Opioid crisis Flashcards
Deaths from opioid ODs over a decade
572,111
Estimate of yearly deaths due to obesity
280,000/yr to 325,000/yr
Versus a mean of 57,000/yr from opioids
But it means a lot more in the US
Overall mortality rates over time, age 45-54
Lifetime Life Expectancy
First, note that US mortality has diverged from that of other nations
So much so that life expectancy US FELL over 2014-2017, for three years running
The first such fall since comprehensive records were kept in 1933
Reasons for decrease in life expectancy
More than 72,000 Americans died from drug overdoses in 2017
Opioid deaths are the reason for decreasing life expectancy
Case/Deaton looked a little deeper into this
Hit middle age population the most
Deaths of Despair
Poisoning
Suicides
Alcohol related deaths: acute alcohol poisoning, cirrhosis of the liver
No word on if auto accidents due to drunken driving were included, but I think not. Would make # higher
Argue that these modalities of death are the result of a pervasive despair
The death belt
In 2000 to 2016 a lot more binge drinking and people dying from this
White and middle aged
People with an education have higher life expectancy
Historically, Opioid OD more common for blacks
But whites DOD outstripped DODs in the black population at about 2003
Arguably, blacks were not impacted by this pattern
Odd as again historically this population dealt with opioid abuse at a higher rate
until about 2014
When fentanyl and carfentanil started coming in from China in large amounts
What’s going on?
Case/Deaton argue that those with HS or less education once had respectable factory jobs that allowed them to live a reasonable life
Those jobs are gone
Leaving many people with no definable purpose, and no hope
Hench “DEATHS OF DESPAIR”
What can we do?
The educational/income/mortality gap between the less educated and the more educated is not really about access to drugs
These are profound social/economic/cultural issues
What can pharmacy do about these problems?
We need to focus on what we CAN do, and stop playing “the one who says NO”
Licit versus Illicit causes of Opioid OD today
In 2019 more than 36,000 deaths involving synthetic opioids occurred in the US, which is more deaths than from any other type of opioid.
Synthetic opioid involved death rates increased by over 15% from 2018-2019 and accounted for nearly 73% of all opioid deaths in 2019
What remains for pharmacist
“supply side” approach to reducing drug abuse
