A 2017 CDC Surveillance Report on Drug-Related Risks and Outcomes highlights some progress but much work yet to be done in curbing the opioid epidemic.

According to the report, there has been a leveling off and declines in opioid prescribing rates since 2012 and high-dose prescribing rates since 2009. This suggests that healthcare providers have become more cautious in their opioid prescribing practices. Of note,

  • The prescribing rate has decreased annually by 4.9% from 2012 through 2016
  • For high dosage opioids (≥90 MME/day), the rate annually decreased by 9.3% from 2009 to 2016
  • However, the average days of supply per prescription has continued to increase since 2006

Unfortunately, opioid-related deaths remain on the rise and in fact have contributed to a decline in life expectancy for the second year in a row. The rate of deaths involving opioids increased from 2.9 per 100,000 in 1999 to 10.4 in 2015. From 2015-2016, deaths from fentanyl and other synthetic opiates more than doubled; deaths from heroin increased nearly 20%; and deaths from other opioids such as hydrocodone and oxycodone increased 14%. Additionally, a March 2018 CDC report  showed a 30% increase in emergency department opioid overdose visits from July-September 2016 vs July-September 2017, which suggests that the death trend will also continue to rise.

It’s also now clear that the true number of opioid deaths is undercounted: a recent study found more than 70,000 deaths from 1999-2015 should be reallocated from unspecified to opioid-related overdose as the cause. Another analysis found that corrected opioid mortality rates in the U.S. in 2014 were actually 24% greater than previously reported.

The CDC report concludes that opioid and other drug overdose remains a large and growing public health crisis for which additional measures are urgently needed. The CDC’s Opioid Overdose Prevention Efforts aim to improve data quality and tracking of trends; scale up promising and effective public health interventions (including PDMPs); supply healthcare providers with tools for evidence-based decision making (such as the Guideline for Prescribing Opioids for Chronic Pain); and partner across sectors to increase access to life-saving treatment such as naloxone.

Learn how to balance the risks and benefits of opioid prescribing in a CO*RE course.

Prescriptions Down, Opioid-Related Deaths Up…Why?

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For Further Reading

  1. CDC Opioid Prescribing Rate Maps
  2. 2017 CDC Surveillance Report on Drug-Related Risks and Outcomes
  3. Highlights from the Annual Surveillance Report of Drug-Related Risks and Outcomes, United States, 2017
  4. U.S. Life Expectancy Declining: Do Opioid Overdose Deaths Play a Role?
  5. Drug Overdose Deaths in the United States, 1999–2016
  6. Fentanyl Deaths Alarmingly High
  7. Emergency Department Data Show Rapid Increases in Opioid Overdoses
  8. Surge in Opioid Overdose Emergency Department Visits
  9. The Effect of Incomplete Death Certificates on Estimates of Unintentional Opioid-Related Overdose Deaths in the United States, 1999-2015
  10. Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates
  11. States Go Their Own Way With Opioid Laws
  12. CDC Guideline for Prescribing Opioids for Chronic Pain
  13. Surgeon General Advises More People To “Be prepared. Get naloxone. Save a life.”