Friday, October 25, 2019

Only 1.3% of deaths from drug overdose involve prescription drugs

At last, data I have been seeking. From The Contribution of Prescribed and Illicit Opioids to Fatal Overdoses in Massachusetts, 2013-2015 by Alexander Y. Walley, MD, MSc, Dana Bernson, MPH, and Marc R. Larochelle.

Ever since the opioid epidemic hit, now taking 70,000 lives a year, the media and policy makers have focused on prescribed drugs as the source of overdoses which has always struck me as extremely unlikely. That focus I have attributed to lawyers colluding with regulators in order to to be able to sue pharmaceutical companies. A convenient scapegoat but, my suspicion, not the actual culprit.

But so far that speculation is based only on reason, knowledge of incentive structures, and observation of human nature, particularly the sub-species, homo politicus, for whom a guiltless culprit who can be sued is more desirable than the hard word of addressing the real cause. I have had no data.

This study is the first I have seen with actual data. It seems to support my supposition. Policy setters have been going after the easy cash cows, not actually crafting policy to the real circumstances. From the findings:
Of 2916 decedents with complete toxicology reports, 1789 (61.4%) had heroin and 1322 (45.3%) had fentanyl detected in postmortem toxicology reports. Of the 491 (16.8%) decedents with ≥1 opioid prescription active on the date of death, prescribed opioids were commonly not detected in toxicology reports, specifically: buprenorphine (56 of 97; 57.7%), oxycodone (93 of 176; 52.8%), and methadone prescribed for opioid use disorder (36 of 112; 32.1%). Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death.

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