Drug overdose deaths aren't just a white, middle-aged, rural problem

A new report from the Centers for Disease Control and Prevention reveals that the problem of drug overdoses has hit a much wider range of people than researchers first realized. Rather than just white, middle-aged, rural Americans, the problem increasingly affects other age groups and races.

Deaths across many groups in the US have spiked in a particularly worrying way since 2013. The percentage of older Americans between the ages of 55 and 64 dying from drug overdoses has more than quadrupled since 1999 — from 4.2 deaths for every 100,000 to 21.8 deaths per 100,000 in 2015.

Holly Hedegaard, one of the CDC report’s authors, said the number of drug overdose deaths has climbed significantly for younger people, too.

“For those 65 and over, we only saw a gradual increase,” she said. “But for those between the ages of 15 and 24, we’re starting to see a steeper curve between 2014 and 2015, and it is perhaps still going up, which is a concern, as we don’t want young people to have this problem.”

Drug overdose deaths have impacted white Americans disproportionately, but that’s also changing

It’s clear white Americans have died disproportionately from drug overdoses in recent years, largely fueled by highly addictive synthetic opioids and heroin.

Seminal research from Princeton economists Angus Deaton and Anne Case in 2015 pointed to the dramatic increase in the mortality of middle-aged white Americans (between the ages of 45 and 54) — and attributed it to higher rates of suicides, drug overdoses, and liver disease.

And since about 2001, drug overdose deaths in the US have increased 7 percent annually for white Americans, compared with an average 2 percent increase for black and Hispanic Americans, respectively.

But data from 2014 and 2015 indicates this might be shifting. The number of black Americans who died from a drug overdose in 2015 jumped from 10.5 deaths for every 100,000 people to 12.2 deaths, marking the largest uptick in drug-related deaths for black Americans in the past 16 years.

Similarly, Hispanic Americans experienced the biggest jump in drug-related deaths in 2015, too, climbing from 6.7 deaths for every 100,00 people to 7.7.

This increase from 2014 to 2015 for both non-Hispanic blacks and Hispanics dying from drug overdoses means “we need to better monitor and see what is happening there,” said Hedegaard.

Deaths spiked in 2013 — and are only getting worse

Drug overdose deaths in the US have nearly tripled since 1999, from 6.1 deaths for every 100,000 people to 16.3 deaths. But as you can see in the chart below, from 2006 to 2010, the number of Americans dying from these drugs remained relatively stable.

But between 2013 and 2015, they jumped 18 percent.

Why? Heroin and synthetic opioids.

Hedegaard said heroin is now responsible for one in four drug overdose deaths.

“Heroin made up 8 percent of drug overdose deaths in 2010, but in a six-year time period grew to make up a quarter,” she said. “That to me is very concerning.”

Fentanyl, an incredibly potent synthetic opioid thought to be at least 50 to 100 times more potent than morphine, has also become much more commonly prescribed and used in recent years.

And deaths from fentanyl more than doubled in a single year — from 1,905 deaths in 2013 to 4,200 deaths in 2014.

Sarah Frostenson

In some states, the death toll has hit full-blown epidemic levels.

In 2015, both West Virginia and New Hampshire reported drug overdose rates double the national rate of 16.3 — 41.5 deaths for every 100,000 people in West Virginia and 34.3 for every 100,000 people in New Hampshire.

But it isn’t just states with large rural populations reporting higher drug overdose rates. In total, 21 states reported drug overdose rates higher than the national average in 2015, including states with larger urban populations like Michigan and Massachusetts.

As you can see in the maps below, not only were far fewer states reporting drug overdose rates higher than the national rate in 1999, but most drug-related deaths were concentrated in the West. Now drug overdose deaths have spread across a more geographically diverse set of states.

The sobering reality is the current drug epidemic in the US is so pervasive that it cuts across geographies, demographics, class divisions, and even political party. On a more hopeful note, as I’ve reported, opioid abuse is one of the few public health issues that draws bipartisan support these days.

New Jersey recently passed one of the most aggressive laws in the country to combat the opioid epidemic, reducing patients’ prescriptions from 30 days to five days and mandating that insurers offer 180 days of coverage without preauthorization. New Jersey is now one of 10 states in the US with laws limiting opioid prescriptions to seven days or less, and other states such as Minnesota and South Carolina are in the process of crafting their own legislation.

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