Thread: Drugs now kill more people than cars and guns

Deadly dose of reality


Drugs now kill more people than cars and guns

• In America's drug death capital
• A dramatic surge in fentanyl cases
• Mom appears to OD next to child

This is America on drugs: A visual guide

By Jen Christensen and Sergio Hernandez, CNNUpdated 2:47 PM ET, Sat September 24, 2016

In modern history, few things have caused such a sharp spike in US deaths as drug overdoses.

CNN reached out to every state for the latest statistics on drug deaths, with half providing data from 2015. It found that drugs deaths continue to rise rapidly in many states.

FATAL ADDICTIONS

Epidemiologists in several states blame the increasing number of drug-related deaths on greater use of heroin and synthetic opioids, such as fentanyl.

"If you look at the cause of death, we just don't normally see increases like this," said Robert Anderson, the chief of the mortality statistics branch at the National Center for Health Care Statistics at the Centers for Disease Control and Prevention.

TOP CAUSE OF ACCIDENTAL DEATHS

Drugs are the leading cause of accidental death in this country. Fatal overdoses surpassed shooting deaths and fatal traffic accidents years ago.

For perspective on how fast drug deaths have risen, Anderson said, consider the sharp rise in heart disease in the early half of the 20th century. It took about 50 years for the rate of heart disease to double. It took drug deaths a fraction of that time.


Oxycodone – Oxycodone is a powerful narcotic pain reliever prescribed for moderate to high pain relief. It's often given in an extended-release formula for patients who will need to be on pain medications for long periods of time.

Patients are warned not to break, chew, crush or dissolve extended-release tablets because the rush of oxycodone into the system could cause serious health problems, including overdose and death.

Though highly addictive, oxycodone is not thought to be as frequently abused as hydrocodone. OxyContin, Percocet, Percodan and Tylox are some trade-name oxycodone products.

Morphine – Morphine is another powerful opioid often administered via syringe for severe pain. It can come in pill form, usually as extended-release tablets and capsules, and is prescribed only to relieve difficult, chronic pain that cannot be controlled by the use of other pain medications.

As with most opioids, mixing medications, drinking alcohol or taking other meds that contain alcohol, or using street drugs while taking morphine, increases the risk of breathing problems or other serious, life-threatening side effects.

Meperidine – Meperidine is another narcotic analgesic, similar to morphine. It's often used to help put people to sleep before an operation and to provide pain relief after childbirth.

The most common brand name is Demerol, which comes in both tablet and liquid forms. It is usually taken with or without food every three or four hours as needed for pain.

As with all opioids, meperidine can cause drowsiness, so never drive a car or operate machinery after taking it until you know how you will react.

Hydromorphone – Hydromorphone is another highly potent prescription painkiller. It's most commonly known by the brand names Dilaudid, pictured here, and Exalgo.

Liquid hydromorphone holds the dubious honor of being frequently mistaken for morphine in hospital "wrong drug" medication errors because of the similarity of the names and appearances.


Methadone – Though methadone is used to relieve severe chronic pain, it's most commonly known for preventing withdrawal symptoms in patients who were addicted to opioid drugs, as a part of their recovery process.

Methadone has many of the same side effects as other opioids, including weakness, headache, nausea and vomiting, stomach pain, sweating, difficulty urinating, mood changes and vision problems, and difficulty falling asleep or staying asleep.

Buprenorphine – Buprenorphine is a opioid used as an alternative to methadone to help addicts recovering from heroin use. Buprenorphine is different from other opioids because it's a "partial opioid agonist," which means that when taken in proper prescribed doses, it should produce less euphoria and physical dependence, and therefore a lower potential for misuse. It's also supposed to have a relatively mild withdrawal profile.

However, if abused by crushing and snorting or injecting, it can suppress breathing and cause dizziness, confusion, unconsciousness and death.

Subutex, the brand name for buprenorphine, is taken as a tablet placed under the tongue and allowed to dissolve.

The brand Suboxone is a combination of buprenorphine and naloxone, an opioid antagonist. Antagonists block the opiate receptors in the brain, keeping the narcotic from creating the high abusers crave.





Photos: Opioids: Addictive painkillers

Opioids: Dangerous prescription painkillers – Prescription and illegal opioids are commonly abused because they are so addictive.

Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain's reward areas and producing an intense feeling of euphoria.

As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.

Heroin – You can't get heroin by prescription, but many heroin users start off abusing prescription opioids, then turn to this illegal opioid.

CNN's Chief Medical Correspondent Dr. Sanjay Gupta has reported on recent research that shows today's typical heroin addict starts using at 23, is more likely to live in affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor.

