US drug overdose deaths rose 7% in 2017 and doubled over a decade, CDC reports

Farida B. Ahmad of the Division of Vital Statistics at the CDC's National Center for Health Statistics, lead author of the report, and her co-authors say the 2017 numbers may be an underestimate because states' investigations into some overdose deaths may not be complete.

Opioids, which include prescription painkillers along with heroin and other illegal synthetic opioid drugs, contributed 49,068 to the total number of overdose deaths, the report indicates. From 2002 to 2017, the CDC estimates a 4.1-fold increase in the total number of deaths due to all types of opioid drugs.

However, the most dramatic increase in deaths was due to fentanyl and other synthetic opioids. Nearly 30,000 overdose deaths resulted from these drugs in 2017, which is 22 times the number of deaths due to these drugs in 2002, the CDC finds.

When describing deaths involving specific drugs, "a single death might be included in more than one category," Ahmad and her co-authors noted. "For example, a death that involved both heroin and fentanyl would be included in both the number of drug overdose deaths involving heroin and the number of drug overdose deaths involving synthetic opioids other than methadone."

Breaking out the numbers in greater detail, they found that overdose deaths involving prescription pain relievers -- exclusive of synthetic opioids -- nearly doubled from 2002 to 2011, yet have remained relatively stable since.

The lowest number of overdose deaths involving cocaine, 4,312 in 2010, rose to a preliminary count of 14,556 in 2017, a 3.5-fold increase, the report also said.

Alex Ebied, a clinical assistant professor at the University of Florida College of Pharmacy, said that because opioid overdose deaths accounted for the majority -- nearly 68% -- of the preliminary total for 2017, the new report is "showcasing the opioid epidemic in the United States."

"It is important to note that this data encompasses both intentional and accidental overdoses," added Ebied, who was not involved in the CDC report.

Examples of accidental overdoses include children finding medications within arm's reach and chronic pain sufferers who have developed a tolerance for their medications and overdose when they try to control the pain from a severe episode, he said.

"While the opioid epidemic is a major concern, it is worth mentioning there are non-opioids overdoses representing 32.1%" of the total overdose deaths for 2017, Ebied said. "Any drug can be abused, but accessibility, cost and addictive properties are major factors."

He said that over-the-counter medications including acetaminophen, a non-opioid pain reliever, or loperamide, an anti-diarrheal, are also abused while ingestion of Tide detergent pods, K2 and "bath salts" are an emerging concern.

"The sharp increase in fentanyl and fentanyl analogs indicates there is abuse of access to this drug class," Ebied said, noting that fentanyl is 100 times more potent than morphine. "Although the Drug Enforcement Administration has a tight control of these controlled substances, accessibility continues to occur.

"A majority of abused prescription drugs were obtained from family and friends, often from the home medicine cabinet," Ebied said. He noted that there are increased efforts toward substance abuse awareness, including the Generation Rx Initiative, an educational program to increase public awareness of prescription medication abuse, and the National Prescription Drug Take Back Day, an initiative to dispose of unused drugs in a responsible way.

Other positive steps include increasing supply of naloxone, the opioid antidote, to first responders, while some states, including his own, are taking steps to limit opioid prescribing.