans died of a drug overdose in 2016 – a 21.5% increase over the 2015 total.  

The sharp rise in drug deaths is blamed largely on illicit fentanyl, a powerful synthetic opioid that has become a scourge on the black market. Deaths involving synthetic opioids doubled in 2016, accounting for about a third of all drug overdoses and nearly half of all opioid-related deaths.

For their latest report, CDC researchers used a new “conservative definition” to count opioid deaths – one that more accurately reflects the number of deaths involving prescription opioids by excluding those attributed to fentanyl and other synthetic opioids.

See earlier post: CDC Over-Counting Rx Opioid Overdose Deaths

Over 17,000 deaths were attributed to prescription opioids in 2016, about half the number that would have been counted under the “traditional definition” used in previous reports.

The new report, based on surveillance data from 31 states and the District of Columbia, shows overdose deaths increasing for both men and women and across all races and demographics.  A wider variety of drugs are also implicated:

  • Fentanyl and synthetic opioid deaths rose 100%
  • Cocaine deaths rose 52.4%
  • Psychostimulant deaths rose 33.3%
  • Heroin deaths rose 19.5%
  • Prescription opioid deaths rose 10.6%

The CDC also acknowledged that illicit fentanyl is often mixed into counterfeit opioid and benzodiazepine pills, heroin and cocaine, likely contributing to overdoses attributed to those substances.

“Inaccurate and Misleading” Overdose Data

Not all opioids are identical in abuse potential and likely lethality, yet government statistics group causes of death in a way that obscures the importance of identifying specific agents involved in deadly overdoses,” Lilly wrote in a peer reviewed article recently published in the Journal of American Physicians and Surgeons..

Lilly faults the National Institute on Drug Abuse (NIDA) for using “inaccurate and misleading” death certificate codes to classify drug deaths. In its report for 2016, NIDA counted illicit fentanyl overdoses as deaths involving prescription opioids. As a result, deaths attributed to pain medication rose by 43 percent, at a time when the number of opioid prescriptions actually declined.

Rather than legal prescription drugs, illicit fentanyl is rapidly increasing and becoming the opioid of choice for those who misuse opioids… Targeting legal prescriptions is thus unlikely to reduce overdose deaths, but it may increase them by driving more users to illegal sources.”

We have a real crisis, and one of the things we need to invest in, if we’re going to make progress, is getting better information,” said Christopher Ruhm, PhD, a professor at the University of Virginia and the author of a overdose study recently published in the journal Addiction.

Is Government Opioid Data Telling the Wrong Story? – March 27, 2018 – By Ed Coghlan

Another report has been issued that concludes that the CDC strategy of targeting legal prescriptions to reduce opioid overdose deaths is not working.

Finally, somebody is stating the obvious. I hope this starts a reappraisal of policy regarding medicinal opioids, but the giant anti-opioid PROPaganada oceanliner has developed so much momentum that it could take a long while to correct it.

Dr. Lilly’s study–published online by the Association of American Physicians and Surgeons– reviewed existing government data. After looking at the Centers for Disease Control and Prevention (CDC) Wonder data base, Dr. Lilly sorts out the deaths associated with illicit fentanyl.  

Until 2013, deaths attributed to synthetic opioids were fairly stable, but a sharp upward trend began then, with an increase of 635% from 2014 to 2016.

Notably, the spike in deaths has occurred while opioid prescribing is being heavily discouraged and placed under increasingly severe constraints.

Dr. Lilly concludes that these policies are apparently driving opioid misusers from legally prescribed drugs to illicit drugs, which are far deadlier because of high potency and unreliable dosing.

One of the critics is Dr. Terri Lewis; a public health advocate shared her feelings with the National Pain Report.

Since the CDC Guidelines were a cloud on the horizon, persons with chronic and intractable pain have questioned the assumptions that CDCs guidelines are predicated upon.  The ultimate error is to base wholesale changes to public policy without accounting for all of the data – including the missing data.

“If fewer than 2% of persons who rely on opiates get into trouble, what’s to be said about the 98% of users for whom opiates have made a profound difference in the quality of their days?

When we ask the wrong questions we get the wrong answers. The recent analyses by Michael Schatman and Stephen Ziegler, Stefan Kertesz, Josh Bloom, and now John Lilly make it abundantly clear that not only is CDC’s recent mea culpa insufficient, but it is still wrong from a design of data perspective.

It demands that the systemic error installed throughout the entire system must be addressed to right the wrong course of public policy so that we can get back to the business of caring for patients instead of servicing errors.”

How many more articles will have to point out that the overdose problem is from illicit fentanyl and has little to do with prescribed medication?

Politicians want to make policies more and more extreme, yet never revisit them to see how they worked out. There seems to be very little thought about the results of the misery they are inflicting on growing numbers of pain patients being cut off.

1 thought on “Problems with CDC’s Fentanyl Reporting

  1. scott michaels

    What must be brought out to the open is the corruption. INSURANCE COMPANIES SAVING BILLIONS OF $$$. Phoenix house making hundreds of millions because KOLODNEYS old boss was the top cdc director. The dea has no brain so they just followed like sheep.
    NOW cdc backtracked. 2 days before medicare is to decide the fate of 1.6 million Americans disabled or elderly that live with extreme pain. THE VERY PEOPLE THAT NEED IT MOST ARE TARGETED TO SUFFER THE MOST.
    EVEN MANY OF TUE AUTBORS OF THE ILLGOTTEN GUIDELINES DISAGREE ON THE METHODS AND RESULTS THAT HAVE BECOME OF THESE INHUMAME TACTICS

    Liked by 1 person

    Reply

Other thoughts?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.