Opioid Epidemic May Be Deadlier Than Expected

The opioid epidemic causes 91 deaths each day, making it the deadliest drug crisis in U.S. history. But the true death toll may be much higher.

Researchers at the Centers for Disease Control and Prevention released a report suggesting that some opioid-related deaths may be overlooked when people die from infectious diseases, such as pneumonia, caused by drug use.

“While my research cannot speak to what percent we are underestimating, we know we are missing cases,” CDC field officer Victoria Hall told CNN. “It does seem like it is almost an iceberg of an epidemic.”

Hall and a team of researchers combed death records in Minnesota for cases that involved infectious diseases. Knowing drug use can lead to such conditions, researchers wanted to see if postmortem toxicology tests found evidence of opioid use in people aged 12 or older.

The study examined 1,676 deaths in the Minnesota Department of Health’s Unexplained Death surveillance system between 2006 and 2015. This system refers unexplained deaths for additional testing.

Researchers identified 59 deaths associated with opioid use. However, the death certificate codes for the deaths were not sufficient for reporting to the statewide opioid surveillance system, which documents opioid-related overdose deaths. As a result, these cases were not included in the state’s opioid death toll.

Hall said that a national standardization for drafting a death certificate does not exist. If someone died of pneumonia caused by opioid use, only the infection would be listed on the certificate. The report found that more than half of unexplained deaths involving opioids listed pneumonia as the cause of death.

The coding affects the opioid-related death count. The CDC relies on information provided by medical examiners when collecting drug overdose data, which means the total number of opioid-related deaths in the United States could be much higher than reported.

Are Opioids Linked To Pneumonia?

Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City, told HealthDay that many emergency department patients who use opioids are at an increased risk of developing respiratory problems. He said people who abuse drugs and either smoke or have an existing respiratory problem, such as asthma, have a greater chance of developing pneumonia or another respiratory disease.

The CDC report is not the only study to link opioid use with respiratory illness.

A 2011 study published in the Journal of the American Geriatrics Society examined more than 3,000 adults aged 65 to 94. Researchers compared patients who had pneumonia with patients who did not. The report found that adults with pneumonia were more likely than the control group to use opioids or benzodiazepines prior to their illness.

More recently, Dr. Andrea Rubinstein of Permanente Medical Group in Santa Rosa, California, led a study that evaluated more than 40,000 hospital patients over a four-year span. Her team found that hospital patients who were prescribed fentanyl, morphine or codeine in the 100 days prior to admission had an increased risk for developing pneumonia while in the hospital.

‘Opioids Don’t Discriminate’

The CDC report showed that people of all ages, ethnicities and backgrounds could be affected by opioids. The deceased were aged 16 to 82, with an average age of 42. Fifty-three percent of cases involved women.

“Opioids don’t discriminate,” said Hall.

Research supports this statement. In 2015, about 276,000 adolescents aged 12 to 17 used painkillers for nonmedical purposes, according to a report by the American Society of Addiction Medicine. Among those, 122,000 battled prescription opioid pain reliever addiction.

The ASAM report also stated that women are more likely than men to be prescribed opioid painkillers, be given higher doses and use them for longer time periods. Women also may develop a dependence on prescription opioid pain relievers more quickly than men do.



Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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