A new report from the National Center for Health Statistics (NCHS) assessing overdose deaths from 2011 to 2016 offers further evidence of fentanyl’s impact on the ever-worsening opioid crisis. The report also emphasizes what public health experts have been saying for years — that most people who suffer fatal overdoses have more than one drug in their system.
Historically, most reporting on fatal overdoses has been limited to the class of drugs involved, but by comparing death certificates to data from the National Vital Statistics System, this new NCHS report is more specific. It was no easy task. Reporting standards for death certificates vary from state to state, and even county to county, and there is no central regulatory body. Along with her fellow researchers, lead author Dr. Holly Hedegaard, a NCHS injury epidemiologist, reviewed the records, searching for drug misspellings, chemical names, brand names and street names noted by coroners and medical examiners.
Oxycodone was the most common drug found in fatal overdoses in 2011, but from 2012 to 2015, heroin took the lead. Starting in 2013, fentanyl use increased 113 percent per year, edging out heroin in 2016 as the drug most commonly cited in overdose death certificates. However, the researchers also found that in most of these deaths, more than one drug was involved
“We’ve had a tendency to think of these drugs in isolation. It’s not really what’s happening,” Dr. Hedegaard told Huffington Post.
In 2016, for example, approximately 70 percent of deaths from heroin or fentanyl, and 74 percent of cocaine-related deaths, also involved another drug. Further analysis of the most common lethal drug combinations — for example, 40 percent of cocaine overdoses also involved fentanyl — “helps us identify potential areas of risk,” Hedegaard said.
The NCHS report also found heroin, fentanyl and cocaine were more likely to be noted in accidental overdose deaths, while prescription and over-the-counter medicines, like oxycodone and diphenhydramine were more frequently cited in deaths by suicide.
“For folks who work in prevention, having information helps them think about what prevention tactics to use or approaches that might be effective,” Hedegaard said.