Opioid Crisis Could Still Worsen with ‘Changing Nature’ of Epidemic, Study Finds

Overdose deaths caused by opioid misuse and addiction will continue to rise as current interventions to limit prescription drug abuse are not enough to address the situation. This is according to a study published in JAMA Network Open by a multi-institute research team. The study concludes that at this pace, the worst opioid crisis in US history could still worsen over time.

The researchers used a dynamic systems model to project overdose death trends from 2016 to 2025 and found that even under the strictest scenarios, an overdose will continue to rise.

The current opioid epidemic affecting the county could be responsible for 700,000 overdose deaths between 2016 and 2025. The study finds that the epidemic’s changing nature makes current solutions ineffective in the long run.

“Preventing people from misusing prescription opioids is important and could help prevent some overdose deaths in the long term, but our study shows that the effect would be limited in reducing the overdose deaths in the immediate future,” said Qiushi Chen, an assistant professor at Penn State and the lead author on the paper. “The majority of overdose deaths are now from illicit opioids, such as heroin and Fentanyl instead of prescription opioids, and this changing nature of the epidemic has reduced the potential impact of programs targeting prescription opioids.”

Chen worked with colleagues from Massachusetts General Hospital, Harvard Medical School, and Boston University Medical School. “The opioid crisis has been a national public health emergency for more than a year, and it’s getting worse,” said Jagpreet Chhatwal, an assistant professor at Harvard Medical School and the senior author on the paper. “We set out to understand how the reduction in incidences of prescription opioid misuse, by interventions of restricting opioid prescriptions supply, would influence the outcomes of overdose deaths in the next decade.”

Chen and the team developed a mathematical model that would allow them to simulate the opioid crisis from 2002 to 2025. The researchers used data available from the Centers for Disease Control (CDC) as well as the National Survey on Drug Use and Health (NSDUH).

The researchers then calibrated the model to match the trends of overdose deaths from specific types of opioid consumption observed from 2002 through 2015. The model was then used to project probable outcomes of the epidemic, based on the continuing trend, through 2025.

If the status quo continues, the annual number of opioid overdose deaths will increase from 33,100 in 2015 to 81,700 in 2025. This is a 147 percent increase. Eighty percent of those overdose deaths will result from the use of illicit opioids like heroin or Fentanyl. Have a look at San Jose's top rehab placement programs.

Researchers also found that interventions aimed at reducing prescription opioid misuse decreased overdose deaths by three to five percent—in every scenario they tested. Even under a hypothetical situation with an extreme modeling scenario, wherein there are no new incidences of prescription opioid misuse after 2015, the researchers found that the deaths in 2025 would still be higher than in 2015.

“More and more people are using illicit opioids. In the past, people might start using pain pills non-medically, which could then lead to illicit opioid usage, but data suggests that even more people are now starting with recreational use of illicit opioids,” Chen said. “Prescription opioids are now not necessarily the gateway that people must use to get to illicit opioids.”

The NSDUH reports that 30 percent of people who developed opioid use disorder did not start with prescription medications. These people started taking heroin or Fentanyl. Should this trend continue, by 2025, nearly half of people with opioid use disorder will have initiated their opioid use with illicit drugs.

“This study demonstrates that initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term,” said co-author Marc LaRochelle, an assistant professor in the Grayken Center for Addiction at the Boston Medical Center. “We need a policy, public health, and health care delivery efforts to amplify harm reduction efforts and access to evidence-based treatment.”

If someone in the family is struggling with opioid addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.