Polysubstance Abuse Connection to Opioid Overdose Death Rate

The National Institute on Drug Abuse has come out with its annual report on drug overdose death rates. As horrific as the total numbers are, the rate of increase in overdose deaths driven by Fentanyl may be the scariest part. And while most news reports are highlighting the role of Fentanyl, few are discussing the involvement of other drugs and their relationship to the increasing rate of opioid related overdoses.

For context, below is the terrifying chart of opioid related overdose deaths:

 Opioid related deaths are up almost 50% since 2015.

Opioid related deaths are up almost 50% since 2015.

At MATClinics, we are not seeing much heroin anymore. Almost all of the illicit street opioids for which our patients test positive feature Fentanyl often cut with many other substances including methadone, morphine, benzodiazepines, cocaine, and others. Patients are often shocked. Many think that they are buying pain pills or bags of heroin. Instead they get whatever the street can provide. That is often a deadly mixture of drugs.

NIDA highlights cocaine and benzodiazepines (e.g. Xanax, Valium, etc.) co-occurrence with opioid deaths. Since 2015, overdose deaths that included cocaine have more than doubled. Based on the chart below you can see that almost all of the growth in cocaine related overdose deaths is accompanied by related opioid use.

 Cocaine overdoses by themselves have been pretty steady. The giant increase is associated with opioid use.

Cocaine overdoses by themselves have been pretty steady. The giant increase is associated with opioid use.

Unfortunately the data are not complete yet, so we can’t see the relationship between opioids and cocaine in 2017, but based on the trajectory of the two lines, it is hard to imagine that the 40% increase in overdoses between 2016 and 2017 isn’t highly correlated to opioid use.

The benzodiazepine picture (below) is similar, although it doesn’t have the same steepness to the growth curve:

Benzos and Opioids.png

What is striking about the chart above is how stable the benzodiazepine alone overdose numbers have been over the last fifteen years. Essentially all of the increase in overdose deaths is explained by the combination of benzodiazepines and opioids. Medically, this is a bit easier to understand than the cocaine relationship. Use of both opioids and benzodiazepines can lead to respiratory depression. The combination of the two can be very dangerous if they are not carefully monitored by professional health care providers.

If you or a loved one is struggling with opioid use, please call us at 410.220.0720 or reach out at info@matclinics.com.