Are the Benefits of Prescription Drugs Large Enough to Excuse Overdose Deaths?

Photo: xcorex

That is the question I found myself asking while looking at a new Centers for Disease Control report that analyzes drug-overdose deaths in Florida from 2003-2009. I am guessing the answer is a resounding yes, but it’s probably a question worth asking. During that period, the death rate for prescription drugs rose 84.2 percent, from 7.3 to 13.4 per 100,000 people. (Note that these numbers represent unintentional deaths, not suicides — although when you’re talking about death by drugs, the intention isn’t always clear.) Interestingly, the death rate from illicit drugs — primarily heroin and cocaine — has fallen 21.4 percent, to 3.4 per 100,000 people.

That makes the rate of death by prescription overdose nearly 4 times that of illicit drugs — and a lot more people use prescriptions than cocaine or heroin. Meanwhile, the overdose rate from alcohol has risen 81.4 percent over the same period, to 2.8 per 100,000. This is a complex issue of course but it is interesting to me that illicit drug-related deaths fell so much, as alcohol and prescription drug-related deaths both increased substantially.

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  1. Curtis says:

    An important stat from that death figure is how many of those deaths were from acetaminophen overdose. Many on Rx pain pills do not realize they are also getting a hefty dose of acetaminophen as well and often take stand alone acetaminophen (Tylenol) on top of it. I believe in Canada, they are allowed to market oxycodone without the acetaminophen half of it. How much difference that would make might be important to look into.

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    • brian h says:

      I live in SoFla and can assure you that oxycodone is available in both APAP and pure formulations. The majority of overdoses here are from combining pure oxycodone (30 mgs and up) with Xanax and rarely involve Percocet (low dose of oxy + acetaminophen.)
      The pill mill problem has been endemic to the area for years and has only just recently been seriously addressed, with mixed results. While shady doctors and clinic owners are indeed being charged, the number who will be successfully prosecuted remains to be seen. For readers of this blog, I urge you to read more about this phenomenon as it falls into a grey area, between legal and black markets, perpetrated by some in one of society’s most respected professions (doctors) as well as those in one of the least respected (dealers.) It’s fascinating.
      While FL’s efforts may seem futile now, I predict pill mills will for the most part disappear here, with the void for addicts filled by heroin dealers. Word on the street is that Las Vegas is the next pill mill frontier. It’s difficult to describe how huge the pill market is here, but my feeling is that it’s at least as bad as the over-hyped crack epidemic in the late 80’s. Like crack, pain pill use will likely spread across state borders, demographics, and become diluted and then largely forgotten.
      Gotta take my Suboxone now; good night.

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  2. ryanoneil says:

    “the lowest death rate of the three categories belongs to the one illicit product.”

    Prescription drugs: 13.4 per 100,000 people
    Illicit drugs: 3.4 per 100,000 people
    Alcohol: 2.8 per 100,000 people

    What am I missing?

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  3. Clifton Griffin says:

    It seems the editorial portion of the article goes a long way in clearing this up.

    Florida’s procedures for detecting drug abusers in the system are apparently poor. Easier access to addictive drugs through illegitimate prescriptions will lead to higher overdose rates, leading to higher overdose death rates.

    Doesn’t seem like a nationwide phenomenon.

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  4. Mike B says:

    Why are suicide deaths from prescription drugs a bad thing? They are a lot less messy and painless than a lot of other methods and help improve a person’s agency over when they wish to no longer go on living. Don’t forget the positive benefits to Social Security and end of life medical programs.

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    • Clifton Griffin says:

      These aren’t deaths from suicide.

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    • Enter your name says:

      Two reasons:

      (1) There are other cheaper, effective, and painless options out there. Suicide by prescription medication is not guaranteed to be painless. (Liver failure, whether caused by acetaminophen overdose or poisonous mushrooms, is not pleasant.) Refusing to give people pills to kill themselves does not doom them to a messy, unpleasant death.

      (2) Planned suicide by prescription medication adds a veneer of respectability to suicide. It’s not just killing myself: it’s killing myself in a “scientific” way, with the approval of authority figures. I don’t have to take full responsibility for my suicide, because society and my physicians have all told me it’s okay to kill myself in this way (with all the same authority that society tells me that jumping off the Golden Gate bridge is not okay, so I won’t do that). They share responsibility for our decision and support me in killing myself. In telling me their reasons for permitting medically arranged suicides as an “ethical” option, they remind me of its advantages (but not the disadvantages). This unfortunately tends to encourage me to kill myself.

      (3) Some suicidal people are method-specific. If pills (or guns, or cars, or whatever) aren’t available, then they won’t commit suicide at all. Given how little thought goes into most suicides (more than half of attempts are the result of less than one hour’s thought), even a small delay can turn a (briefly) suicidal person into a productive adult who will live and work for decades.

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      • Stacy Turner-Quigg says:

        I am extremely addicted to prescription medications. I have attempted suicide 4 times in the last 11 years and several accidental overdoses. I have done some of the most horrible things to people because of them. During the last 11 years. I literally began asking for help since an overdose that put me on life support. I died. A few times I was admitted because of policy and a few times I went to resources that I had…..
        I have NOT ONCE been able to get help from a hospital, a Dr. …..There is a few hospitals that really saw in my eyes how scared I am. They wanted so badly to help me, their resources are basically none. There where drugs I listed (that ARE TO extremely addictive and I was told “Oh those are not addictive, people come off those all the time.” No anyone can get addicted, not everyone gets addicted to everything…..there are people that cry out for alcohol addiction, meth addiction….everything but prescription medications. I am so afraid I am going to die of an overdose…..
        I have lost so many friends and family members that I honestly have no idea how many. I literally have got to the point where I began to naturally begin to become “just like” the personality of the person or people around me just so they would not abandon me…..I needed so badly those good people around me, a lot of them I really did have a lot in common with, one in particular.
        I don’t want to hurt people anymore, PILLS ARE ADDICTIVE, not to everyone though.

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  5. Justin Dearing says:

    To turn the issue around, are these suicides beneficial for society as a whole? Now I’m morally against abortion despite any economical benefit such as what is alleged in the last chapter of Freakanomics. However, I still wish to understand the costs of my moral stand.

    On the subject of suicide, I lean more towards personal choice, and don’t necessarily think a person killing themselves is doing wrong intrinsically (unless their pregnant). Regardless of my personal feeling on the matter, I’d like to know the economic implications of these suicides. Would these people have killed themselves otherwise? Would they become criminals or burdens to society like you allege unwanted children that could not be aborted do?

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  6. aubrey says:

    Its much higher than the non-suicide death rate from guns, anyway.

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  7. Enter your name says:

    I think we’re seeing some substitution in the market, as people move from “dangerous” (meaning possibly contaminated) street drugs to “safe” (meaning properly manufactured) prescription medications. This accounts for both the rising deaths in the one category and the falling deaths in the other.

    Most people (wrongly) believe that prescription drugs are less likely to cause serious adverse effects than other substances. It’s like someone taking herbal pills because they’re “natural” and therefore “harmless”. If the substance has enough power to help you, then it has enough power to hurt you. That’s why they’re prescription-only medications, rather than being sold next to the candy.

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  8. AaronS says:

    For the patient, there is the assumption that if the doctor has prescribed the medicine, then all is well. Of course, a doctor cannot take into account all the many variables that come into play for each person.

    The freelance user, though, may take special precautions, proceeding under the assumption that they do NOT know it all, can make a mistake, can be forced to go to the ER and then face criminal charges, can actually die. So maybe they proceed more carefully?

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