Abstract
IntroductionUS drug overdose deaths are at historic levels. For every fatal drug overdose, there are many more non-fatal; however, minimal nationally representative data exist on trends in the ratio of fatal to non-fatal drug overdoses and how this differs by drug type.MethodsData from the Centers for Disease Control and Prevention’s National Vital Statistics System were used to assess the number of fatal overdoses; data from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database were used to estimate the number of non-fatal overdoses treated in emergency departments. Counts of fatal and non-fatal overdoses by drug type (all drug, all opioid, synthetic opioid, heroin, stimulant, and opioid and stimulant polysubstance) were calculated from 2010 to 2020 (for non-fatal synthetic opioid-involved overdoses, from 2016 to 2020 only). Trends in overdose counts and the ratio of fatal to non-fatal overdoses were assessed.ResultsOn average, counts of fatal overdoses increased quarterly among all drug types, and non-fatal overdoses increased among most drug types. Over the 11-year period, the greatest average quarterly percent change (AQPC) in fatal overdose counts was among synthetic opioid-involved overdoses (AQPC: 7.1%; 95% CI: 6.0 to 8.2) and for non-fatal overdoses was among heroin-involved overdoses (AQPC: 4.3%; 95% CI: 3.9 to 4.8). During 2010‒2020, there was approximately 1 fatal overdose per 15 non-fatal. The ratio of fatal to non-fatal drug overdoses increased among every drug type except heroin; ratio increases were driven by greater relative increases in fatal overdoses compared with non-fatal.ConclusionsAssessment of the ratio of fatal to non-fatal drug overdoses can be used to understand the lethality of different drugs and inform response and prevention efforts.
Subject
Public Health, Environmental and Occupational Health
Reference34 articles.
1. National Center for Health Statistics . Drug overdose deaths in the United States, 2001–2021. Hyattsville, MD, 2022. doi:10.15620/cdc:122556
2. Trends in deaths involving heroin and synthetic opioids excluding methadone, and law enforcement drug product reports, by census region - United States, 2006-2015;O’Donnell;MMWR Morb Mortal Wkly Rep,2017
3. Pergolizzi J , Magnusson P , LeQuang JAK , et al . Illicitly manufactured fentanyl entering the United States. Cureus 2021;13:e17496. doi:10.7759/cureus.17496
4. Centers for Disease Control and Prevention . Increase in fatal drug overdoses across the United States driven by synthetic opioids before and during the COVID-19 pandemic. 2020. Available: https://emergency.cdc.gov/han/2020/han00438.asp [Accessed 15 Sep 2022].
5. Trends in US emergency department visits for mental health, overdose, and violence outcomes before and during the COVID-19 pandemic;Holland;JAMA Psychiatry,2021