Effect of Existing Opioid Misuse Interventions on Opioid Overdose Mortality

by | Apr 8, 2019 | 2019, Alternative Therapies

Written by Joyce Smith, BS. The study model projects that if no further reduction in the misuse of opioids occurs during the coming years, the annual number of opioid overdose deaths will increase from 33,100 in 2015 to 81,700 by 2025, reflecting a 147% increase.

Does prescription opioid misuse correlate with the number of opioid overdose deaths in the United States? The number of deaths due to opioid overdose have tripled over the last ten years from approximately 17,500 in 2006 to 42,200 in 2016 1. As a result, the cost burden to society, which includes health care, criminal justice system, and lost productivity costs estimated at $78.5 billion in 2013, is expected to increase substantially in the coming years 2. Prescription drug-monitoring programs and opioid- prescribing guidelines restricting the supply of opioid medications have been implemented; 3 however, they have shown only modest results 4. Today the use of opioids has increasingly shifted from the misuse of prescription opioids to the use of illegal opioids such as heroin and fentanyl, thus clouding any future projections of the opioid epidemic 5.

Researchers Chen et al developed a systemic dynamics model (compartmental model) 6 to simulate the projected use of nonmedical opioids in the United States from 2002 through to 2025. Their goal 7 was to calibrate the trends of opioid misuse and overdose deaths up to the year 2015, and then project the outcomes from 2016-2025. They also wanted to evaluate the effects of lowering the incidence of nonmedical opioid use on the number of projected overdose deaths.

According to their system dynamics model study, and given existing conditions, they related the following results:

  • If no further reduction in the misuse of opioids occurs during the coming years, the study model projects that the annual number opioid overdose deaths will increase from 33,100 in 2015 to 81,700 by 2025, reflecting a 147% increase.
  • The model also projects that during that timeframe, a total of approximately 700,000 people will die from an opioid overdose, with 80% of deaths occurring from illegal drugs like heroin and fentanyl.
  • By 2025, researchers estimate that half of all new opioid users will begin with illegal drugs like heroin and fentanyl rather than prescription drugs.
  • In all scenarios tested, interventions implemented towards reducing misuse of prescription opioids were projected to decrease overdose deaths over this period by only 3.0%-5.3%.

Prevention of prescription opioid misuse alone is projected to have a modest effect on lowering opioid overdose in the near future. They recommend that a multipronged approach including additional policy interventions is needed to dramatically alter the projected course of the opioid epidemic in the coming years. Interventions include identifying those with opioid use disorder (OUD) 8, improved access to medications like methadone and buprenorphine 9, increasing OUD training programs in medical and nursing schools,8 and controlling the supply of illegal heroine and fentanyl. Future studies will be mandatory to evaluate the effectiveness of this multipronged approach. Study limitations included the use of a data source model calibration which could underestimate the number of overdose deaths

Chen et al believe that “initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term and that policy, public health and health care delivery efforts are needed to amplify harm reduction efforts and access to evidence-based treatment”.

Source: Chen, Qiushi, Marc R. Larochelle, Davis T. Weaver, Anna P. Lietz, Peter P. Mueller, Sarah Mercaldo, Sarah E. Wakeman et al. “Prevention of Prescription Opioid Misuse and Projected Overdose Deaths in the United States.” JAMA network open 2, no. 2 (2019): e187621-e187621.

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Posted April 8, 2019.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

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