Is medications more responsible for death than we think?

According to a study that has shown drug-associated deaths to be twice as high as stats suggest, rising drug use in the United States is taking its toll on mortality rates.

Misuse of the opioid can cause more deaths than previously thought by experts.

An average, 130 people die from an opioid overdose each day in the U.S. in what the Centers for Disease Control and Prevention (CDC) have called a heroin “epidemic.”

Death by drug toxicity— or overdose — has soared in all regions and among all ethnic groups since 2000.

More than 70,200 people died in the US in 2017 as a result of an overdose of narcotics. About 68 percent of these deaths involved opioids, with six times that number in 1999.

Opioids include prescription medicines like some pain relievers and illicit drugs like heroin. Opioids cause euphoria, and can be addictive.

But what if drug records that focus on death through overdose and drug-related mental and behavioral disorders aren’t a true reflection of the drug epidemic’s death toll?

What if the drug epidemic is behind the negative trends in U.S. life expectancy?

There were the questions the researchers had set out to answer behind a recent study in PLOS ONE. We were studying widespread drug-related deaths of U.S. people between the ages of 15 and 64.

Nine per cent of deaths were drug-related among this subset of population, based on data on overdose rates. In less than 20 years, this number has risen by 4 per cent.

According to Medical News Today, co-author Prof. Samuel Preston of Philadelphia’s University of Pennsylvania said, “Increasing mortality among working-age Americans was not limited to drug overdose, and we concluded that the rapid increase in drug use and abuse was likely to involve death from other causes of death.”

The full effect of drugs on mortality

Prof. Preston and co-author Dr. Dana Glei of Georgetown University in Washington, DC, maintain that drugs can kill beyond overdose in multiple ways.

These include infectious diseases such as HIV and hepatitis, circulatory diseases, poor judgement accidents, and suicide.

“In general, people who are chronic users of drugs have a much higher mortality,” Prof. Preston says.

To examine the level of drug-related mortality, the researchers looked at data from the National Center for Health Statistics (part of the CDC), which included over 44 million deaths in all 50 states over an 18-year period in people aged 15–64 years.

What they found was that drug-coded deaths, or in other words, those due to psychiatric and behavioral overdoses and drug-related disorders, only represented half of all drug-associated deaths.

“Apart from those deaths attributed to drugs on death certificates, the most important causes of death accounted for the effect of drugs were cardiovascular disorders and external causes of death for working-age men,” Prof. Preston said.

For example, looking at 2016, Prof. Preston and Dr. Glei found that the total number of drug-related deaths was 142,000, which is 2.25 times higher than the 63,000 drug-related deaths recorded, mostly attributed to overdose.

The effect of drugs on U.S. life expectancy

Prof. Preston and Dr. Glei found that on average, life expectancy for people who use drugs dropped by 1.4 years for men and 0.7 years for women after the age of 15.

Although this may not sound like much, researchers say it is enough to influence trends in U.S. life expectancy and account for the recent reversal of trends in life expectancy.

“We estimate that the impact of drugs is responsible for the reduction in U.S. life expectancy at age 15 since 2010.”

– Prof. Samuel Preston

“If one were to eliminate those deaths where we estimate were caused by drug use and abuse, we estimate that the life expectancy for men at age 15 in 2016 would increase by 1.4 years and for women by 0.7 years,” added Prof. Preston.

For those in West Virginia, the state that the drug epidemic has hit the hardest, the drop in life expectancy more than doubled. Opioid-associated deaths here recorded 39 per cent of male deaths and 27 per cent of female deaths among those aged 15–64 years.

Massachusetts, Maryland, Pennsylvania, and Ohio are other hard-hit counties.

Nebraska was the state which had the lowest rate of drug-related deaths in both sexes.

While the study recalculated the extent of the drug epidemic in the United States, it did not shed any light on the root causes.

“For now, this research is aimed at painting a broad picture and getting to the true extent of the US drug epidemic,” says Prof. Preston.

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