According to the CDC, deaths from overdoses of prescription drugs and heroin continue to be the leading cause of unintentional death for Americans, rising 14% from 2013 to 2014.

Fentanyl – Fentanyl citrate, pictured here, is a Class II controlled substance and one of the most powerful opioids on the market. It's often administered via injection or transdermal patch, or in lozenge form for pain after surgery, for difficult-to-manage chronic pain and for people who have developed a tolerance to other opioids.

The type of fentanyl usually associated with overdoses is bought on the street in powder or pill form and is often mixed with heroin in a clandestine lab to increase the high it produces. Street names include Apache, China girl, goodfella, jackpot, murder 8, TNT and Tango and Cash.

Codeine – Codeine is one of the weakest opioids, often given when painkillers such as acetaminophen or ibuprofen fail to work. Because it decreases activity in the part of the brain that controls coughing, it's frequently mixed with other liquids to develop cough syrups for colds and flu. It's also frequently used for pain relief after removal of tonsils and adenoids in children. The FDA is investigating the safety of codeine-based cough remedies for children younger than 18 due to concerns that it can lead to shallow, slowed or difficult breathing.

Hydrocodone – These pills are a more powerful form of codeine, called hydrocodone, and are often mixed with acetaminophen. Hydrocodone is the most frequently prescribed opioid painkiller, according to the U.S. Food and Drug Administration, and the most abused. An overdose of hydrocodone can cause "cold and clammy skin, severely constricted pupils, and slow breathing that can lead to a loss of consciousness and death."

Oxycodone – Oxycodone is a powerful narcotic pain reliever prescribed for moderate to high pain relief. It's often given in an extended-release formula for patients who will need to be on pain medications for long periods of time.

Patients are warned not to break, chew, crush or dissolve extended-release tablets because the rush of oxycodone into the system could cause serious health problems, including overdose and death.

Though highly addictive, oxycodone is not thought to be as frequently abused as hydrocodone. OxyContin, Percocet, Percodan and Tylox are some trade-name oxycodone products.

Morphine – Morphine is another powerful opioid often administered via syringe for severe pain. It can come in pill form, usually as extended-release tablets and capsules, and is prescribed only to relieve difficult, chronic pain that cannot be controlled by the use of other pain medications.

As with most opioids, mixing medications, drinking alcohol or taking other meds that contain alcohol, or using street drugs while taking morphine, increases the risk of breathing problems or other serious, life-threatening side effects.

Meperidine – Meperidine is another narcotic analgesic, similar to morphine. It's often used to help put people to sleep before an operation and to provide pain relief after childbirth.

The most common brand name is Demerol, which comes in both tablet and liquid forms. It is usually taken with or without food every three or four hours as needed for pain.

As with all opioids, meperidine can cause drowsiness, so never drive a car or operate machinery after taking it until you know how you will react.

Hydromorphone – Hydromorphone is another highly potent prescription painkiller. It's most commonly known by the brand names Dilaudid, pictured here, and Exalgo.

Liquid hydromorphone holds the dubious honor of being frequently mistaken for morphine in hospital "wrong drug" medication errors because of the similarity of the names and appearances.

Methadone – Though methadone is used to relieve severe chronic pain, it's most commonly known for preventing withdrawal symptoms in patients who were addicted to opioid drugs, as a part of their recovery process.

Methadone has many of the same side effects as other opioids, including weakness, headache, nausea and vomiting, stomach pain, sweating, difficulty urinating, mood changes and vision problems, and difficulty falling asleep or staying asleep.

Buprenorphine – Buprenorphine is a opioid used as an alternative to methadone to help addicts recovering from heroin use. Buprenorphine is different from other opioids because it's a "partial opioid agonist," which means that when taken in proper prescribed doses, it should produce less euphoria and physical dependence, and therefore a lower potential for misuse. It's also supposed to have a relatively mild withdrawal profile.

However, if abused by crushing and snorting or injecting, it can suppress breathing and cause dizziness, confusion, unconsciousness and death.

Subutex, the brand name for buprenorphine, is taken as a tablet placed under the tongue and allowed to dissolve.

The brand Suboxone is a combination of buprenorphine and naloxone, an opioid antagonist. Antagonists block the opiate receptors in the brain, keeping the narcotic from creating the high abusers crave.

Opioids: Dangerous prescription painkillers – Prescription and illegal opioids are commonly abused because they are so addictive.

Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel-good hormone dopamine in the brain's reward areas and producing an intense feeling of euphoria.

As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.

