Drug overdose deaths increased significantly in the US from 2013 to 2014, with increases in opioid deaths indicated as the main factor in the increase in drug overall deaths. This according to analysis of multiple cause-of-death mortality data and examination of current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths. The study found:

• The death rate from the most commonly prescribed opioid pain relievers increased 9% from 2013 to 2014.

• The death rate from heroin increased 26%, and the death rate from synthetic opioids, a category that includes illicitly manufactured fentanyl and synthetic opioid pain relievers other than methadone, increased 80%.

• Nearly every aspect of the opioid overdose death epidemic worsened in 2014.

Citation: Russ RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths – United States, 2000-2014. MMWR Morb Mortal Wkly Rep.64(early release);1-5.

Commentary: Prescription drug overdose deaths have continued to soar, with no decrease in sight. Over the same period of time, opioid pain reliever prescribing has quadrupled. In 2014, there were approximately one and a half times more drug overdose deaths in the United States than deaths from motor vehicle crashes. The solutions will have to come from every part of society. From the practitioners’ point-of-view, it will require ongoing vigilance to treat pain appropriately while at the same time being alert to the possibility of drug diversion and abuse. —Neil Skolnik, MD