The Crisis of Misuse and Abuse: Bigger and Longer Than Opioids

New Data Analysis Finds Decades-Long Exponential Growth in Overdose Fatalities

An analysis conducted by researchers at University of Pittsburgh Graduate School of Public Health concludes that rising death rates from drug overdoses in the US long precede the now notorious “opioid crisis,” and that a near perfect exponential growth curve in these rates can be tracked back to the end of the 1970s. The smooth, unbroken curve is composed of variations in drug types and demographics, and, according to the authors, suggests that effective control and prevention efforts must go beyond regulation of specific substances to address the underlying causes of the epidemic of misuse. Senior author Donald Burke, MD, Pitt Public Health dean and UPMC-Jonas Salk Chair of Global Health, commented, “Understanding the forces holding these multiple individual drug epidemics together in a tight upward exponential trajectory will be important in revealing the root causes of the epidemic, and this understanding could be crucial to prevention and intervention strategies.” The analysis was published last week in the journal Science.

The research team consulted the full database of accidental drug overdose deaths reported by the US National Vital Statistics System since 1979, the beginning of data collection on the topic. In aggregate, the overdose death rate forms a near perfect exponential curve, about which Dr. Burke said “This remarkably smooth, long-term epidemic growth pattern really caught our attention. If we can figure it out, we should be able to bend that curve downward.” A deeper analysis of the overdose rates for specific substances and of the demographic characteristics of overdose casualties revealed no discernable patterns over 4 decades. The authors suggest that overdose prevention might be better served by addressing factors that contribute to drug availability, such as improved supply chains and manufacturing efficiencies, and drug demand, such as dissolution of communities, loss of purpose, and despair. “Evidence-based public health responses have contained past epidemics,” Dr. Burke concluded. “If we understand and address these root causes at the same time that we take on the opioid crisis, we should be able to curb the epidemic for good.”

Read about the findings.

The journal article may be read here.

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