Understanding the Rise in Overdose Deaths Involving Opioids and Non-opioid Prescription Drugs in the United States.

Details

• Alternative Title:
  The International Journal on Drug Policy, 2025, v. 141: Understanding the Rise in Overdose Deaths Involving Opioids and Non-opioid Prescription Drugs in the United States.
• Journal Article:
  The International Journal on Drug Policy
• Personal Author:
  Powell, David ; Peet, Evan D. ; Pacula, Rosalie Liccardo
• Description:
  Previous studies demonstrate that the reformulation of OxyContin in the U.S. in 2010 induced substitution to illicit opioids, causing illicit opioid markets to grow disproportionately fast in states more exposed to the reformulation. In this paper, we examine if this shift to the illicit market also led to a rise in polysubstance overdose deaths involving non-opioid prescription drugs, including gabapentinoids and "Z-drugs" and, separately, benzodiazepines.
  
  Using a difference-in-differences framework, the relationship between exposure to reformulation and overdose death rates including specific substances was studied in each year from 1999 to 2020 while accounting for fixed differences across states, common nationwide shocks, and state-level differences in pain reliever misuse prior to reformulation. Exposure to reformulation was measured as the pre-reformulation rate of OxyContin misuse.
  
  Exposure to reformulation predicted growth in overdose deaths involving gabapentinoids and Z-drugs. There is less evidence that it predicted growth in overdose deaths involving benzodiazepines. However, for all substances, there is strong evidence that pre-reformulation OxyContin misuse rates predicted post-reformulation growth in overdose deaths concurrently involving synthetic opioids.
  
  The opioid crisis has changed in radical ways. This study links a major supply-side intervention to the increase in polysubstance overdose deaths involving non-opioid prescription drugs, specifically gabapentinoids and Z-drugs.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Drug Overdose
  • Analgesics, Opioid
  • Prescription Drug Misuse
  • Benzodiazepines
  • Prescription Drugs
• Keywords:
  • opioid crisis
  • gabapentinoids
  • Z-drugs
  • benzodiazepines
  • illicit drug markets
  • OxyContin reformulation
• Source:
  The International Journal on Drug Policy, 2025, v. 141
• DOI:
  https://doi.org/10.1016/j.drugpo.2023.104104
• ISSN:
  0955-3959 ; 1873-4758
• Pubmed ID:
  37422359
• Pubmed Central ID:
  PMC10770297
• Document Type:
  Text
• Funding:
  P50 DA046351/DA/NIDA NIH HHSUnited States/ ; R01 CE002999/CE/NCIPC CDC HHSUnited States/ ; R21 DA052655/DA/NIDA NIH HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  104104 (25 pdf pages)
• Volume:
  141
• Download URL:
  https://stacks.cdc.gov/view/cdc/140536/cdc_140536_DS1.pdf
• File Type:
  [PDF - 1.25 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8c01b6d907d19469f2555d9acd8146f09b7377030130e0a63b4d408ee6fa56c1f0e7a9e78e7ae01985509f7b67057ed7815bd05f6d6835b86fdc789fe688b442