The Opioid Crisis Actually Began 40 Years Ago.
Overdose epidemic has grown exponentially for decades
The U.S. opioid epidemic is part of a much larger drug crisis that started 40 years ago, a new study suggested.
Overdose death rates have climbed exponentially since 1979, though the type of drug and the demographics of those who die from overdoses have changed over time, reported Don Burke, MD, of the University of Pittsburgh, and colleagues in Science.
“Death rates from drug overdoses in the U.S. have been on an exponential growth curve that began at least 15 years before the mid-1990s surge in opioid prescribing, suggesting that overdose death rates may continue along this same historical growth trajectory for years to come,” study author Hawre Jalal, MD, PhD, also of the University of Pittsburgh, told MedPage Today. “When we plot the annual sum of all drug overdoses, we get a remarkably smooth, inexorable exponential curve.”
But there is no predictable pattern to the overdose rates for any of these drugs individually: Cocaine overdose death rates shifted down and up several times over the past 20 years. “Prescription opioids have been on a fairly steady, steep climb,” Jalal noted. “Heroin deaths shot up in 2010, followed in 2013 by synthetic opioids, such as fentanyl. Methamphetamine appears to be on the verge of its own dramatic climb.”
Yet, despite the varying waves of overdose deaths, the overall annual death rate has risen nonstop.
In their study, Burke and co-authors studied accidental drug poisoning deaths in the U.S. National Vital Statistics System since 1979, when drug overdoses first were reported in their own category. The drug overdoses plotted as a near-perfect curve over 40 years.
“The current epidemic of overdose deaths due to prescription opioids, heroin, and fentanyl appears to be the most recent manifestation of a more fundamental, longer-term process,” Burke said in a statement. “Understanding the forces holding these multiple individual drug epidemics together in a tight upward exponential trajectory will be important in revealing the root causes of the epidemic, and this understanding could be crucial to prevention and intervention strategies.
“This remarkably smooth, long-term epidemic growth pattern really caught our attention,” he added. “If we can figure it out, we should be able to bend that curve downward.”
The researchers noted several limitations to their analysis: the level of specificity of drug reporting varied among states and counties. Categories of specific drug mortality rates were not mutually exclusive, and coroners and medical examiners may not have been able to identify newer substances. However, these ambiguities did not affect the main finding of an exponential increase in the overall drug overdose rate, since each overdose death was counted once, the team said.
The research was supported in part by grants from the CDC, the National Institutes of Health, and the Robert Wood Johnson Foundation.
The authors reported having no competing interests.