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Opioid Deaths Up, Illicit Fentanyl to Blame

— Deaths from synthetic opioids spiked 72% in one year

MedpageToday

Opioid overdose deaths continue to rise, driven by increases in fatalities from illicit opioids like heroin and street fentanyl, CDC researchers said.

There were 33,091 opioid-related deaths in 2015, up from 28,647 the previous year, Rose Rudd, MSPH, of the CDC, and colleagues .

While deaths related to natural and semisynthetic opioids -- morphine, codeine, and many other commonly prescribed pain drugs such as oxycodone and hydrocodone -- were up 2.6% year-over-year, deaths from heroin rose 21% and deaths from synthetic opioids other than methadone -- such as fentanyl and tramadol -- shot up 72% in that time.

Specifically, synthetic opioid deaths rose to 9,580 from 5,544, and heroin deaths went to 12,989 from 10,574.

"Too many Americans are feeling the devastation of the opioid crisis either from misuse of prescription opioids or use of illicit opioids," CDC Director , said in a statement.

The increase in natural and semisynthetic opioid deaths is a slower rise than in years past, and it "illustrates an ongoing problem with prescription opioids," the researchers wrote. "However, the increase has slowed from 2013-2014, potentially because of policy and health system changes, required prescription drug management plan review, legislative changes in naloxone distribution, and prescribing guidelines."

Illicit opioids are a major part of the problem -- particularly illicitly made fentanyl, the researchers said. Deaths from synthetic opioids have spiked across many states, with the largest overall increases in New York (136%), Connecticut (126%), and Illinois (120%). South Carolina, North Carolina, and Tennessee saw the biggest overall increases in heroin deaths.

Federal agencies have not developed a coordinated plan of action against illicitly manufactured fentanyl.

The number of deaths tied to synthetic opioids has been associated with the number of drug products seized by law enforcement that have tested positive for fentanyl -- but not with fentanyl prescribing rates, the researchers noted.

Overall drug deaths rose to 52,404 -- up from 47,055 in 2014. There was progress in only one area, with methadone deaths slowing by about 9%, the researchers said.

"The ongoing epidemic of opioid deaths requires intense attention and action," the team wrote, noting that misuse of prescription opioids intertwines with that of illicit opioids, "underscoring the need for continued prevention efforts around prescription opioids."

Rudd and colleagues also called for intensifying efforts to distribute naloxone, enhance access to treatment -- particularly medication-assisted treatment -- and implement harm-reduction services.

"A multifaceted, coordinated approach between public health and public safety is also necessary to address the U.S. opioid epidemic."

Federal data were sourced from the National Vital Statistics System. State-level data were collected from death certificates.

Disclosures

The authors disclosed no financial relationships with industry.

Primary Source

Morbidity & Mortality Weekly Report

Rudd RA, et al "Increases in drug and opioid-involved overdose deaths -- U.S., 2010-2015" MMWR 2016.