CDC Admits Rx Opioid Deaths ‘Significantly Inflated’
By Pat Anson, Editor
Researchers with the Centers for Disease Control and Prevention have acknowledged that the agency’s methods for tracking overdose deaths are inaccurate and have significantly overestimated the number of Americans that have died due to prescription opioids.
In an editorial appearing in the American Journal of Public Health, four researchers in the CDC’s Division of Unintentional Injury Prevention say many overdoses involving illicit fentanyl and other synthetic black market opioids have been erroneously counted as prescription drug deaths.
“Availability of illicitly manufactured synthetic opioids (e.g., fentanyl) that traditionally were prescription medications has increased. This has blurred the lines between prescription and illicit opioid-involved deaths,” they wrote. “Traditionally, the Centers for Disease Control and Prevention (CDC) and others have included synthetic opioid deaths in estimates of ‘prescription’ opioid deaths. However, with IMF (illicitly manufactured fentanyl) likely being involved more recently, estimating prescription opioid–involved deaths with the inclusion of synthetic opioid–involved deaths could significantly inflate estimates.”
How inflated were the overdose numbers? Using the agency’s “traditional definition” for prescription opioids, the CDC estimated that 32,445 Americans died from overdoses of pain medication in 2016.
Under a new “conservative definition” – one that excludes the “high proportion of deaths” involving synthetic opioids like fentanyl – the death toll from prescription opioids is cut nearly in half to 17,087 overdoses.
The researchers note that even that estimate is likely wrong for a variety of reasons:
- The number of deaths involving diverted prescriptions or counterfeit drugs is unknown
- Toxicology tests cannot distinguish between pharmaceutical fentanyl and illicit fentanyl
- Drugs are not identified on death certificates in 20% of overdose deaths
- Multiple drugs are involved in almost half of drug overdose deaths
The editorial by CDC researchers Puja Seth, Rose Rudd, Rita Noonan and Tamara Haegerich carries a disclaimer that their views “do not necessarily represent the official position” of the CDC. But given the agency’s past reluctance to let employees speak to the media without prior approval, it’s highly unlikely the editorial was not cleared beforehand.
A spokesperson for the CDC said the agency first noticed the growing number of deaths caused by illicit fentanyl in 2015 and changed the way it calculated opioid overdoses that year. She said the explanation for the change was being published now “to document the method in peer-reviewed literature.”
However, as one of our readers pointed out, the inflated overdose numbers can still be found on the agency’s website, with only a vague explanation that some may be fentanyl-related:
“In 2016 there were 32,445 deaths involving prescription opioids, equivalent to about 89 deaths per day. This was an increase from approximately 22,598 in 2015. However, a significant portion of the increase in deaths was due to deaths involving synthetic opioids other than methadone, which likely includes illegally-made fentanyl.”
President Trump’s opioid commission warned last year that a better system was needed to keep track of overdose deaths. “We do not have sufficiently accurate and systematic data from medical examiners around the country to determine overdose deaths, both in their cause and the actual number of deaths,” the commission said in its final report.
The CDC has recently implemented a new overdose surveillance system in 32 states that supplements data from death certificates with toxicology tests and death scene investigations to more accurately reflect which drugs are involved in overdose deaths.
Lies and Damned Lies
We’ve written before about how confusing, flimsy and exaggerated the numbers can be for overdoses (see “Lies, Damned Lies, and Overdose Statistics”). Last October, PNN reported that the Drug Enforcement Administration changed its definition of prescription drug deaths for three consecutive years in an annual report, apparently in an effort to inflate the number of Americans dying of overdoses.
In 2016, we reported that within one week the CDC and the White House Office of National Drug Control Policy released three different estimates of the number of Americans that died from prescription opioids the year before. The numbers were wildly different, ranging from a low of 12,700 to a high of 17,536 deaths.
To be clear, one overdose is too many. But if we are ever going to find real solutions to the overdose crisis, we need to find accurate numbers to reflect what is causing so many drug deaths. Pinning the blame on prescription opioids, pain patients and prescribers has only led to a growing catastrophe in pain care – where doctors are too fearful to prescribe opioids and patients can’t get treatment.
As the CDC researchers say in their editorial, “inaccurate conclusions” not only mask what’s driving the overdose crisis — they mask the solutions too.
