Drug Overdoses on Rise Worldwide, Warrant More Study.
Deaths from prescription opioid use have climbed worldwide in the past several years, while deaths from illicit drug use have declined, but research to understand the distinct determinants of overdose is lacking, according to a study co-authored by School of Public Health researchers.
The study, published in the American Journal of Public Health and co-authored by Dean Sandro Galea, reviewed articles published between 1980 and 2013 that dealt with unintentional overdoses in an effort to document the global prevalence, trends, mortality rates, and correlates of overdoses.
While the research team found wide variability in mortality rates attributable to overdose, most studies on longitudinal trends of deaths or overdose-related hospitalizations showed increases over time. For example, there was a 467.7 percent increase reported in methadone deaths in the US between 1999 and 2005, and a 1,186 percent increase in heroin deaths in England and Wales from 1974 to 1992.
The study found that with the recent increase in prescription opioid deaths, drug overdose is not just an “urban problem”—rural areas have seen significant increases in overdose deaths. In rural Virginia between 1997 and 2003, for example, fatalities attributed to overdose increased by 300 percent. In Utah, prescription opioid deaths increased fivefold from 2000 to 2009. Prescription drug overdose is now the leading cause of injury death in Ohio, with particularly high rates in the rural Appalachian areas of the state.
Lifetime prevalence of drug users personally experiencing a nonfatal overdose varied widely across studies, ranging from 16.6 percent to 68 percent. The researchers noted that health care costs associated with overdose treatment are substantial: From 1999 to 2008, hospitalization rates for overdoses in the US increased by 55 percent, costing about $737 million in 2008. They found little data available on overdose hospitalization costs in other countries.
Dean Galea and colleagues said there is a need to invest in research to understand environmental and other determinants of drug overdose worldwide.
“A combination of studies on individuals who overdose and the settings where overdoses occur will help us better tailor interventions to the types of strategies that are most likely to have a major impact on this epidemic,” they wrote.
Besides Dean Galea, authors on the study included: Laura Sampson, statistical analyst in the Department of Epidemiology; Silvia S. Martins of the Department of Epidemiology, Columbia University Mailman School of Public Health; and Magdalena Cerdá of the Department of Emergency Medicine, University of California-Davis.