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US leads developed nations in drug overdose deaths

The rate of premature drug overdose mortality was the highest in the United States, compared with several other developed nations, according to a study published in Annals of Internal Medicine.

“Drug overdose mortality rates in the United States have more than doubled during the 21st century, reaching an estimated 63,632 deaths in 2016,” Yingxi Chen, MD, PhD, postdoctoral fellow at the National Cancer Institute, and colleagues wrote. “Recent increases have also been reported in other high-income countries, raising concerns that the problem has grown internationally.”

Chen and colleagues examined data from the WHO mortality database to investigate how many deaths due to drug overdoses occurred between 2001 and 2015 by country, year, age and sex. The researchers used the International Classification of Diseases, 10th Revision, codes for mental and behavioral disorders due to substance use and poisoning by external causes and poisoning of undetermined intent to define overdose death.

Only countries with fewer than 10% of drug overdose deaths coded as poisoning of undetermined intent were included. Thirteen countries were eligible for the analysis, including the U.S., Australia, Chile, Denmark, England, Wales, Estonia, Finland, Germany, Mexico, the Netherlands, Norway and Spain.

To concentrate on premature mortality, only individuals aged 20 to 64 years were included.

Data showed that in 2015, the rate of drug overdose mortality for both men and women were highest in the U.S. (35 deaths per 100,000 men; 20 deaths per 100,000 women) and lowest in Mexico (1 death per 100,000 men; 0.2 deaths per 100,000 women). There was a substantial variation in mortality trends by country.

Between 2001 and 2015, Estonia had the highest average annual percentage of change in the rates of drug overdose mortality (6.9% in men; 7.9% in women) and the United States had the second highest average change (4.3% in men; 5.3% in women). The drug overdose mortality rates also increased in Australia and the Netherlands.

Conversely, Norway had high mortality rates but demonstrated the greatest decline in drug overdose mortality in both men (average annual percentage of change: –3.2%) and women (average annual percentage of change: –2%). Mexican men and women, Spanish men and Danish women showed significant decreases in the rate of overdose mortality. Overall, men aged 35 to 49 years and women aged 50 to 64 years had the highest rates of mortality.

“Our data highlight the severity of the drug overdose epidemic in the United States, which has premature mortality rates more than twice those of any other country studied, although worrisome trends were also observed in men and women in 5 of the 13 countries studied between 2001 and 2015,” Chen and colleagues concluded. “Of note, decreases were also observed in several countries.”

“Urgent public action is needed, as are improvements in maintaining the quality of systems and data,” they added. “Detailed evaluations of the policies of countries with declining rates may help identify approaches that can be applied elsewhere to prevent further premature deaths.” – by Alaina Tedesco

Disclosures: The authors report no relevant financial disclosures.