“When we started to analyze the data, I was struck by the increasing death rates, particularly from overdoses,” says Dr. Burke. “The rates started to increase dramatically about 10 years ago. Now, drug overdoses are the leading cause of death among middle-aged Pennsylvanians.”
Karl Williams, MD, MPH, Allegheny County Medical Examiner, reports that 109 people died from drug overdoses in 2000. In 2015, 349 people had fatal overdoses. Over the past several years, deaths from heroin overdose have increased dramatically. 50 people in Allegheny County died from heroin overdoses in 2010. In 2015, that number jumped to 206. (All figures are from https://www.overdosefreepa.pitt.edu/overdose-data/.)
The Centers for Diseases Control and Prevention published key research in mid-2015:
• Heroin use in the United States increased 63 percent from 2002 through 2013. This increase happened among men and women, most age groups and all income levels.
• From 2002 through 2013, the rate of heroin-related overdose deaths nearly quadrupled.
So, why has heroin abuse increased so quickly?
Dr. Burke found that, about 15 years ago, doctors started prescribing slow-acting painkillers, including drugs like OxyContin (the brand name of a certain kind of opioid). The belief was that these drugs were not addictive. At the same time, doctors were being encouraged to be both more aggressive and compassionate about treating pain. Doctors were prescribing many of the opioid-like drugs. The slow-acting painkillers ended up being dangerously addictive. Once prescription painkillers became more widely available, people started selling them illegally. Heroin use became an epidemic that quickly got out of hand. Then, cheap heroin became available. It became cheaper to use heroin than to use OxyContin.
One of the important ways to combat drug abuse is through research. President Obama’s new budget calls for $1.1 billion over the next two years to fight the heroin use and prescription drug abuse epidemics. In his position as dean of Pitt Public Health, Dr. Burke has already funded several new research projects, including studies to find ways to improve the distribution of Narcan, an emergency-use drug that can reverse overdoses; learn from people who use these drugs about their ideas for fighting the epidemic; study prescription patterns and identify the patterns that often lead to overdoses; to use social media data to look for patterns of talk about drug use; and also to look at patterns of death in detail in Pennsylvania to see where the clusters are and how those patterns are changing over time. Dr. Burke wants the research to help predict which interventions will help best and to evaluate how well the interventions are working.
Allegheny County Health Department Director Karen Hacker, MD, MPH, created a countywide standing order that allows any licensed pharmacy to dispense naloxone, or Narcan, both to people at risk of a heroin or opioid-related overdose and to those who may witness one. For a list of participating pharmacies, go to https://www.achd.net/overdoseprevention/index.html.
To avoid becoming addicted to prescription painkillers, use them only as directed by a health care provider. They are safe and effective when used properly. If you or someone you know is having trouble with addiction, talk to a health care provider. Many treatment options are available.
As Dr. Burke says, “The most important thing is getting people into treatment so that they have a nondependent life.”
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