Opioids implicated in the majority of pharmaceutical overdose deaths

Opioids are a major contributor to drug overdose deaths, either when taken alone or in combination with other drugs, a new research letter said.

Researchers examined 2010 data from the National Vital Statistics System multiple cause-of-death file, which is based on death certificates. Results were published in the Feb. 20 Journal of the American Medical Association.

There were 38,329 drug overdose deaths in the U.S., of which 57.7% involved pharmaceuticals and 24.6% involved unspecified drugs. Seventy-four percent of the pharmaceutical-related overdose deaths were unintentional, 17% were suicides and 8.4% were of undetermined intent.

The drugs most commonly involved in pharmaceutical-related overdose deaths, either alone or in combination with other pharmaceuticals, were opioids (75.2%), benzodiazepines (29.4%), antidepressants (17.6%) and antiepileptic and antiparkinsonism drugs (7.8%).

Opioids were involved in 77% of deaths that also involved benzodiazepines, 65.5% of deaths that involved antiepileptic and antiparkinsonism medications, 58% of deaths that involved antipsychotic and neuroleptic drugs, 57.6% of deaths involving antidepressants, 56.5% of deaths involving other analgesics, antipyretics, and antirheumatics; and 54.2% of deaths involving other psychotropic drugs.

The analysis is limited by the fact that 25% of death certificates analyzed didn't specify the drugs involved in the overdose, the authors noted, meaning the numbers in the analysis are undercounts. The analysis does confirm the large role that opioids play in pharmaceutical overdose deaths, as well as the “frequent involvement of drugs typically prescribed for mental health conditions such as benzodiazepines, antidepressants and antipsychotics,” they wrote.

The authors concluded that it's important for clinicians to appropriately screen for, identify and manage mental health disorders, as well as use prescription drug monitoring programs and electronic health records when possible.