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Premature opioid-related deaths rise enormously across the US
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The number of opioid-related deaths rose by 345% between 2001 and 2016 in the United States, findings published in JAMA Network Open revealed.
The burden was especially high among adults aged 24 to 35 years, with data showing 20% of deaths among this age group involved opioids in 2016.
“In the United States, prescription opioid overdose contributed to 830,652 [years of life lost] among people younger than 65 years in 2008; however, this estimate was based on crude estimates of burden,” Tara Gomes, PhD, of the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, and the Institute for Clinical Evaluative Sciences, in Toronto, and colleagues wrote. “Given the rapidly rising rate of opioid-related death across the United States, as well as the dramatically increasing role of fentanyl and other illicit opioids, more recent estimates of this burden are required.”
To evaluate the burden of opioid-related mortality in the U.S. over time, researchers compared the percentage of deaths attributable to opioids and the associated person-years of life lost from 2001 to 2016 at different time points and by age group using a serial cross-sectional design.
The investigators separated patients into groups based on their age at time of death — 0 to 14 years, 15 to 24 years, 25 to 34 years, 35 to 44 years, 45 to 54 years, 55 to 64 years and 65 years or older — then quantified the burden of opioid-related deaths. When analyzing the age-specific proportion of opioid-related deaths, researchers compared percentages in the years 2001, 2006, 2011 and 2016. They calculated the years of life lost using standard 5-year life expectancy tables.
Overall, 335,123 opioid-related deaths in the U.S. met study inclusion criteria over the 15-year period. The number of opioid-related deaths increased by 345%, from 9,489 in 2001 to 42,245 in 2016 (33.3 to 130.7 deaths per million population). Men accounted for 67.5% of these deaths (n = 28,496) and the median age at death was 40 years by 2016. In addition, the proportion of deaths attributable to opioids rose by 292%, from 0.4% in 2001 to 1.5% in 2016, increasing steadily over time in all age groups (P < .001 for all groups).
Adults aged 25 to 34 years experienced the largest absolute increase, from 4.2% in 2001 to 20% in 2016 (15.8% increase), followed by teenagers and young adults aged 15 to 24 years, from 2.9% to 12.4% (9.4% increase). However, older adults had the largest relative increases, from 0.2% to 1.7% among those aged 55 to 64 years (754% increase) and from 0.01% to 0.07% among those aged 65 years and older (635% increase).
According to the results, opioid-related U.S. deaths were responsible for 1,681,359 years of life lost (5.2 per 1,000 population) in 2016. The highest burden from opioid-related deaths was among adults aged 25 to 34 years and those aged 35 to 44 years (12.9 and 9.9 years of life lost per 1,000 population). The burden of opioid-related death was higher among men than women, with the rate among men aged 25 to 34 years increasing to 18.1 years of life lost per 1,000 population in 2016. Furthermore, total years of life lost in this population represented 24.5% of all years of life lost in the U.S. in 2016.
“Premature death from opioid-related causes imposes an enormous and growing public health
burden across the United States,” Gomes and colleagues wrote. “These trends highlight a need for tailored programs and policies that focus on both appropriate prescribing and harm reduction in these demographics.” – by Savannah Demko
Disclosure: Gomes reports grants from the Canadian Institutes of Health Research and from the Ontario Ministry of Health and Long-Term Care. Please see the full study for other authors’ relevant financial disclosures.