Each day in the United States, 110 people die from overdosing on either legal or illegal drugs, with death rates rising at a quick pace over the past couple of decades. Fresh analysis of this situation from the University of Pittsburgh Graduate School of Public Health finds overdose mortality rates are significantly higher in Pennsylvania compared to national averages, with the state ranking among the top 20 for such deaths.

The researchers also found overdose death rates spiked among young white women in particular, while in the most recent statistical year, the highest rates belong to those in their late 20s and early 30s. The new analysis also reveals drug overdoses cause more total years of lost life than either car crashes, HIV, or even cancer.

“We saw a 14-fold increase in the rates of overdose deaths [over 35 years],” Lauren Balmert, a doctoral student researcher at the University of Pittsburgh department of biostatistics, told Medical Daily in an email. She explained the analysis and resulting numbers take into account the general increase in the nation’s population — which likely increase the total number of deaths, no matter the cause — during that time period.

Accidental Death in America

In 2008, accidental drug poisonings, which caused more than 41,000 deaths that year, surpassed the motor vehicle accidents as the leading cause of accidental death in the U.S. Since then, biostatisticians have been finding higher rates of drug overdose deaths in some areas of the country. Notably, Pennsylvania and 19 other states showed significantly higher rates of overdose deaths when compared to the national average.

The purpose of this analysis, then, was to examine county and state-level accidental poisoning mortality trends in PA between the years 1979 and 2014. To better target groups in need of intervention programs, the researchers, led by Professor Gary Marsh, identified specific demographic and geographic subgroups most at risk for accidental overdose death.

Using a repository and retrieval system for detailed death data, the Mortality and Population Data System, the team broke down overdose deaths in Pennsylvania from 1979 to 2014 by sex, age, and race. Mortality data, which derives from the National Center for Health Statistics, is based on electronic death certificate records with specific codes assigned for cause of death. The team began their analysis in 1979 because changes in reporting code make it impossible to make comparisons with previous years, while they ended with 2014 because this is the most recent statistical year.

Place, Age, Sex, and Race

Examining the data, the team observed the pattern of overdose deaths to be concentrated around the counties of southwestern Pennsylvania, those surrounding Philadelphia, and some in northeast Pennsylvania near Scranton. Specifically, Philadelphia County has the highest overdose death rate, but the numbers put Allegheny County in a close second place, with rates rapidly increasing there since the mid-1990s.

The greatest increase in overdose deaths occurred among those between the ages of 35 and 44, whose mortality numbers grew almost 22-fold since 1979. However, a younger age group overtook them in 2014; the highest number of overdose deaths belong to people between 25 and 34 in 2014.

Racial differences were also observed. While overdose death rates peak for white men between ages 25 and 44, for black men, that peak occurs between ages 45 and 65.

“We speculate that these differences in age groups reflect different patterns in drug use among blacks and whites,” Balmert said, adding past studies reveal white adults are more likely to use cocaine and nonmedical painkillers than others, while crack cocaine is more prevalent among blacks.

Accidental overdose rates are also higher among men than women, yet the female sex is responsible for a more dramatic spike in deaths, particularly in the most recent five years studied. Unusually, these high death rates spanned a wider age range for women compared to both men and the national average: ages 25 through 54 for white women, 35 to 64 for black women.

According to the researchers, previous research indicates women are more likely to accelerate from drug use to substance abuse while entering into treatment programs at more severe dependence levels than men.

“While this analysis examined accidental poisoning deaths in Pennsylvania, many of these findings are applicable to other states as well,” concluded Marsh and his colleagues, adding the state is battling this epidemic of drug overdoses with some additional funding granted by the Centers for Disease Control and Prevention. Based on these findings, they say, public health officials can now design intervention programs targeting the appropriate demographic groups.

Source: Balmert LC, Buchanich JM, Pringle JL, Williams KE, Burke DS, Marsh GM. Patterns and Trends in Accidental Poisoning Deaths: Pennsylvania’s Experience 1979-2014. PLOS ONE. 2016.