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Rising drug overdose deaths
00:09:33
In the US, more people are dying from drug overdoses than from road traffic accidents...
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- [00:00]
Ruth Alexander
This is the short edition of More or Less, first broadcast on the BBC World Service.
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BBC Announcer
Thank you for downloading from the BBC. For details of our complete range of podcasts and our terms of use, go to bbcworldservice.com podcasts
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Ruth Alexander
hello, and welcome to More or Less on the BBC World Service. I'm Ruth Alexander. Tributes pour in for Philip Seymour Hoffman, who was found dead at his home in New York after an apparent drug overdose.
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Los Angeles County Coroner
The Los Angeles County Coroner's office has released toxicology information regarding the death of Michael Jackson, and it found that, quote, the drugs propofol and lorazepam were found to be the primary drugs responsible for Mr. Jackson's death.
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Medical Examiner or Official
We do now have a cause of death in the tragic death of Cory Monteith, and that cause of death was a mixed drug toxicity, and it involved heroin primarily and also alcohol.
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Ruth Alexander
The American actor Philip Seymour Hoffman has become the latest celebrity to die from a drug overdose, in this case, heroin. His premature death made headlines around the world, but what's less reported is the rising number of people in the United States in general who are dying from drug overdoses. Ben Carter's been looking at this and is with me.
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Dr. Len Palazzi
Ruth.
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Ben Carter
The latest figures show that in the last decade, the number of people that died from drug overdoses more than doubled, from 17,000 in the year 2000 to 38,000 in 2010. And in fact, in 2009, for the first time, more people died from drug overdoses than from traffic accidents or guns.
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Ruth Alexander
Gosh. So overdoses killed more people than guns in America. But we've looked at this kind of thing before, and I know the number of gun deaths and road deaths are both decreasing there.
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Ben Carter
That's true. But there is a clear upward trend in overdose deaths. And what the figures also show is that the biggest driver of the increase are deaths relating to legitimate drugs that you can get with a prescription from a doctor. Like in the case of Michael Jackson. This. These have trebled over the last 10 years.
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Ruth Alexander
And in some ways, it's not a surprise, as the quantity of prescription painkillers sold to pharmacies, hospitals and Doctors offices was four times larger in 2010 than about 10 years earlier in 1999. So does all this mean, then, that prescription drugs in the United States now account for more deaths than illegal drugs like heroin and cocaine?
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Ben Carter
Yes, it does. In 2010, prescription drugs killed more than 22,000 people in the United States, and that's more than twice as many as cocaine and heroin combined. But one thing we do need to bear in mind is that in 2012, an estimated 12 and a half million people reported using prescription painkillers without supervision from a doctor, which means there must
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Ruth Alexander
be a huge black market for these drugs. And do these overdose figures include intentional and unintentional overdoses?
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Ben Carter
They do, but four out of five overdoses are unintentional. And there's one particular class of prescription drug that is a big problem, opioids, which include morphine, methadone and fentanyl. And these are being used a lot more frequently, which is not Good news. As Dr. Len Palazzi from the Centers for Disease Control and Prevention explains, the
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Dr. Len Palazzi
main problem with this class of drugs is they're. Well, there's two problems, really. They address pain, but they also, at the same time have a euphoric effect. You feel much better when you're taking them. And they, at high doses, can suppress the brain, in particular the breathing centers in the brain, so that when taken in excess, as in the situation where someone is abusing the drugs, they can suppress the brain to the point where you stop breathing. So it's a class of drugs that is particularly risky because of its ability to cause fatal overdoses.
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Ben Carter
Now, in the 1990s, New York had one of the highest overall drug overdose rates, which was attributed to heavy heroin and cocaine use. Now it has one of the lowest rates. And that's because while other states have seen prescription drug overdose deaths spiral, New York is clamping down on their misuse.
