Chart: Synthetic opioids killed more people than Rx opioids

Synthetic opioids such as fentanyl in 2016 surpassed prescription opioids as the leading cause of overdose death in the United States, according to study published Tuesday in JAMA.

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Study findings

For the study, researchers used data from CDC's National Vital Statistics System to estimate the number of overdose deaths involving synthetic opioids, prescription opioids, and heroin for 2010 through 2016.

Overall, the study showed more than 63,000 overdose deaths occurred in 2016, of which 42,249 were related to opioids. Of the opioid-related deaths, the researchers found:

  • 19,413 involved synthetic opioids;
  • 17,087 involved prescription opioids; and
  • 15,469 involved heroin.

The researchers found the share of opioid-related deaths involving synthetic opioids increased from 14.3% in 2010 to 45.9% in 2016. In comparison, the researchers found the share of opioid-related deaths involving prescription opioids decreased from 69.1% in 2010 to 40.4% in 2016.

In addition, the researchers found a significant rise in the involvement of synthetic opioids in overdose deaths involving prescription opioids, heroin, and all other illicit or psychotherapeutic drugs. Of the synthetic-opioid-related deaths in 2016, the researchers found 79.7% involved another drug or alcohol.

According to Modern Healthcare, drug dealers are increasingly lacing other drugs with synthetic opioids, which are typically cheaper and easily accessible. The synthetic drugs can also be more potent: The Drug Enforcement Administration has said fentanyl is up to 50 times more powerful than heroin and up to 100 times more powerful then morphine, Modern Healthcare reports.

Discussion

According to the researchers, the findings "underscore the rapidly increasing involvement of synthetic opioids in the drug overdose epidemic and in recent increases in overdose deaths involving illicit and psychotherapeutic drugs."

The researchers said "some of the increase in synthetic opioid involvement found in this study may be related to increased testing and detection of synthetic opioids." But they also wrote a "[l]ack of awareness about synthetic opioid potency, variability, availability, and increasing adulteration of the illicit drug supply poses substantial risks to individual and public health."

For instance, first responders are increasingly being equipped with naloxone to reverse the side effects of an opioid-related overdose, but Modern Healthcare reports that investigators in Georgia reported a synthetic opioid product that contained a strain of fentanyl that has been resistant to naloxone.

Emily Einstein, a co-author of the research letter and a health science policy analyst at the National Institute on Drug Abuse, said, "We have been very focused on the threat of prescription opioid overdose deaths, and this paper shows us that we need to remain vigilant about the ever-shifting nature of the crisis" (Ross Johnson, Modern Healthcare, 5/1; Kaplan, Los Angeles Times, 5/1; Kight/Stevens, Axios, 5/4; Jones et al., JAMA, 5/1).

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