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The opioid epidemic in the United States could be responsible for 700,000 overdose deaths between 2016 and 2025, according to a new study published today in the United States. JAMA Network open now.
"Preventing people from misusing prescription opioids is important and may help prevent some overdose deaths in the long run, but our study shows that the effect would be to reduce the number of overdose deaths in a population. near future, "said Qiushi Chen, Assistant Professor at Harold and Inge Marcus Department of Industrial Engineering and Manufacturing at Penn State and the main author on paper. "The majority of overdose deaths are now caused by illicit opioids, such as heroin and fentanyl, instead of prescription opioids, and this changing nature of the epidemic has reduces the potential impact of programs targeting prescription opioids. "
In an attempt to understand the concrete results of prescription opioid abuse limitation programs, Chen worked with colleagues at Mbadachusetts General Hospital, Harvard Medical School, and Boston University Medical School.
"The opioid crisis has been a national public health emergency for over a year and is worsening," said Jagpreet Chhatwal, an badistant professor at Harvard Medical School and a scientist at the decision of the University of Toronto. Institute of Technology Assessment of the Mbadachusetts General Hospital (MGH-ITA). ). Chhatwal is the main author of the document. "We sought to understand how reducing the incidence of prescription opioid abuse, by interventions restricting the supply of opioid prescriptions, would affect the outcomes of opioids. overdose deaths over the next decade. "
Chen and the team have come up with a mathematical model to simulate the opioid crisis from 2002 to 2025. Using data available in the Centers for Disease Control (CDC) and I & # 39; National Survey of Drug Use and Health (NSDUH), researchers calibrated the pattern trends observed between 2002 and 2015 regarding overdose deaths due to certain types of opioids – abuse of use recreational prescriptions with illicit opioids – then used the model to project the likely outcomes of the epidemic, based on 2025 trends.
The researchers found that, if the status quo was maintained, the annual number of opioid overdose deaths would drop from 33,100 in 2015 to 81,700 in 2025, an increase of 147%. Eighty percent of these overdose deaths will result from the use of illicit opioids, such as heroin or fentanyl. In each scenario tested, researchers found that interventions to reduce misuse of prescription opioids reduced the number of overdose deaths by 3 to 5%.
In an extreme modeling scenario, a hypothetical situation in which there is literally no new incidence of prescription opioid abuse after 2015, the researchers found that the number of deaths in 2025 would still be higher than in 2015 .
"More and more people are consuming illicit opioids." In the past, badgesics could start taking painkillers, which could then lead to illicit opioid use, but the data suggests that more and more people are people are starting to use illicit opioids for recreational purposes. "Chen said. "Prescription opioids are not necessarily the gateway to use to get to illicit opioids."
According to the NSDUH, 30% of people who developed an opioid use disorder did not start with prescription drugs, but immediately started with heroin or fentanyl. Chen and his team anticipate that the trend will continue and that in 2025, nearly half of people with opioid consumption disorders will have started their opioid use with illicit drugs.
"This study demonstrates that prescription opioid-based initiatives are insufficient to counteract the opioid overdose death pattern in the short and medium term," said the report. author Marc LaRochelle, badistant professor at the Grayken Center for Addiction at Boston Medical. Center. "We need efforts in policy, public health and health care delivery to amplify harm reduction efforts and access to factual treatment."
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Davis Weaver, a medical student at Case Western University and a research badociate at MGH-ITA; Anna Lietz, Research Associate at MGH-ITA; Peter Mueller, postdoctoral fellow at MGH-ITA and Harvard Medical School; Sarah Wakeman, Medical Director of the Substance Use Disorders Initiative at MGH and Assistant Professor of Medicine at Harvard University; Kenneth Freedberg, Professor of Medicine at Harvard Medical School and the MGH and Director of the Epidemiology and Outcomes Research Program at the Harvard University AIDS Research Center; Tiana Raphel, medical student at the Southwestern Medical School at the University of Texas and research badociate at MGH-ITA; Amy Knudsen, badistant professor of radiology at Harvard Medical School and senior scientist at MGH-ITA; and Pari Pandharipande, badociate professor of radiology at Harvard Medical School and director of MGH-ITA.
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