Study Finds Commonality in 61% of Opioid Deaths

As the staggering toll—in terms of bodies, emotions, money, and our life expectancy—of the opioid epidemic comes into sharper focus, the idea of those who are most at risk is crystallizing, too, thanks to research out of Columbia University Medical Center. What a press release calls the "largest study of opioid deaths" was published Tuesday in the American Journal of Psychiatry. Researchers started with 13,089 adults who were under age 65, in the Medicaid program, and died of an opioid overdose between the years 2001 and 2007. A review of their medical histories and filled prescriptions resulted in a couple of big takeaways. As Bloomberg puts it, the numbers confirm "America's opioid epidemic began at the pharmacy."

The researchers found about two-thirds (61.5%) of those who died had been diagnosed with non-cancer chronic pain and prescribed an opioid. Many had also been diagnosed with depression or anxiety, and lead investigator Dr. Mark Olfson sees two lessons in that. First, that there's an opportunity for "clinical intervention," whereby clinics that treat chronic pain or mental health issues could pair those services with substance abuse treatment. Second, this group was more likely to have filled prescriptions for both opioids and anti-anxiety benzodiazepines; the combination promotes respiratory depression, "the unusually slow and shallow breathing that is the primary cause of death in most fatal opioid overdoses," says Olfson. Doctors should avoid prescribing the two together. (Read about how opioid patients' urine became "liquid gold.")