U.S. OD Death Rate Worst Among Wealthier Nations

MONDAY, Nov. 12, 2018 (HealthDay News) -- With the rate of drug overdose deaths more than doubling since the turn of the century, the United States now leads the world in these preventable tragedies.

New research from investigators at the U.S. National Cancer Institute (NCI) indicates that drug-related death rates in the United States are now more than double what they are in many other developed nations.

For the study, the researchers analyzed the World Health Organization's mortality database to determine overdose death trends from 2001 through 2015 across 13 countries.

"The U.S. had the highest death rate due to drug overdoses, which accounted for 35 deaths in [every] 100,000 men and 20 deaths in [every] 100,000 women in 2015," said study author Dr. Yingxi Chen.

Those figures reflect both accidental drug-related deaths and drug-related suicides among men and women aged 20 to 64, according to Chen. She is a postdoctoral fellow with the NCI's radiation epidemiology branch in the division of cancer epidemiology and genetics.

The study included information from Australia, Chile, Denmark, England, Estonia, Finland, Germany, Mexico, the Netherlands, Norway, Spain, Wales and the United States. Five of those countries saw worsening overdose death rates over the course of the study period.

Chen said the second highest overdose death rate among men was seen in Estonia. By 2015, that nation was experiencing 20 deaths per 100,000 men. That was followed by Norway, at 16 deaths per 100,000 men, and England and Wales, each at 15 deaths per 100,000 men.

"Overall, the absolute rates in men were generally double the rates in women," Chen said, "although we observed higher increases in rates among women than men in most countries."

Among women, Norway had the second highest rate (at 8 deaths per 100,000), followed by Australia (7) and Finland (6).

Chen said it's unclear why some nations are faring better than others.

And some are. For example, while Norway's overdose fatality rates remain relatively high, that country saw the largest decrease in risk during the study timeframe among both men and women. Spain also saw significant declines among men during the study timeframe, while Denmark experienced the same downward trend among women.

Notably, all of those countries have embraced programs designed to decrease the risk, Chen said.

Those programs include the establishment of needle and syringe exchange programs; efforts to distribute the opioid overdose prevention drug naloxone (Narcan) for at-home use; the designations of drug consumption "safe" rooms; and the increased availability of heroin treatment centers.

Currently, Denmark has all four programs implemented, Chen noted, while Norway and Spain have launched three of the programs.

Still, Chen stressed that the study "did not evaluate whether these declines are attributed to those intervention programs, nor whether those programs would work in the U.S."

The researchers reported their findings Nov. 13 in the Annals of Internal Medicine.

The study team noted that in 2016, nearly 64,000 American men and women died of a drug overdose.

Across all 13 countries, death rates were found to be highest among men aged 35 to 49 and among women aged 50 to 64.

As for the United States, both Chen and Dave Thomas, a health scientist in the division of epidemiology, services and prevention research at the U.S. National Institute on Drug Abuse, said the problem is rooted in the exploding opioid epidemic.

"This increase in drug overdoses was originally driven by the over-prescription of opioids [such as OxyContin], and by far the U.S. is the leader in opioid prescribing," Thomas said.

"But more recently, heroin and synthetic opioids like fentanyl have accounted for an increasing share of the U.S. opioid overdose deaths," he added.

More information

There's more on America's opioid crisis at the U.S. Centers for Disease Control and Prevention.