Disturbing Study Shows U.S. Opioid Crisis May Be Much Worse Than Believed

ROCHESTER, N.Y. — The opioid crisis in the United States is already incredibly hard to ignore. Whether you’ve been affected yourself, have a close family member or friend who has dealt with opioid addiction, or just know a few acquaintances who have experienced its repercussions, it’s become virtually impossible for the average American to still bury their head in the sand when it comes to the reality of the situation. Now, a new piece of research is declaring that public knowledge regarding opioid overdose statistics is just the tip of the iceberg.

Opioid crisis graph
New research in the journal Addiction shows that the deaths from opioid-related overdoses may be 28% higher than previously reported. This discrepancy is more pronounced in several states, including Alabama, Mississippi, Pennsylvania, Louisiana, and Indiana, where the estimated number of deaths more than doubles. (University of Rochester Medical Center)

The study, conducted at the University of Rochester Medical Center, states that U.S. deaths related to opioid overdoses may be 28% higher that originally reported due to inadequate death records. Certain states may be especially inaccurate, with Pennsylvania, Indiana, Louisiana, Alabama, and Mississippi specifically being mentioned as drastic offenders in this regard. It’s estimated that the opioid deaths in these states may be more than double what was originally reported.

These discrepancies, if true, are warping the overall perception of the opioid crisis’ impact on the American public. Furthermore, these true statistics not coming to light are likely impeding the development and funding of various programs that could help combat the crisis.

“A substantial share of fatal drug overdoses is missing information on specific drug involvement, leading to underreporting of opioid-related death rates and a misrepresentation of the extent of the opioid crisis,” comments senior author Elaine Hill, Ph.D., an economist and assistant professor in the University of Rochester Medical Center (URMC) Department of Public Health Sciences, in a release. “The corrected estimates of opioid-related deaths in this study are not trivial and show that the human toll has been substantially higher than reported, by several thousand lives taken each year.”

The research team examined unidentified drug overdoses between the years 1999-2016, and discovered that a staggering 72% involved prescription opioids, fentanyl, or heroin. All of that adds up to 99,160 deaths clearly involving opioids that go unrecognized.

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The study’s authors first recognized this unsettling problem while researching the various impacts of natural resources extraction on Americans. Coincidentally, many regions of the United States hit hardest by the opioid crisis also just happen to be areas linked to shale gas development and coal mining.

At the time, Hill was trying to determine if the shale gas boom had any effect whatsoever on opioid use. However, once she started collecting and analyzing pertinent data, she discovered that 22% of all drug-related overdoses in those regions were considered “unclassified.” That means the drugs involved in the death were not listed at all.

Now, anytime a generally healthy individual passes away suddenly, a medical examiner should help determine a cause of death through toxicology, autopsy, evidence gathered at the scene, etc. Unfortunately, that doesn’t always happen. Procedures like toxicology reports are expensive, time consuming, and often dependent upon that local areas’s resources and funding. That, combined with many families not exactly being eager to recognize opioid use as the cause of death due to its stigma, leads to many deaths not being as thoroughly investigated as they probably should be.

It’s also worth mentioning that in some U.S. states it isn’t exactly difficult to get a job as a medical examiner or coroner, some don’t even need professional experience or training.

Using a complex statistical analysis, the study’s authors compared known opioid-related deaths to unconfirmed cases. This approach revealed an unbelievable number of correlations between cases, linked to factors like previous opioid use or chronic pain conditions. Basically, this means the odds are incredibly high that the vast majority of those unconfirmed deaths were in fact due to opioid overdoses.

Just to give an example of a how misleading official statistics may be: the number of reported opioid deaths in Pennsylvania was 12,374, but according to the study’s calculations that number should be 26,586.

“The underreporting of opioid-related deaths is very dependent upon location and this new data alters our perception of the intensity of the problem,” Hill concludes. “Understanding the true extent and geography of the opioid crisis is a critical factor in the national response to the epidemic and the allocation of federal and state resources to prevent overdoses, treat opioid use disorders, regulate the prescription of opioid medications, and curb the illegal trafficking of drugs.”

The study is published in Addiction.

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