SAFE Glen Cove Coalition: Heroin More Potent in Eastern U.S.

A new study published in the journal JAMA Network Open found that the mortality rate from synthetic opioids in 28 states more than doubled every two years from 1999 to 2016. The District of Columbia saw the greatest increase in its opioid mortality rate, which more than tripled every year since 2013.

From 1999 to 2016, opioid-related mortality rates – driven by synthetics – rapidly increased across the eastern United States, according to researchers at Stanford University. In 28 states, the mortality rates from synthetic opioids more than doubled every two years. Synthetic opioids are man made drugs such as fentanyl, as opposed to semi-synthetic opioids such as hydrocodone and oxycodone, or natural opioids such as codeine and morphine. Fentanyl is up to 50 times more powerful than heroin, and just ¼ of a milligram can be deadly. For comparison, a standard low-dose aspirin is 81 mg. Cutting that tablet into 324 pieces, one of those pieces would equal ¼ milligram.

The study maintains that at the national level, opioids were responsible for shaving 0.36 years off Americans' life expectancy in 2016-a greater loss of life than caused by guns or motor vehicle accidents.

New Hampshire and West Virginia saw the biggest drops in life expectancy, of more than a year, due to opioid deaths. Montana and Oregon were the only states to see a decline in opioid deaths from 1999 to 2016.

Researchers claim that despite the large differences in deaths across states, there's no evidence to suggest that there's differences in use. They think that the heroin just continues to get more and more potent in the eastern United States, whereas heroin in the western United States has traditionally been brown tar heroin and that it's much harder to lace with fentanyl or other synthetic opioids.

According to the study, research suggests the opioid epidemic has evolved as a series of 3 intertwined but distinct epidemics, or waves, based on the types of opioids associated with mortality: 1990s-2010: Prescription painkillers; 2010-present: Heroin; 2013-present: Synthetic opioids.

Utilizing data from the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics and the U.S. census, researchers identified 351,630 opioid-related deaths from 1999 to 2016. Over that 18-year period, deaths from opioids increased by 455%. Men, on average, died at age 39.8 and women at age 43.5. The number of opioid deaths is probably under reported because synthetic opioids require additional testing by a medical examiner. Going forward, researchers are hopeful that testing for synthetic opioids will become standard whenever the cause of someone's death is classified as an overdose.

While there's early evidence that the explosive rate of opioid deaths has started to decrease, opioids killed more than 49,000 people in the United States in 2017. In terms of viable solutions to the epidemic, researchers are reframing the problem not as an overdose epidemic but as an addiction epidemic and that preventing opioid addiction is necessary for the long term, so that this crisis ultimately comes to an end. Additionally, treatment should be as accessible, available and affordable as heroin.

JAMA Network Open is an international, peer-reviewed, open access, general medical journal that publishes research on clinical care, innovation in health care, health policy, and global health across all health disciplines and countries for clinicians, investigators, and policy makers. To read the article please visit https://www.cnn.com/2019/02/22/health/opioid-deaths-states-study/index.html.

The Centers for Disease Control and Prevention is a federal agency that conducts and supports health promotion, prevention and preparedness activities in the United States, with the goal of improving overall public health. To learn more about the CDC please visit www.cdc.gov.

The SAFE Glen Cove Coalition is joining in the fight against this epidemic by conducting an opioid prevention awareness campaign entitled, "Keeping Glen Cove SAFE," in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencove or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org