Opioid-related deaths on rise in eastern states

New research reflects an expansion of opioid-related deaths from rural, low-income states to eastern states.

According to the research findings, which were published in JAMA Network Open, the District of Columbia has experienced the fastest-growing opioid overdose death rate, tripling every year since 2013. The highest rates of opioid-related deaths occurred in eight statesConnecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire, and Ohio—and Florida and Pennsylvania had opioid-related mortality rates that were doubling every 2 years.

The research team analyzed data from the National Center for Health Statistics and the U.S. Census, looking at 351, 630 residents from across the United States who died from opioid-related causes from January 1, 1999, to December 31, 2016.

Since the cross-sectional study looked at multiple causes of death data, researchers also found that deaths from synthetic opioids, such as fentanyl, were more common than deaths from heroin overdoses.

"People aren't aware their drugs are laced and more potent than they expected, putting them at higher risk of overdose," said lead author Mathew Kiang, ScD, from Stanford University School of Medicine.

Study authors noted limitations of the research, including possible underreporting of opioid-related mortality, especially in eastern states. The presence of fentanyl in toxicology reports could also be underreported, they noted, because it requires an additional toxicology test to be requested by the coroner.

In the study, the researchers depicted the evolution of the opioid epidemic in three waves:

  • Prescriptions opioids from the 1990s to about 2010
  • Heroin from 2010 until recently
  • Synthetic opioids from about 2013 until now

Overall, opioid-related deaths in the United States have increased more than fourfold during an 18-year period, according to the study.

The researchers wrote that the current findings “indicate that policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids and rapidly expanding epidemics in northeastern states and consider the potential for synthetic opioid epidemics outside of the heroin supply.”