Prescription drug abuse deadlier than use of illegal drugs

A surge in methadone abuse in Florida matches a national trend that also finds emergency visits for narcotic analgesics outnumbering visits for heroin overdoses.

By Andis Robeznieks, AMNews staff. Dec. 16, 2002. Additional information

The abuse of prescription drugs is sending more people to the hospital and, in Florida, more people are being sent to the morgue from prescription drug overdoses than overdoses of cocaine and heroin, according to reports from Florida medical examiners and the U.S. Dept. of Health and Human Services.

Abuse of oxycodone and hydrocodone continues to rise, but a surge in methadone abuse has health and law enforcement officials particularly concerned. The Florida Dept. of Law Enforcement recently issued a public alert to raise awareness of the fact that methadone-related deaths rose 31% (from 194 to 254) in the first six months of this year compared with the last six months of 2001.

Between January and June of this year, the latest Drugs Identified in Deceased Persons report from the Florida medical examiner shows that:

Cocaine was present in 579 deaths, and listed as the cause in 180.
Benzodiazepine was present in 734 deaths, and listed as the cause in 150.
Methadone was present in 254 deaths, and listed as the cause in 133.
Heroin was present in 141 deaths, and listed as the cause in 121.
Oxycodone was present in 267 deaths, and listed as the cause in 112.
Hydrocodone was present in 248 deaths, and listed as the cause in 61.

Although the number of deceased persons who had oxycodone or hydrocodone in their systems increased, the number of times an overdose of those drugs was seen as the cause of death decreased 20% and 14%.

Some officials think that the decrease of deaths tied to these painkillers is linked to the increase in methadone deaths. "One theory is that doctors may be prescribing more methadone because of the bad rap oxycodone has been getting," said Vickie Marsey, a program administrator for the FDLE's medical examiners commission.

Although there is no exact federal counterpart to Florida's medical examiner's report, the Substance Abuse and Mental Health Services Administration, an HHS agency, does compile similar statistics in its Drug Abuse Warning Network report.

Florida is seeing more overdose deaths from prescription drugs than from cocaine and heroin.

In the DAWN report issued this fall, drug mentions were compiled from 458 emergency departments in 21 metropolitan areas in 2001.

"Our trends show that, in 2001, more people are showing up in emergency rooms for narcotic analgesics than for heroin," said SAMHSA spokeswoman Leah Young.

In 2001, the DAWN report estimated that 43% of the 1.1 million emergency department drug mentions were a result of abusing legal prescription or nonprescription medications. This included 135,949 mentions of anti-anxiety drugs, sedatives and hypnotics; 103,972 mentions of benzodiazepine abuse; and 61,012 mentions of improper use of antidepressants.

The number of benzodiazepine mentions increased more than 12% from 2000, and included a 16% increase in alprazolam drugs.

National figures on methadone appear to match those of Florida. Emergency department mentions of that drug were up 37% from 2000 to 2001, and have risen some 230% since 1994.

"The trend is definitely there," Young said, but she added that the trend isn't uniform.

Methadone deaths rose 31% in Florida during the first six months of 2002.

In the St. Louis and Philadelphia metropolitan areas, for example, she said there were more deaths from narcotic analgesics than from heroin or morphine; but in the Detroit, Seattle and Washington, D.C., areas, heroin and morphine deaths were higher.

"It seems to be all over the map," Young said. "It seems to depend on the city."

Although the news is grim, Marsey pointed to two positive items in the Florida report: Heroin-related deaths decreased 15% and methylated amphetamine-related deaths dropped 29%. In fact, of the 52 deaths in Florida related to methylated amphetamines between January and June of 2002, the drug was considered the direct cause of only eight of those deaths.

Although abuse of methylated amphetamines continues, Marsey said the drug's users are becoming aware of how dangerous they can be.

"I heard that, among the youths who use these club drugs, they now know the signs [of overdose], and don't leave their friends to die anymore," she said. "Now, they take them to the hospital."

ADDITIONAL INFORMATION:

Weblink

Report, "2002 Interim Report of Drugs Identified in Deceased Persons by Florida Medical Examiners," Florida Dept. of Law Enforcement, in pdf (http://www.fdle.state.fl.us/publications/examiner_drug_report_2002.pdf)

Press release from the Substance Abuse and Mental Health Services Administration regarding release of 2001 Drug Abuse Warning Network report (http://www.samhsa.gov/news/newsreleases/020821nr_dawn2001.htm)

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