Over the past 16 years, the rate of drug overdose from prescription opioid drugs skyrocketed seven-fold in New York City. In fact, researchers from Columbia’s Mailman School of Public Health call it nothing less than an “epidemic.”
Who are the people in New York overdosing on drugs like Oxycontin? If you immediately think the answer is most likely poor people and/or blacks — and if you assume the drugs in question are illicit ones sold on the streets — you are wrong. The people overdosing are mostly white residents of New York who have the money to visit doctors who, it turns out, often provide the prescriptions for these too-often deadly drugs.
A new study by a Columbia University’s Mailman School of Public Health research team is one of the earliest and most comprehensive analyses of how the opioid epidemic has affected a major American city. Their findings, just published in the journal Drug and Alcohol Dependence, show the fatality rate for prescription opioid drugs for white males is three times higher than for blacks.
The researchers looked at two classes of prescription opioids — painkillers like Oxycontin (oxycodone) and methadone, which is used to treat heroin addiction — and used data from New York’s Office of the Chief Medical Examiner for the period from 1990 to 2006. They investigated factors associated with deaths from prescription opioids and compared them to fatalities from heroin, which in the past have been the most common type of opioid fatalities in urban areas.
So is the enormous increase in deaths by drug overdose caused by heroin or even addicts overdosing on methadone? Not at all. In fact, the rate of methadone overdose has stayed about steady. Instead, the epidemic in drug deaths has been driven entirely by prescription pain reliever overdoses. What’s more, the drug deaths were mostly concentrated in neighborhoods with high-income inequality and lower-than-average rates of poverty.
In a media statement, Magdalena Cerda, DrPH, assistant professor of epidemiology at Columbia’s Mailman School of Public Health and the lead author on the study, pointed out that more often than not, opioid drug addiction begins by people getting these medications on their own (perhaps using someone else’s prescription or buying the drugs illicitly). But, bottom line, those dying from the drugs have usually moved on to getting a steady source of the prescription drugs legally from a physician.
“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,” Cerda said in the press statement. She added that users of prescription opioids they get from a doctor may perceive these medications as safer than other drugs.
The researchers noted that over the past two decades, prescription drug overdoses have risen dramatically in the U. S. with overdose fatalities exceeding the number of suicide deaths by 2006. By 2009, accidental prescription drug overdoses even exceeded the number of motor vehicle deaths. And as reported previously, a Brandeis University study found that prescription painkillers are now responsible for more fatal overdoses in the U.S. than heroin and cocaine combined.
So, what can be done to reverse the trend? Important strategies, according to the authors of the new study, include regulating Big Pharma’s aggressive marketing of potent drugs like Oxycontin, controlling the over-prescribing of pain relievers, and taking stricter measures to regulate the sales of these medications. They also recommend more law enforcement measures to identify illicit networks that distribute these drugs and educational outreach programs about the dangers of these drugs for not only patients but also doctors.