Heroin – You can't get heroin by prescription, but many heroin users start off abusing prescription opioids, then turn to this illegal opioid.

CNN's Chief Medical Correspondent Dr. Sanjay Gupta has reported on recent research that shows today's typical heroin addict starts using at 23, is more likely to live in affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor.

According to the CDC, deaths from overdoses of prescription drugs and heroin continue to be the leading cause of unintentional death for Americans, rising 14% from 2013 to 2014.

Fentanyl – Fentanyl citrate, pictured here, is a Class II controlled substance and one of the most powerful opioids on the market. It's often administered via injection or transdermal patch, or in lozenge form for pain after surgery, for difficult-to-manage chronic pain and for people who have developed a tolerance to other opioids.

The type of fentanyl usually associated with overdoses is bought on the street in powder or pill form and is often mixed with heroin in a clandestine lab to increase the high it produces. Street names include Apache, China girl, goodfella, jackpot, murder 8, TNT and Tango and Cash.

Codeine – Codeine is one of the weakest opioids, often given when painkillers such as acetaminophen or ibuprofen fail to work. Because it decreases activity in the part of the brain that controls coughing, it's frequently mixed with other liquids to develop cough syrups for colds and flu. It's also frequently used for pain relief after removal of tonsils and adenoids in children. The FDA is investigating the safety of codeine-based cough remedies for children younger than 18 due to concerns that it can lead to shallow, slowed or difficult breathing.

Hydrocodone – These pills are a more powerful form of codeine, called hydrocodone, and are often mixed with acetaminophen. Hydrocodone is the most frequently prescribed opioid painkiller, according to the U.S. Food and Drug Administration, and the most abused. An overdose of hydrocodone can cause "cold and clammy skin, severely constricted pupils, and slow breathing that can lead to a loss of consciousness and death."

Oxycodone – Oxycodone is a powerful narcotic pain reliever prescribed for moderate to high pain relief. It's often given in an extended-release formula for patients who will need to be on pain medications for long periods of time.

Patients are warned not to break, chew, crush or dissolve extended-release tablets because the rush of oxycodone into the system could cause serious health problems, including overdose and death.

Though highly addictive, oxycodone is not thought to be as frequently abused as hydrocodone. OxyContin, Percocet, Percodan and Tylox are some trade-name oxycodone products.


The only thing comparable might be the HIV epidemic when it first reached the United States in the late 1980s, when there were no drugs to treat it. But unlike with HIV, where demonstrators took to the streets to demand help, the drug epidemic often happened out of the spotlight.

That might be because drug deaths have disproportionately hit small towns and rural America, mainly in Appalachia and in the Southwest, far away from the eye of the national media. It became a particularly dangerous problem for middle-age white men and women.

HEROIN'S DEADLY EFFECT

Heroin-related deaths increased 439% from 1999 to 2014. As of 2014, heroin-related deaths had more than tripled in five years and quintupled in 10 years.

In 2014, opioids were involved in 28,647 deaths -- 61% of all US drug overdose deaths -- and 10,574 were related to heroin, in particular. Data from 2014 reflects "two distinct but interrelated trends," the CDC notes, a longterm increase in overdose deaths due to prescription opioids and a surge in illicit opioid overdose deaths, mostly related to heroin.

NATIONWIDE EPIDEMIC

In 2010, West Virginia moved into the top spot on the list of states with the highest number of drug deaths. From 2014 to 2015 alone, the number of deaths in that state increased by 12%. New Hampshire saw a 24% increase in deaths in that same time period.

How to get help
Struggling with addiction or know someone who is? Here are several organizations that help addicts beat back their habits and regain their lives.



The state that has struggled the longest is New Mexico. Its Rio Arriba County has the highest number of drug deaths for a single county in the United States, according to data analysis of more than 15 years of records from the CDC and state departments of health. Looking at drug death data from 1999 to 2014, New Mexico most often holds the No. 1 spot for the highest number of deaths.

The sharp uptick in deaths seems to coincide with Americans' increasing use of drugs like illicit fentanyl.
Pop star Prince died of a fentanyl overdose in April.

The pain reliever is often given to cancer patients and is more than 100 times as strong as morphine and 30 to 50 times more powerful than heroin.

STATE HIT THE HARDEST

Appalachia has struggled with a number of high-profile overdose cases recently.

West Virginiais home to six of the top 20 counties in the country with the largest concentrations of drug-related deaths. Kentucky has the most, with nine counties on that list. Ohio has also been hard-hit by the epidemic.

http://www.cnn.com/2016/09/23/health...ide/index.html

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