Opioid-Related Deaths in the U.S. Could Be Far Higher Than Previously Thought, Study Suggests

The number of deaths linked to opioids in the U.S. over the past two decades could be almost 30 percent higher than previously thought, a study has revealed.

Researchers looked at data on people who died of drug overdoses between 1999 to 2016 from a database kept by the National Center for Health Statistics in the U.S., which included a total of 632,331 cases. This enabled the team to match up information on death records with drug overdoses without a specific cause.

Of those, 78.2 percent of cases had information on the drug involved, while 21.8 percent didn't. The team found that 71.8 percent of unclassified drug overdoses over the course of the study involved opioids, or approximately 28 percent more than previously reported. That amounts to 99,160 additional deaths linked to prescription opioids, heroin, or fentanyl.

The team found states including Alabama, Mississippi, Pennsylvania, Louisiana, and Indiana, had the highest discrepancies. According to a statement by the University of Rochester where the researchers are based, the number of reported opioid-related deaths in Pennsylvania, for instance, was 12,374, but the research puts the figure at 26,586.

The research comes amid an opioid overdose epidemic which kills 130 Americans every day on average, according to the U.S. Centers for Disease Control and Prevention. Of the over 70,200 individuals who died of a drug overdose in 2017, around 68 percent had taken an opioid. That included prescription and illegal drugs like heroin and its stronger synthetic counterpart fentanyl. The crisis started after a rise in opioid prescriptions in the 1990s.

Andrew J. Boslett, Alina Denham, and Elaine L. Hill co-authored the paper published in the journal Addiction. They told Newsweek: "We suspect that the driver of underreporting of opioid overdoses in the United States may be due to a lack of resources for medical examination, as well as continued (though decreasing) reliance on coroners, who are elected officials with potentially only limited experience in medical examination."

Explaining why they carried out the study, they said: "A number of researchers have speculated that socio-economic malaise in many areas of the country over the last twenty years has played a role in increasing drug overdose-related abuse and mortality.

"Over the last few years, we have been developing research on whether the shale boom, coal bust, and other economic shocks have influenced the drug overdose epidemic, in a meaningful way. As we developed this study, we noticed by looking at the data and reading through the literature that around 20 to 25 percent of drug overdoses did not have a drug-of-cause listed in the death record.

"We realized that this was an issue, not only for our studies—which would rely on high-quality estimates of local drug and opioid overdose rates across space and time—but also for the country's understanding of the toll of the opioid overdose epidemic."

The team went on: "We suspect that the driver of underreporting of opioid overdoses in the United States may be due to a lack of resources for medical examination, as well as continued (though decreasing) reliance on coroners, who are elected officials with potentially only limited experience in medical examination."

Highlighting the limitations of their study, the team they could have applied more advanced tools in machine learning.

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