25 February 2019

Among rich nations, US has highest rate of fatal drug ODs

According to a news release, the United States has had the highest drug overdose mortality among its peer countries for more than 10 years.

It's a ranking that no country would want to have: A new study shows America has taken the lead in drug overdose deaths, with rates almost four times higher than in 17 other wealthy nations.

Drug overdose deaths in the United States have more than tripled over the past 20 years, driven largely by the opioid epidemic, the researchers noted.

Drug overdose epidemic

In 2017, more than 70 000 Americans died from drug overdoses. According to the National Safety Council, more Americans are likely to die from an opioid overdose than a car crash.

"The United States is experiencing a drug overdose epidemic of unprecedented magnitude, not only judging by its own history, but also compared to the experiences of other high-income countries," said study author Jessica Ho. She's an assistant professor at the University of Southern California's Leonard Davis School of Gerontology.

"For over a decade now, the United States has had the highest drug overdose mortality among its peer countries," Ho said in a university news release.

In fact, drug deaths in the United States are more than 27 times higher than in Italy and Japan, which have the lowest rates, and are double the rates of Finland and Sweden, the countries with the next highest death rates.

Drug overdose deaths have also affected life expectancy. In 2013, drug overdoses made up 12% of the life expectancy gap among men and 8% among women between the United States and other high-income countries.

Commercial hyping of painkiller

If it weren't for drug overdose deaths, the life expectancy gap would have been much smaller between 2003 and 2013, the researchers added.

"On average, Americans are living 2.6 fewer years than people in other high-income countries. This puts the United States more than a decade behind the life expectancy levels achieved by other high-income countries," Ho said.

The researchers said the epidemic is being driven by factors that include fee-for-service reimbursement systems and linking doctors' pay to patient satisfaction.

Other factors include commercial hyping of the opioid painkiller OxyContin (oxycodone), American attitudes about pain and medicine, and the lack of substance abuse treatment. In the United States, only about 10% of addicts receive treatment, the researchers noted.

While America leads in overdose deaths, increases in overdose deaths are starting to crop up in Australia, Canada and the United Kingdom, Ho noted.

A common challenge

Australia has seen a 14-fold increase in oxycodone use between 1997 and 2008, and Ontario, Canada, saw an 850% increase in oxycodone use between 1991 and 2007. These increases have resulted in many more overdose deaths in both nations, the study showed.

Although the American opioid epidemic started with prescription drugs, it is now becoming an epidemic of heroin and fentanyl, which is also affecting other countries.

"The use of prescription opioids and synthetic drugs like fentanyl are becoming increasingly common in many high-income countries and constitute a common challenge to be confronted by these countries," Ho said.

For the study, Ho and colleagues used data from the Human Mortality Database and the World Health Organization Mortality Database for 18 countries, along with data from vital statistics agencies in Canada and the United States.

The report was published in the journal Population and Development Review.

Image credit: iStock


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