04 April 2015

Death By Drugs: 2012 & 2013

Previous years: 2010, 2011(A), 2011(B), and 2014.

I thought I'd look to see where our death rates from overdoses are and found two Virginia ME reports that I had not previously done. Red is in top five for overdose deaths and deaths caused by legal medication (as measured by the ME: fentanyl, hydrocodone, methadone, and oxycodone - hereinafter FHMO). Yellow is only in the top five for deaths caused by FHMO.
2012 Overdose Deaths
2013 Overdose Deaths
2012 follows the pattern we've seen for years where FHMO have been killing people dead in higher percentages for a long time. However, 2013 is very different. To begin with, the municipalities which have the highest percentage of deaths are not the ones we are accustomed to seeing (except Dickenson County). Emporia and Martinsville are probably anomalous spikes and Charles City County may be as well. However, there's another interesting development. Deaths are not coming from the regular sources.

Top 5 (Overall Deaths)  FHMO  Heroin/Cocaine
1 Martinsville  (58.2)     21.8         14.5
2 Charles City County  (42.1)       28.1      00.0
3 Dickenson  (38.7)     25.8      00.0
4 Emporia  (35.8)     17.9      17.9
5 Patrick  (32.7)     16.3        5.4
All death rates per 100,000

You'll notice that in most of these municipalities FHMO and H/C do not add up to total deaths.  I think I know what the cause of the difference is. About this time is when the synthetic drugs really started hitting hard and some of them are truly nasty. Unfortunately, the ME does not seem to have statistics about them.

The top ten drugs that in the systems of people who died by overdose:

     2012           2013    
 1      Morphine  214      Alprazolam  290    
 2      Ethanol  252
     Morphine  283
 3      Diazepam  208
     Ethanol 249
 4      Oxycodone  197      Diazepam  234
 5      Alprazolam  192
     Oxycodone  207
 6      Heroin  163
     Heroin  161
 7      Methadone  115
     Cocaine  142
 8      Diphenhydramine  115    
     Clonazepam  134
 9      Hydrocodone  98      Methadone  119
 10       Citalopram  86      Codeine  117
 10       Cocaine  86  ~~~~~~~~~~~~~~~~
Diazepam includes its metabolite and heroin is measured by its metabolite.

Not sure where all the morphine is coming from unless the ME is counting people in hospitals who are in the late stages of painful terminal illnesses. Other than that, the rest of the drugs involved in overdoses seem to track with experience.  Alprazolam (Xanax) and Diazepam (Valium) are anti- anxiety meds.  Although Clonazepam (Klonopin) is described by the ME as an anti-convulsant, we see it most often prescribed as an anti-anxiety drug.  Citalopram is an anti-depressant that is also given to handle anxiety.  Doctors hand these happy pills out like they are candy on Halloween.  Ethanol is, simply put, booze.  Oxycodone and hydrocodone are narcotics used for "pain management."  Methadone can theoretically be used to handle pain, but it mostly used as a legal substitute high for illegal highs. Diphenhydramine is an addictive hypnotic medicine used in over the counter sleep aids.

Surprisingly, heroin has not shown an increase. I say surprisingly because in the last several years there has been a narrative stating that heroin dealers have cut their prices and increased their quality in order to compete with the pills. The wave of heroin is coming! And yet, it never seems to appear in significant amounts outside of its normal stomping grounds.

1 comment:

Piedmont said...

My understanding is that diphenhydramine (Benadryl, Unisom) is more subject to psychological dependence than to actual addiction.