Pennsylvania and Florida Are the two states hardest hit by the opioid epidemic, according to a study published Friday by the Journal of the American Medical Association (JAMA).
The two states, along with the District of Columbia, had opioid-related mortality rates that were at least doubling every two years, in research that looked at opioid-related mortality in the U.S. from 1999 to 2016. During that period of time, there were more than 44.9 million deaths from opioids among U.S. residents.
Higher rates of opioid-related mortality and more rapid increases in mortality were observed in the eastern United States, with eight states (Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire, and Ohio) experiencing opioid-related mortality rates that were at least doubling every three years.
“The life expectancy lost at age 15 from opioids is now greater than that lost from deaths due to firearms or motor vehicle crashes in most of the United States,” the study revealed.
“Although opioid-related mortality has been stereotyped as a rural, low-income phenomenon concentrated among Appalachian or midwestern states, it has spread rapidly, particularly among the eastern states,” reads the report. “The increase in mortality has been driven primarily by synthetic opioids, which shows a distinct geographical patterning from east to west.”
Chief among the synthetic opioids is fentanyl, which can be 50 times more powerful than heroin and is a key cause of overdose deaths. The use of highly potent white heroin from Mexico is common in Pennsylvania and the eastern U.S., and fentanyl is more easily blended into this type of heroin than the brown tar variety typically used out west.
In 2017, Pennsylvania’s coroners and medical examiners reported a total of 5,456 drug-related overdose deaths, or 43 deaths per 100,000 population, nearly twice the national average of 22 deaths per 100,000. Drug-related overdose deaths in Pennsylvania increased by 65 percent overall between 2015 and 2017, largely attributed to fentanyl and related substances, according to a comprehensive assessment of the Commonwealth’s opioid crisis by the DEA Philadelphia Field Division and the University of Pittsburgh School of Pharmacy’s Program Evaluation Research Unit, Pennsylvania Opioid Overdose Reduction Technical Assistance Center.
The JAMA study released Friday observed that the opioid epidemic is not a single epidemic, but evolved as a series of three intertwined but distinct waves based on the types of opioids associated with mortality.
“In the first wave, opioid-related deaths were associated with prescription painkillers from the 1990s until about 2010,” the study noted. “From 2010 until the present, the second wave was associated with a large increase in heroin-related deaths. In the third and current wave, which started around 2013, the rapid increase is associated with illicitly manufactured synthetic opioids.”
“Our findings indicate that policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids and rapidly expanding epidemics in northeastern states and consider the potential for synthetic opioid epidemics outside of the heroin supply,” the report concluded.
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