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Deaths from heroin, opioid pain relievers increased in some states

The heroin death rate doubled overall in a 28-state review, and twice as many people from those states died from prescription opioids in 2012 compared with heroin, CDC investigators reported in MMWR.

Analysis of death certificate data from 28 states for 2010 to 2012 also showed that five states had increases in opioid pain-relief deaths, seven states showed declines and 16 states showed no change. Overall, in 2012, the death rate from opioid pain relievers declined from 6 per 100,000 population to 5.6 per 100,000. In states with decreases in opioid-related deaths, the reduction was not associated with a link in heroin deaths, according to the report.

“Reducing inappropriate opioid prescribing remains a crucial public health strategy to address both prescription opioid and heroin overdoses,” CDC Director Tom Frieden, MD, MPH, said in a press release. “Addressing prescription opioid abuse by changing prescribing is likely to prevent heroin use in the long term.”

While not included in the study, the release reported that “approximately three out of four new heroin users report having abused prescription opioids prior to using heroin.”

Heroin deaths rose in 15 of the 18 states with data the CDC deemed “statistically accurate.” Among the study’s limitations, researchers wrote that if heroin metabolites resulting from an opioid pain reliever are found in a toxicology report, death certificates may indicate the death as a heroin overdose, rather than from an opioid.

Between 2010 and 2012, heroin death rates for the 28 states rose from 1 per 100,000 population to 2.1 per 100,000, with increases in all age groups and census regions. All racial and ethnic groups exhibited increases, with the exception of American Indians and Alaska Natives. Researchers cautioned that data for these groups may be underreported.

“This study is another reminder of the seriousness of the prescription opioid overdose epidemic and the connection to heroin overdoses,” Grant Baldwin, PhD, MPH, director, division of unintentional injury prevention, said in the release. “CDC and other federal agencies are working to promote a smart, coordinated approach to reduce inappropriate prescribing and help people addicted to these drugs.”