Opioid-related deaths strike DC, eastern states

Opioid-related deaths, particularly those associated with synthetic opioids, have impacted the eastern states, according to new research published in JAMA Network Open. Washington D.C. had the highest increase in death rates across the U.S.—more than tripling every year since 2013.

The research comes after other recent statistics projected opioid deaths will increase an astounding 147 percent by 2025. 

“As the opioid epidemic evolves, it is vital to identify changes in the geographical distribution of opioid-related deaths, and the specific opioids to which those deaths are attributed, to ensure that federal and state public health interventions remain appropriately targeted,” wrote lead author Mathew V. Kiang, ScD, of the Stanford University School of Medicine in Palo Alto, California, and colleagues.

The researchers sought to identify changes in the geographical distribution of opioid-related deaths across the U.S., and further stratified the deaths by opioid type. They specifically assessed opioid-related deaths involving any opioid, heroine, synthetic opioids and natural and semi-synthetic opioids, occurring between Jan. 1, 1999 to Dec. 31, 2016 across the nation. 

A total of 351,564 men and women died from opioid-related causes over that time period. The average age of death was 39.8 years for men and 43.5 years for women. Opioid-related death rates, especially from synthetic opioids, “rapidly increased” in all of the eastern U.S. In most states, deaths that were associated with natural and semisynthetic opioids, including painkillers, remained steady.

Overall, the researchers found 28 states had death rates related to synthetic opioids that more than doubled every two years. Among the 28 total states, the death rates from natural and semisynthetic opioids ranged from 2 to 19 deaths, per 100,000 people. 

Specifically, eight states—Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire and Ohio—had opioid-related death rates that doubled every three years. Florida, Pennsylvania and Washington D.C. had opioid-related death rates that at least doubled every two years.

Overall opioid-related deaths resulted in 0.36 years of life expectancy lost in 2016, with 0.17 years of life expectancy lost due exclusively to synthetic opioids. In New Hampshire and West Virginia, life expectancy declined more than a year because of opioid-related deaths in 2016.

“Although opioid-related mortality has been stereotyped as a rural, low-income phenomenon concentrated among Appalachian or midwestern states, it has spread rapidly, particularly among the eastern states,” Kiang and colleagues wrote.

While the research is bleak, there are silver linings. The Trump administration and the federal government are increasing efforts to double down on opioid-related deaths by passing legislation to fund various solutions. 

At the state-level, policies are being implemented to curb the opioid epidemic and subsequent deaths. In fact, recent evidence suggests a decline in deaths in Ohio because of increased access to naloxone—medication that treats narcotic overdoses in emergency situations––needle exchange programs and increased support for those with mental health and addiction problems.

“Our findings indicate that policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids and rapidly expanding epidemics in northeastern states and consider the potential for synthetic opioid epidemics outside of the heroin supply,” the researchers concluded.