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Dr. Len Palazzi
New York City in particular, is trying to do a lot to address the problems that they've been seeing in the last three or four years, in particular related to the opioid pain relievers. So they've become much more aggressive in terms of things like asking their providers to check the state's prescription monitoring program before they prescribe the drugs. And they're using the data from the prescription monitoring program, mapping it, trying to establish where there are unusual patterns or excessive amounts of drugs being prescribed. They're also ramping up programs to harm reduction programs and distribution of naloxone. They're doing a variety of things to try to prevent fatal overdoses and prevent substance abuse from beginning in the first place.
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Ruth Alexander
Do the states that sell the most prescription drugs then have the most people dying due to prescription drug overdoses?
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Ben Carter
Well, as Len Pahlazi mentioned, states like New York have tighter rules on the dispensing of prescription drugs and see lower rates of death through overdose. But elsewhere, there isn't any real correlation. For example, out of the 52 states, New Mexico has the highest prescription drug overdose rate, but is only ranked 32nd in terms of the amount of drugs that are being sold, whereas Oregon is ranked 4th in drugs sold, but only 31st on death rate.
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Ruth Alexander
When we look at the number of people dying through illegal drug overdoses as a whole, it's a similar story too. There's no real geographic split. For example, Virginia has one of the lowest rates in the country, but its neighbour, West Virginia has the highest rate in the country.
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Ben Carter
But what the data does show is that some of the more rural, less populated states like Nebraska and the Dakotas, have the lowest rates of drug overdose deaths in the country. And as Dr. Pollozzi says, the reason for that might be that the illegal drug overdose deaths tend to be associated with urban centers.
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Ruth Alexander
So Philip Seymour Hoffman and Cory Monteith, who was an actor with the American sitcom Glee, they both died from a heroin overdose. So let's consider what the trends are for heroin use in the United States.
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Ben Carter
Well, the number of heroin users has doubled in the last five years, and that's partly because the rise in the use of prescription drugs and a subsequent attempt to clamp down on their distribution has led to an unforeseen consequence.
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Dr. Len Palazzi
The reasons for that are probably multiple. There's been a dramatic increase, according to the dea, in the amount of heroin being imported into the us. Law enforcement agencies are reporting to the DEA widespread availability increasing every year over the last four or five for heroin in multiple markets in the United States, particularly in the eastern part of the United States. And it may be for some people who began using prescription pain relievers and are now dependent on them, that heroin is more available than it was before. Perhaps it's even more potent than it was before, and it might be even cheaper than buying the prescription drugs on the black market on the street. So for people who are, especially those people who are heavy users of the prescription painkillers, that's the group that's more likely in survey data to now report using heroin increasingly.
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Ruth Alexander
And Ben, you've been looking at other countries too. Have other nations seen this rise in heroin use? At the United States, there isn't data
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Ben Carter
for Africa and Asia, but heroin use across Europe has actually been on the decline during the last decade.
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Ruth Alexander
And what about overdose deaths? How do other countries compare to the US on that?
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Ben Carter
Again, the European data shows that the number of drug overdose Deaths dropped by 20% between 2007 and 2012. Here's Isabelle Giraudon, a scientific analyst at the European Monitoring Centre for Drugs and Drug Addiction.
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Isabelle Giraudon
The European trend is very much driven by what we see in the uk, in Germany, in Spain, and the fact is that they've observed a decrease in the number. So that's really put all the European trends down. But then after you've got other countries, you know, in the south, in the east of Europe, smaller countries like Romania, Hungary, Slovakia, Latvia, for example, Lithuania, these countries have observed an increase, so their weight in the European total is smaller. But the trend is not as good as what we observed in the uk, in Germany or in Spain, for example.
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Ruth Alexander
Isabelle Giraudin and thanks Ben Carter if there are any numbers you'd like us to investigate or explain, do please email us. Our address is more or lessbc.co.uk and you can also sign up for a free download of this program at our website, bbcworldservice.com more or less There are
- [09:17]
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