The opioid crisis may be far worse than we thought

In a new study, researchers found that the number of deaths attributed to opioid-related overdoses could be 28% higher than reported due to incomplete death records.

This discrepancy is more pronounced in several states, including Alabama, Mississippi, Pennsylvania, Louisiana, and Indiana, where the estimated number of deaths more than doubles—obscuring the scope of the opioid crisis and potentially affecting programs and funding intended to confront the epidemic.

The research was conducted by a team from the University of Rochester Medical Center.

In the study, the team obtained death records of individuals identified as having died from drug overdoses from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

In addition to the cause, the records also include any additional medical issues that might have contributed to death.

They found that almost 72% of unclassified drug overdoses that occurred between 1999-2016 involved prescription opioids, heroin, or fentanyl—translating into an estimated 99,160 additional opioid-related deaths.

While the overall percentage of unclassified deaths declined over time, a phenomenon that the researchers speculate is due to a more focused effort by federal, state, and local officials to understand the scope of the crisis, in several states, the number remained high.

The new estimates of actual opioid-related deaths show a pronounced increase in states like Alabama, Mississippi, Pennsylvania, Louisiana, and Indiana.

In fact, in each of these states, the number of opioid-related deaths increased by more than 100%.

In Pennsylvania, for example, the number of reported opioid-related deaths was 12,374. The study estimates the actual number of deaths was 26,586.

Consequently, the state’s total number of deaths in places it behind only California and Florida, states with much higher populations, and moves Pennsylvania from the fifteenth to sixth in terms of highest per capita death rates in 2016.

The team says the underreporting of opioid-related deaths is very dependent upon location and this new data alters our perception of the intensity of the problem.

Understanding the true extent and geography of the opioid crisis is a critical factor in the national response to the epidemic and the allocation of federal and state resources to prevent overdoses, treat opioid use disorders, regulate the prescription of opioid medications, and curb the illegal trafficking of drugs.

The lead author of the study is Elaine Hill, Ph.D., an economist and assistant professor at the University of Rochester Medical Center (URMC) Department of Public Health Sciences.

The study is published in the journal Addiction.

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