The rise in non-fatal and fatal overdoses involving stimulants with and without opioids in the United States

Details

• Alternative Title:
  Addiction
• Personal Author:
  Hoots, Brooke ; Vivolo-Kantor, Alana ; Seth, Puja
• Description:
  Aims
  
  To examine trends and recent changes in non-fatal and fatal stimulant overdose rates with and without opioids to improve the descriptive characterization of the US overdose epidemic.
  
  Design
  
  Secondaryanalysis of non-fatal (2006–16) and fatal (2006–17) drug overdose trends, focusing on the most recent years of data available to examine rate changes by demographics (2015–16 for non-fatal and 2016–17 for fatal).
  
  Setting
  
  Non-fatal drug overdoses from the Healthcare Cost and Utilization Project’s Nationwide Emergency Department Sample; drug overdose deaths from the National Vital Statistics System.
  
  Participants/cases
  
  International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) codes for cocaine, psychostimulants and opioids were used to classify non-fatal drug overdoses. Drug overdose deaths were identified using ICD-10 multiple cause-of-death codes for cocaine, psychostimulants, all opioids, heroin and synthetic opioids.
  
  Measurements
  
  Percentage of changes in age-adjusted non-fatal and fatal rates of cocaine and psychostimulant-involved drug overdose with and without opioids.
  
  Findings
  
  Overall, cocaine-involved non-fatal overdose rates with an opioid increased from 2006 to 2016 [annual percentage change (APC) = 14.7], while rates without an opioid increased from 2006 to 2012 (APC = 11.3) and then remained stable (APC = −7.5). Psychostimulant-involved non-fatal rates with and without an opioid increased from 2006 to 2016 (APC = 49.9 with opioids; 13.9 without opioids). Cocaine-involved death rates with and without opioids increased from 2014 to 2017 (APC = 46.0 with opioids, 23.6 without opioids). Psychostimulant-involved death rates with opioids increased from 2010 to 2015 (APC = 28.6), with a dramatic increase from 2015 to 2017 (APC = 50.5), while rates without opioids increased from 2008 to 2017 (APC = 22.6). In 2016, 27% of non-fatal cocaine- and 14% of psychostimulant-involved overdoses included a reported opioid; 72.7% of cocaine- and 50.3% of psychostimulant-involved deaths involved an opioid in 2017. From 2015 to 2016, cocaine-involved and psychostimulant-involved non-fatal overdose rates with an opioid increased 17.0 and 5.9%, respectively; cocaine-involved and psychostimulant-involved non-fatal overdoses without opioids decreased 13.6 and increased 18.9%, respectively. Death rates involving stimulants increased with and without opioids from 2016 to 2017 (cocaine with and without opioids = 37.7 and 23.3%; psychostimulants with and without opioids = 52.2 and 23.0%). Death rates involving stimulants with synthetic opioids increased dramatically from 2016 to 2017 (1.3–2.3 per 100000 for cocaine and 0.3–0.8 for psychostimulants).
  
  Conclusions
  
  While increases in cocaine-involved deaths in the United States from 2006 seem to be driven by opioids, particularly synthetic opioids, increases in non-fatal and fatal overdoses involving psychostimulants are occurring with and without opioids.
  
  
• Subjects:
  Adolescent Adult Aged Analgesics, Opioid Central Nervous System Stimulants Cocaine Drug Overdose Female Heroin Humans Male Middle Aged United States Young Adult

  More +
• Keywords:
  Emergency Department Opioids Overdose Stimulants
• Source:
  Addiction. 115(5):946-958
• Pubmed ID:
  31912625
• Pubmed Central ID:
  PMC11301974
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  115
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:36b9af89e4ceec25c5cda0c7c5f933295da67b18aa2cc6459edbde0e467f38476caf1d674dbbe3416db9bd42e9e9c1e2bc4eae0391375489a0be68b7a1a8e403
• Download URL:
  https://stacks.cdc.gov/view/cdc/159598/cdc_159598_DS1.pdf
• File Type:
  [PDF - 483.19 KB ]