“Obtaining an accurate count of the true burden and differentiating between prescription and illicit opioid-involved deaths are essential to implement and evaluate public health and public safety efforts,” they wrote. “If deaths involving synthetic opioids—likely IMF—are categorized as prescription opioid overdose deaths, then the ability to evaluate the effect of interventions targeting high-risk prescribing practices on prescription opioid–involved deaths is hindered. Decreases in prescription opioid–involved deaths could be masked by increases in IMF deaths, resulting in inaccurate conclusions. ”
I am Passionate Pachyderms, The Brutally Honest Elephant In Every Room, and I Tell It Like It Is!
4 Comments on “CDC Admits They Artificially Inflated Number Of deaths Caused By Prescription Pain Medications”
This is an absolutely fantastic article, and cuts to the heart of the matter. CDC lied, and keeps lying on this issue.
I have tried to follow your link to send my comments as a pain patient to https://www.regulations.gov and it would not go thru so I will post my comment here I hope that someone will pass it on. In 1993, at Queens Hospital after undertaking my third neck surgery, that had broke before I was able to leave the hospital, I was diagnosed with a very painful rare generic bone disease Alkaptonuria/Ochronosis where my bones turn black, brittle and all the cartilage and disc are eaten away from between my joints and vertebra and there is no treatment in which to make it stop. I have my bones grinding against each other, in my neck with this disease progressively stripping away all the cartilage and disc on down my spine= along with my hip, that they cut into to take a plug to put in my neck BUT this disease they diagnosed me with is a NON-operative disease – they only made my condition worse every time they cut into me- its painful to do most everything. There is no known cure for this rare generic bone disease -pain medicine is the only way I can get dressed in the morning or walk or do anything – when your bones have NO cushion between them and your bones are grinding against bones, it is impossible to do anything without being in PAIN. My doctor of twenty seven years has retired and failed to refer me to a doctor who could / would take my case. I was put on permanent disability because of this disease yet ,no one here in Hawaii will help me deal with it,I have doctors around the world who have interviewed me about this disease and are willing to send information to any doctor willing to take my case But I still have yet to find a doctor especially now, that all doctors wish to have patients that require NO pain medication. The last PCP I went to stood at the door to her exam room while looking at my medical records and yelled at me – I do not prescribe pain pills, I told her I did not come to her for pain pills but to have a doctor who could help me navigate this disease that I had doctors Dr,Wendy Introne – a leading doctor in Genetics who would fax her information on dealing with this disease And she never once opened the faxes! I am being treated like a AIDS patient in the 1980’s that no one wants to treat ITS NOT MY FAULTI was BORN WITH THIS DISEASE why is this medical system treating me like I have leprosy PLEASE I only wish to live in dignity. I bought my own home when I was young and still healthy, I have always been an independent woman, I paid my taxes and never owed any one any thing, I have never used alcohol or drugs , the only thing wrong was I was born with a incurable disease YET I am now being treated so badly My rights as a human being are being denied – and at times I am feeling like i want to die than to have to be treated with such disregard. Now, since all this has happened – this Opioid Crisis, having been denied my medication MY disease has spread down my spine – when it had stayed mostly only in my neck for over thirty years And its now attacking my heart. I have MRI’s to prove everything I am writing is true. You can have any agency DEA, SSI, my medical records – and you will see I have never done anything, in anyway, to deserve the way I have been treated. Every 21st of every month I am being made to travel to the other side of the island, to get half the dosage I was getting and need, to keep this disease from spreading, then be driven to other side of island and be made to wait three hours just to get my medicine for the month, THIS is also bringing much distress to my condition, causing the HGA levels to get sky high, making my urine turn black from the stress of that day, every single month. I start to cry when I think of what I am being made to go thru, is it really that this government wants people like me to give up and die, when I think of all the taxes my father paid in his life time- I know he is turning in his grave to see how this country is now treating his children. I must state I am not a addict I was put on opioid medicine in 1993, for a incurable disease that no other medicine can help, I have never abused this medicine and it helps me live a decent life -being able to dress myself and was my clothes that without it I could not do, Yet because people use it and get high they have made me suffer, IT IS NOT HUMANE to treat patients who are legitimate this way. Virginia Leigh Holloway-Brandford
Well said, people in pain are not criminals, stop lumping them in with abusers. This is insulting demoralizing and depressing when you know the one thing out there that provides relief for you, you cannot get because criminals sell and abuse it it. Totally unrelated to you.
The American Leftist want to take all guns away from responsible gun owners. They group law abiding gun owners with criminals to justify anti 2nd amendment actions.
Likewise law abiding chronic pain patients are grouped with street and illicit drug dealers and users. They have no 2nd amendment to protect them. But the American Declaration of Independence lays out the framework and moral clarity to protect our suffering pain community.
Major lawsuits will be required to gain the civil rights of chronic pain patients.