CDC Reports on Florida Drug Overdose Deaths, 2003--2009
Prescription drug overdose deaths are a known to be a national epidemic. In 2009, the most commonly abused prescription drugs were pain relievers, tranquilizers, stimulants, and sedatives. In the United States in 2007, unintentional poisonings were the second leading cause of injury death after motor-vehicle crashes. Most of these (93%) unintentional poisoning deaths were caused by drug overdose.
According to the Centers for Disease Control and Prevention, more than 20,000 persons in the United States die from drug overdose each year. Those with the highest rates are adults ages 35–44 and persons living in the South and West regions of this country. Opioid drugs, commonly prescribed to relieve pain, are the most common source of drug overdose deaths.
The July 8 issue of the CDC MMWR summarizes the Florida’s overdose deaths from 2003 to 2009.
The report begins by noting from 1990 to 2001 in Florida, the nonsuicidal poisoning death rate increased 325%. For the report, the CDC analyzed data from the Florida Medical Examiners Commission for the period 2003--2009 from datasets of the Florida Medical Examiners Commission, which contain information on 34 types of drugs frequently abused, including ethanol (grain or beverage alcohol), prescription drugs, and illicit drugs.
Drug-related deaths are divided into two categories: 1) drug-caused deaths, for which postmortem medical examiner toxicology testing determined that drugs were present in lethal amounts; and 2) drug-present deaths, for which drugs were found in nonlethal amounts. This analysis included only drug-caused deaths, referred to in this report as drug overdose deaths.
During 2003--2009, a total of 16,550 drug overdose deaths were recorded by Florida medical examiners. The annual number of deaths increased 61.0%, from 1,804 to 2,905, and the death rate increased 47.5%, from 10.6 to 15.7 per 100,000 population.
During 2003--2009, 85.9% of drug overdose deaths were unintentional, 11.1% were suicides, 2.6% were of undetermined intent, and 0.4% were homicides or pending.
Prescription medications were implicated in 76.1% of all drug overdose deaths, and illicit drugs were implicated in 33.9% of deaths; in 10.0% of deaths, both prescription and illicit drugs were found in lethal concentrations.
The death rates were noted to have increased during 2003—2009 for all substances except cocaine and heroin. There was an 82.4% increase death rate associated with prescription drugs (from 7.3 to 13.4 per 100,000 population).
The three prescription drugs associated with the greatest increase death rate were oxycodone (264.6%), alprazolam (233.8%) and methadone (79.2%).
Conversely, the death rate for heroin decreased 62.2% from 2003 to 2009, and the death rate for cocaine increased until 2007 and then decreased 39.1% from 2007 to 2009.
In 2009, approximately eight drug overdose deaths occurred each day. Prescription drugs were involved fours times as often as illicit drugs. The highest death rate in 2009 was for oxycodone (6.4 per 100,00 population), followed by alprazolam (4.4), methadone (3.9), cocaine (2.8), morphine (1.6), hydrocodone (1.4), and heroin (0.5).
Similar recent changes in drug-specific death counts have been reported by the Office of the State Medical Examiner in Kentucky. From 2007 to 2009, the number of deaths involving oxycodone in Kentucky doubled, the number involving alprazolam increased tenfold, and the numbers involving cocaine or methadone declined.
It is not known whether these specific trends with oxycodone and alprazolam are nationwide, regional, or indicative of common risk factors in Florida and Kentucky.