While heroin overdoses have declined, overdoses from prescription opioids such as oxycodone (marketed as Oxycontin) increased seven-fold in New York City over a 16-year period. The Columbia University researchers behind a new study analyzing the prescription opioid epidemic say it is especially prevalent among higher-income whites. The findings appear in the journalDrug and Alcohol Dependence.
Using data from the city’s Office of the Chief Medical Examiner for the period 1990-2006, the researchers examined the factors associated with death from prescription opioids versus heroin. They found that the increase in the rate of drug overdose was driven entirely by analgesic overdoses, which were 2.7 per 100,000 persons in 2006 or seven times higher than in 1990. Meanwhile, methadone overdoses remained stable, and heroin overdoses declined.
Over the last 20 years, prescription drug overdoses have risen dramatically in the U. S. By 2006, overdose fatalities exceeded the number of suicides, and by 2009, they exceeded the number of motor vehicle deaths.
The analysis showed whites were much more likely to overdose on analgesics than blacks or Hispanics. By 2006, the fatality rate among white males was almost two times higher than the rate among Latinos and three times higher than the rate among blacks.
“A possible reason for the concentration of fatalities among whites is that this group is more likely to have access to a doctor who can write prescriptions,” says Magdalena Cerdá, the lead author on the study. “However, more often than not, those who get addicted have begun using the drug through illicit channels rather than through a prescription.” The researchers think that price may also play a role. Since heroin costs less than analgesics, users of prescription opioids may perceive they are safer than other drugs.
The study suggests that the profile of a recreational prescription opioid user is very different from the heroin consumer, with less involvement in street-based forms of drug-trafficking and use of other drugs such as cocaine. Because of the different demographics between heroin and prescription opioid users, a different public health approach is needed to target the latter group, say the authors. “We need a different type of response to it,” said Cerdá, who also calls for more regulation of the aggressive marketing of drugs like Oxycontin.
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