Although prescription opioid and heroin use have adverse consequences for all age groups, it is not known if specific birth cohorts have greater risk than others. Researchers used National Center for Health Statistics data to compare opioid overdose mortality between 1999 and 2014 among birth cohorts defined by 2-year intervals, starting with 1935–1936 and ending with 1997–1998. People ≤16 and ≥66 years were excluded due to a low number of overdose deaths.
- Compared with the 1977–1978 (approximately 21–36 years old) birth cohort, individuals born between 1949 and 1964 (approximately 35–65) had a 12–27% increase in prescription opioid overdose mortality (highest risk in 1955–1956 cohort: relative risk [RR], 1.27) and a 7–33% increase in heroin overdose mortality (highest risk in 1953–1954 cohort: RR, 1.32).
- Compared with the 1977–1978 birth cohort, individuals born between 1979 and 1990 had a 5–16% increase in prescription opioid overdose mortality (highest risk in 1985–1986 cohort: RR, 1.16) and a 13–23% increase in heroin overdose mortality (highest risk in 1989–1990 cohort: RR, 1.23).
Comments: These national data suggest excess prescription opioid and heroin overdose mortality among Baby Boomers and Millennials. While it is useful to know which birth cohorts are at increased risk of adverse outcomes, it is not clear that public health and clinical interventions targeted to these specific demographic groups would be more effective or necessary than universal interventions.
Kevin L. Kraemer, MD, MSc
Reference: Huang X, Keyes KM, Li G. Increasing prescription opioid and heroin overdose mortality in the United States, 1999–2014: an age-period-cohort analysis. Am J Public Health. 2018;108:131–136.