Opioid Addiction Is Reducing US Life Expectancy

WASHINGTON (CN) — Deaths from opioid overdoses tripled in the 15 years from 2000 to 2015, according to a study published Tuesday by the Centers for Disease Control.

Opioids are natural painkillers, such as morphine and heroin, and prescription drugs such as Oxycontin, oxycodone, hydrocodone and Fentanyl, which function as synthetic opiates.

Deaths from opioid overdoses increased from 17,415 in 2000 to 52,404 in 2015, according to the study, “Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000-2015.”

The death rate per 100,000 people increased from 6.2 to 16.3, with most of the increase related to opioid deaths. The complete study was published by the Journal of the American Medical Association.

Deaths from drug poisoning more than doubled in the United States from 2000 to 2015, and poisoning deaths involving opioids more than tripled. Lead author Deborah Dowell, M.D., M.P.H., of the Centers for Disease Control and Prevention in Atlanta, and her colleagues estimated the number of deaths and death rates using information on death certificates registered in states and the District of Columbia.

But the actual death rate from opioids could be even higher, because complete information on death certificates is not included in as many as 25 percent of drug-poisoning deaths.

The precise nature of addiction is controversial; there is no actual definition of it. Nor do physicians or scientists know why some people can become addicted to a drug quickly, while others do not. But studies indicate that the longer a person is prescribed an opioid painkiller, the greater the likelihood of long-term addiction.

According to a CDC study released in March, the probability of long-term opioid use increases most sharply in the first days of therapy, particularly after five days or one month of prescribed opioids. Six percent of people with at least one day of opioid therapy were on opioids one year later, and the rate increased to 13.5 percent for people whose first episodes of opioid use were for eight days or more.

Heroin and other opioids once were concentrated in big U.S. cities, but the abundance of prescription drugs and cheap heroin from Mexico have flooded rural America. Montana Attorney General Tim Fox on Tuesday released a report that shows heroin violations in his state increased by 1,557 percent from 2010 to 2015.

Americans’ life expectancy rose by 0.20 years from 1970 to 2000, gained another 0.15 years gained from 2000 to 2014, but it declined from 2014 to 2015. Americans’ life expectancy now is lower than in most high-income countries, and the gap is expected to increase, according to the CDC study.

Reducing opioid-related deaths will be crucial to increasing Americans’ life expectancy once again, the CDC said.

From 2000 to 2015, Americans’ life expectancy rose from 76.8 years to 78.8 years. The gain came mainly from decrease rates of deaths from heart disease, cancer, cerebrovascular diseases, diabetes, influenza and pneumonia, chronic lower respiratory diseases and kidney disease. But in that time death rates from unintentional injuries, Alzheimer’s, suicide, chronic liver disease and septicemia increased, contributing a loss of .33 years to life expectancy, the study found.

Since heroin is an opioid, abusers of that drug have moved into prescription drug abuse, and because their dosages are consistent, many users view these drugs as safer to use than heroin.

But the study found evidence that prescription opioid users are moving to heroin, which has become less expensive and more accessible.

According to Yngvild Olsen, M.D., an addiction specialist, the opioid epidemic began in the 1990s at the confluence of two events: a need medical professionals’ need to treat pain, and the arrival of new prescription opioid medications.

“These efforts to treat pain more effectively coincided with relentless and misleading marketing of prescription opioids by manufacturers, who minimized the risks of misuse and addiction,” Olsen wrote in a JAMA editorial, adding that “these efforts also coincided with the introduction of patient satisfaction surveys tied to physician performance and reimbursement in some areas, including the assessment of pain.”

“In retrospect, it is significant that this campaign occurred in the absence of substantial evidence for the long-term effectiveness of opioids … without substantial training, understanding, and acknowledgment of addiction as a preventable, identifiable, and treatable disease.”

Insurance companies may also be contributing to the prescription epidemic. In a study of about 1.3 million prescription opioid users, 67 percent of the people who used opioids for more than one year were on commercial insurance plans (non-Medicaid or Medicare).

Dozens of counties and cities have sued major pharmaceutical companies this year, blaming them for the deaths, crime and violence linked to opioid addiction and abuse.

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