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CDC Opioid Overdose Death Rates Over-Reported by Half

April 5, 2018
Agency says inflated estimates were caused by blurred lines between prescription and illicit opioids

A PPM Brief

Four researchers at the US Centers for Disease Control and Prevention (CDC)1 have published an editorial that outlines how the agency’s tracking methods and tallies of prescription opioid deaths have been deemed overestimated and inaccurate. The agency announced that the introduction of illicit fentanyl and other synthetic black market opioids have been incorrectly counted as prescription drug deaths, affecting the total count reported.

“Traditionally, the CDC and others have included synthetic opioid deaths in estimates of ‘prescription’ opioid deaths,” the researchers wrote. “However, with IMF (illicitly manufactured fentanyl) likely being involved more recently, estimating prescription opioid–involved deaths with the inclusion of synthetic opioid–involved deaths could significantly inflate estimates.”

Starting in 2015, the CDC had changed the way it had calculated opioid overdoses due to the rise of illicit fentanyl deaths. In 2016, the CDC announced that 32,445 Americans had died from overdoses of opioid pain medication. However, excluding fentanyl and similar synthetics, that number is now reported as 17,087 overdoses; a drop of nearly a half.

Even with the refined count, the estimate is still put into question due to the unknown number of deaths involving diverted prescriptions or counterfeit drugs; toxicology tests being unable to distinguish between pharmaceutical fentanyl and illicit fentanyl; drugs not being identified on death certificates in 20% of overdose deaths; and how multiple drugs are typically involved in almost half of drug overdose deaths, noted the agency.1

In an effort to counteract these errors, the CDC has implemented new overdose surveillance systems in 32 states to obtain data from death certificates with toxicology tests and death scene investigations for better accuracy.1 These adjustments come just months after President Trump’s declared public health emergency based on opioid overdoses and deaths, as well as a soft “ban” of evidence-based terminology.

See also an editorial on safety concerns regarding the CDC’s opioid calculator and the FDA's recent shift in tone on opioid prescribing.

Last updated on: April 13, 2018
Continue Reading:
FDA, AAPM Open Talks on Evidence-Based Opioid Prescribing
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