Opioid Overdose Deaths

Opioid Overdose Deaths in the United States

Introduction

The Administration’s balanced public health and public safety approach to drug policy is built on the scientific research demonstrating that substance use disorder is a chronic disease of the brain that can be successfully prevented and treated, and from which people can recover. The Administration has directed Federal agencies to expand community-based efforts to prevent drug use before it begins, empower healthcare workers to intervene early at the first signs of a substance use disorder, expand access to treatment for those who need it, support the millions of Americans in recovery, and pursue targeted approaches to drug enforcement.

The Centers for Disease Control and Prevention (CDC) released in December 2016 that showed that overdose deaths associated with prescription and illicit opioids increased to 33,091 in 2015 (see data summary below). The increase in deaths was driven in large part by continued sharp increases in deaths involving heroin and synthetic opioids such as fentanyl. As in 2014, overdose deaths involving prescription opioids (excluding the category of synthetic opioids that includes fentanyl) rose only slightly, suggesting that efforts in recent years to reduce the misuse of these drugs may be having an impact.

“The prescription opioid and heroin epidemic continues to devastate communities and families across the country—in large part because too many people still do not get effective substance use disorder treatment,” said Michael Botticelli, Director of National Drug Control Policy. “That is why the President has called since February for $1 billion in new funding to expand access to treatment. This week Congress finally acted on the President’s request. The Administration will work to get this new funding out to States as quickly as possible to make sure that every American who wants treatment for an opioid use disorder is able to get it.”

“The epidemic of deaths involving opioids continues to worsen,” said CDC Director Tom Frieden, M.D., M.P.H. “Prescription opioid misuse and use of heroin and illicitly manufactured fentanyl are intertwined and deeply troubling problems. We need to drastically improve both the treatment of pain and the treatment of opioid use disorders and increase the use of naloxone to reverse opioid overdose. We must also work collaboratively with our public safety partners to further reduce access to illicit opioids.”

The data released today are for 2015; since then the Administration has taken significant new actions to address the epidemic, including:

  • Issuing the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain – the Agency’s first-ever recommendations for primary care clinicians on prescribing opioids. Subsequently, more than 60 medical schools, nearly 200 nursing schools and more than 50 pharmacy schools have committed to prescriber training.
  • Establishing enhanced measures in conjunction with the Chinese government to combat the supply of fentanyl and its analogues coming to the United States.
  • Providing new funding to 271 Community Health Centers across the country to increase substance use disorder treatment services, with a specific focus on expanding medication-assisted treatment for opioid use disorders in underserved communities.
  • Increasing the patient limit from 100 to 275 for practitioners prescribing buprenorphine to treat opioid use disorders. Since August 2016, more than 2,000 practitioners have applied for and been granted waivers to prescribe at the increased limit—improving access to medication-assisted treatment (MAT).
  • Increasing funding by nearly $100 million to improve opioid prescribing, increase access to naloxone, build MAT treatment capacity to address the epidemic, and improve state surveillance efforts.
  • This week, Congress passed the 21st Century Cures Act, which provides $1 billion in new funding that the President requested to combat the epidemic, primarily by increasing access to substance use disorder treatment.

2015 Drug Overdose Data

According to the National Center for Health Statistics, the number of overdose deaths involving opioids rose from 28,647 in 2014 to 33,091 in 2015.

  • Heroin overdose deaths rose from 10,574 in 2014 to 12,990 in 2015, an increase of 23 percent.
  • Overdose deaths involving synthetic opioids other than methadone rose from 5,544 in 2014 to 9,580 in 2015, an increase of 73 percent. This category of opioids is dominated by fentanyl-related overdoses, and recent research indicates the fentanyl involved in these deaths is illicitly manufactured, not from medications containing fentanyl.
  • Taken together, 19,885 Americans lost their lives in 2015 to deaths involving primarily illicit opioids: heroin, synthetic opioids other than methadone (e.g., fentanyl), or a mixture of the two.
  • Overdose deaths involving prescription opioids, excluding the category predominated by illicit fentanyl, rose only slightly from 16,941 in 2014 to 17,536 in 2015, a 4% increase.

NOTE: A portion of the overdose deaths involved both illicit opioids and prescription opioids.

Some Details

  • The Affordable Care Act created the largest expansion of mental health and substance use disorder coverage in a generation. It is estimated that the ACA expanded mental health and substance use disorder benefits and parity protections to more than 60 million people.
  • The Centers for Disease Control and Prevention (CDC) issued its Guideline for Prescribing Opioids for Chronic Pain – the Agency’s first-ever recommendations for primary care clinicians on prescribing opioids. Subsequently, more than 60 medical schools, nearly 200 nursing schools and more than 50 pharmacy schools committed to prescriber training.
  • The Surgeon General’s first-ever Report on Alcohol, Drugs, and Health addressed alcohol, illicit drugs, and prescription drug misuse, with chapters dedicated to neurobiology,
  • Prevention, treatment, recovery, health systems integration and recommendations for the future. It provided an in-depth look at the science of substance use disorders and addiction, called for a cultural shift in the way Americans talk about the issue, and recommended additional actions to prevent and treat these conditions, and promote recovery.
  • SAMHSA finalized a rule in July 2016 that allows practitioners who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to now obtain a waiver to treat up to 275 patients. As of October 2016, 2,400 practitioners have applied for and been granted waivers to prescribe at the increased limit—improving access to buprenorphine, which is prescribed along with psychosocial supports as part of MAT.

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