Washington News: Prescription Opioids Fuel Sharp Rise in Poisoning Deaths

October 1, 2007 10:27 am Topics: Drug poisoning

Published in the October 2007 Washington State Board of Pharmacy Newsletter

A jump in overdose deaths from the use of prescription pain killers has created what many medical officials are describing as a poisoning epidemic. There were 923 poisoning deaths in Washington State in 2005.

Both in Washington State and nationally, poisoning death rates have increased dramatically since 1980. In Washington, males ages 35 to 54 had the highest death rates. More than 90% of poisoning deaths are drug overdoses, most involving multiple drugs. Nationally and in Washington, prescription opiate overdose deaths have fueled the rise in poisoning deaths.

The rise in deaths mirrors an increase in the volume of opiates prescribed. From 1997 to 2004, sales of methadone and oxycodone increased 974% and 580%, respectively. Only methadone dispensed through pharmacies and hospitals is included, not methadone dispensed in methadone maintenance treatment programs. During this time, overdose deaths that involved methadone increased rapidly.

The shift in opiate prescribing began at the end of the 1990s when various entities in Washington State recognized the important use of opioids for chronic non-cancer pain. These new policies reflected a major shift in thinking. Some evidence suggested patients were suffering from under treatment. Addiction from chronic opiate use was, at the time, thought to be a relatively low risk.

To date, interventions to change behaviors and risk factors linked to the epidemic of poisoning deaths have not been systematically evaluated. Promising strategies include stronger regulation to reduce the unsafe use of drugs, increased physician awareness, and support for best practices in treating drug dependence.