Indiana overdose deaths growing

A report released earlier this year by the Indiana University Center for Health Policy carries a sobering title and message.

The report - "Fatal Drug Overdoses: A Growing Concern in Indiana" - outlines a mushrooming problem in the Hoosier state as the number of drug-induced overdose deaths increased nearly 150 percent between 1999 and 2004, according to the report, which turned to the Indiana State Department of Health for its statistics.

The use and abuse of prescription drug medications appear to be driving that increase, along with the use of two or more substances, according to the report.

"Heroin, cocaine, prescription drugs and alcohol are the substances most commonly used in accidental overdoses," the report states. "Opiates are the substances most commonly detected during post-mortem examinations, but they are seldom the only substance found. Alcohol and benzodiazepines in conjunction with opioids play a significant role in overdose fatalities."

And the American Medical Association reported in 1999 that prescription drugs were involved in 70 percent of all drug-related deaths in the United States. Alcohol also plays a major role - in at least half of opiate overdoses, alcohol had been used just before death, the report said.

Authors of the report said Indiana's drug-induced death rates were substantially lower than comparable U.S. rates in 1999, but they have since matched them.

The Centers for Disease Control and Prevention  reported in 2007 that the national rate of drug-induced deaths increased from 0.07 in 1999 to 0.11 in 2004 (per 1,000 population) while Indiana's drug-induced mortality rate of 0.04 in 1999 more than doubled to 0.10 by 2004 and reached 0.11 in 2005.

Jackson County is not considered what the report termed a "hot spot," but there were 16 drug-induced deaths here from 1999 to 2005, the latest statistics available.

Neighboring Bartholo-mew, Monroe and Scott counties do fall in that category, with Bartholomew showing 49 such deaths, Monroe 71 and Scott 26, according to the report.

What's causing this increase in Indiana?

"We might assume that substance use has expanded over the years and that the increase is a result; however, this assumption appears to be incorrect," the report states. Data from the National Survey on Drug Use and Health showed no significant increase in the rates of current (or past-month) illicit drug use or binge alcohol use in Indiana from 1999 to 2005.

"The answer to this question may lie in two factors that have shown dramatic increase: nonmedical (or recreational) use of prescription drugs and polysubstance use," the report continued, citing a 2005 report from the National Institute on Drug Abuse.

It said that according to "emergency department accounts, hydroco-done and oxycodone overdoses (opioid pain relievers that are among the most popular prescription medications in drug-abuse cases) increased by 170 percent and 450 percent, respectively, between 1994 and 2002."

It added that "distribution of oxycodone to retail registrants in Indiana (pharmacies, hospitals and physicians) nearly doubled from about 29 million dosage units in 2002 to a projected 54 million in 2007."
 
The report said  "treatment admissions for polysubstance abuse increased significantly in Indiana from 2000 to 2005; 62 percent of Hoosiers entering substance abuse treatment in 2005 reported using two or more drugs, and 28 percent used three or more drugs," both of which are higher than overall U.S. rates.

About the IU Center for Health Policy

The Indiana University Center for Health Policy is a nonpartisan applied research organization in the School of Public and Environmental Affairs at Indiana University-Purdue University Indianapolis. Its researchers work on policy issues that affect the quality of health care delivery and access to health care.

Its mission is to collaborate with state and local government and public and private healthcare organizations in policy and program development, program evaluation and applied research on health policy-related issues.

It is a partner center to the Center for Urban Policy and the Environment.

For information about the Center for Health Policy and access to other reports, visit its Web site at http://www.healthpolicy.iupui.edu/.

About the report

Much of the research for "Fatal Drug Overdoses: A Growing Concern in Indiana" was taken from work completed for Indiana's Office of the Governor and Indiana Division of Mental Health and Addiction and funded by a grant from the U.S. Department of Health and Human Services' Center for Substance Abuse Prevention, as part of the Strategic Prevention Framework State Incentive Grant Program.

About the authors

Authors of the report are Marion Greene, research coordinator, Center for Health Policy, and Eric R. Wright, PhD, director, Indiana University Center for Health Policy, and Sean Mullins, graduate assistant, Center for Health Policy. It was edited by Marilyn Michael Yurk, Center for Urban Policy and the Environment.