One in 22 deaths attributed to opioid toxicity in 2021

Key takeaways:

• The years of life lost due to opioid toxicity increased threefold from 2011 to 2021.
• The proportion of deaths by opioid toxicity more than doubled among those aged 15 to 19 years from 2019 to 2021.

In 2021, unintentional opioid toxicity was attributed to one in 22 deaths among all adults and one in 10 deaths among those aged 15 to 19 years, a recent study found.

Despite signs that deaths due to opioid toxicity had slowed from 2017 to 2019, “the COVID-19 pandemic carried with it major changes in societal priorities and access to health services that, along with the increasing dangers of the unregulated drug supply, were anticipated to aggravate opioid-related harms,” Tara Gomes, PhD, an assistant professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy, and colleagues wrote in JAMA Network Open.

“We sought to characterize the growing societal burden of unintentional opioid-related deaths in the U.S. and examine patterns during the COVID-19 pandemic and across demographic subgroups of the population,” they wrote.

To do this, the researchers used 2011 to 2021 data from the CDC Wide-Ranging Online Data for Epidemiologic Research Multiple Cause of Death database, examining deaths attributable to opioid toxicity by calendar year and age group. They also measured the total years of life lost (YLL) from opioid-related deaths by year, age group and gender.

Overall, there were 422,605 unintentional deaths from opioid toxicity during the study period. The median age at death was 39 years, while 69.7% were men.

Gomes and colleagues found that the number of unintentional deaths due to opioid toxicity increased by 289% over the examined period, from 19,395 in 2011 to 75,477 in 2021.

All deaths attributable to opioid toxicity also rose over the decade, from 1.8% in 2011 to 4.5% in 2021, “with a statistically significant trend observed in all age groups,” the researchers wrote.

By 2021, unintentional opioid toxicity accounted for:

• 10.2% of all deaths among those aged 15 to 19 years;
• 21.7% of all deaths among those aged 20 to 29 years; and
• 21% of all deaths among those aged 30 to 39 years.

The burden of deaths due to opioid toxicity was most pronounced among men aged 30 to 39 years, with 15,685 deaths from opioid toxicity in 2021. However, the increase in the proportion of opioid toxicity-attributable deaths was highest among those aged 15 to 19 years, more than doubling from 2019 to 2021.

Overall, the YLL increased from 777,597 in 2011 to 2,922,497 in 2021, a rise of 276%. Gomes and colleagues noted that YLL levels remained consistent from 2017 (7.1 YLL per 1,000 individuals) to 2019 (7.2 YLL per 1,000), but then jumped by 62.9% from 2019 to 2021 (11.7 YLL per 1,000).

The researchers pointed out that the findings highlight “the enormous societal burden imparted by the overdose crisis in the U.S. over the past decade,” specifically among younger adults and adolescents who are “disproportionately impacted by substance-related harms.”

They added that the absolute number of total deaths due to opioid toxicity and associated YLL in 2020 and 2021 for those aged younger than 40 years greatly surpassed deaths attributed to COVID-19, “indicating the distinct impact of drug toxicity-related deaths among younger individuals.”

“This aligns with previous observations of accelerating substance-related harm among adolescents and warrants further attention and expansion of harm reduction and treatment programs tailored to this demographic population,” Gomes and colleagues wrote.