About News New Research: Non-Opioid Drug Death Rates Are Also on the Rise Nov 21, 2019 Matt Kelly New Research: Non-Opioid Drug Death Rates Are Also on the Rise Drugs overdoses in the United States have been on the rise, and studies have paid particular attention to prescription opioids, heroin and synthetic opioids, such as fentanyl. But University of Virginia researcher Christopher Ruhm fears the scrutiny on opioids is diverting attention from the rise in non-opioid-related drug deaths; in the 17-year period from 1999 to 2016, such deaths increased by 274%, according to his calculations. Ruhm, a professor of public policy and economics at the Frank Batten School of Leadership and Public Policy, studies the determinants of health and risky behaviors and the causes and consequences of alcohol and illegal drug policies. He has more than 140 pieces published as book chapters and articles in economics, public policy and health journals. During the 1996-97 academic year, he was senior economist on President Bill Clinton’s Council of Economic Advisers, dealing with health policy, aging and labor market issues. He is currently a research associate in the health economics, health care policy and children’s programs at the National Bureau of Economic Research. Ruhm recently published in Health Affairs his research on the rising drug death rates involving non-opioids, and agreed to field some questions about his work from UVA Today. Q. What is the contribution of non-opioid drugs to the U.S. drug overdose death-rate growth? A. Over the 1999 to 2016 period of my study, the number of drug deaths increased by almost 47,000 from (16,849 to 63,632). During the same period, the number of overdose deaths involving non-opioid drugs rose nearly 29,000 (from 10,466 to 39,121). By this metric, we can think of non-opioid drugs as contributing to around 60% of the overall increase. However, it is important to recognize that multiple drug use is common – for example, many overdose deaths involve the use of both opioids and non-opioids, so that assigning the contribution correctly is complicated. Q. Why is this contribution not well-understood? A. I think there are two reasons for this. First, a great deal of attention has been paid to opioid deaths – which are obviously an enormous problem – but this has reduced the attention paid, by both researchers and policymakers, to non-opioid deaths. Second, non-opioid drugs consist of multiple categories, complicating the analysis of them and of communicating the results of these analyses to the public. Q. Are people combining opioid and non-opioid drugs? A. Absolutely. “Poly-drug use” is frequent and it raises the risk of adverse events, including death, compared to using a single category of drugs. With that said, deaths involving non-opioids, without the simultaneous use of opioids, are also common and rising rapidly. Q. What is driving this fairly steep increase in death rates? A. One of the most striking results is the very rapid increase in deaths involving stimulants; these grew more than 10-fold over the period studied, although they did start from a fairly low rate. There have also been rapid increases in deaths involving sedatives, although these almost always occur in combination with other drugs – typically some types of opioids. Q. Has your research suggested steps that would help curb opioid and non-opioid use to decrease the death rate? A. The first step is to more fully recognize the scope of the problem and the speed with which it is growing, so as to take proactive steps quickly. Next, it is important to recognize that some interventions designed to reduce opioid deaths will also be applicable to non-opioids, but that specialized interventions are also likely to be needed. For instance, such policies may include enhanced epidemiological assessment and monitoring, targeted prevention and treatment efforts, greater use of educational materials, medication contracts agreed to by patients, and limitations on the numbers of pills prescribed when physicians suspect diversion or abuse of medications for attention deficit hyperactivity disorder. There has also been particular concern about students’ misuse of prescribed stimulants as study aids. Interventions proposed to address this include multidisciplinary campus action plans and early intervention strategies to assess risk and prevent the progression to serious substance abuse. Q. What drew you to conduct research in this area? A. I originally became interested in the issue of drug fatalities because of some unrelated research in which poisoning deaths turned out to play a key role. It was only after obtaining that result that I learned that more than 90% of poisoning fatalities are drug overdose deaths. When I realized this, I began my research in the general area and discovered the very rapid increases in drug deaths – this was before these had received a great deal of public notice. The attention that did later come focused almost exclusively on opioids, and so I was interested in examining whether the problem was being conceived of too narrowly. Q. In your research, what have you learned that surprised you? A. I knew that poly-drug use was an issue, but had not realized how prevalent it is. I had also not realized how similar many legal and illicit drugs are. For example, oxycodone (a major prescription opioid) is chemically almost identical to heroin and some prescription ADHD medications are fairly similar to methamphetamines. Q. In your research, what have you learned about yourself? A. I would like to think that doing this research has increased the level of compassion I have for others less fortunate than myself. Individuals have different levels of susceptibility to drugs and other forms of addiction and I am lucky to have a relatively low level of susceptibility myself. But, in my work, I hope to be of some help to those less fortunate in this regard. Christopher J. Ruhm Christopher J. Ruhm is a professor of public policy and economics at the Frank Batten School of Leadership and Public Policy. Ruhm’s recent research has focused on the role of government policies in helping parents with young children balance the competing needs of work and family life, and on examining how various aspects of health are produced – including the growth and sources of drug poisoning deaths in the United States, the rise in obesity and the relationship between macroeconomic conditions and health. Read full bio Related Content Christopher J. Ruhm Estimated Prevalence of and Factors Associated With Clinically Significant Anxiety and Depression Among US Adults During the First Year of the COVID-19 Pandemic Research How much did clinically significant anxiety and depression increase among US adults during the first year of the COVID-19 pandemic? In this survey study of more than 1.4 million respondents in the US Behavioral Risk Factor Surveillance System survey, responses to a screening question calibrated to a 4-item Patient Health Questionnaire score of 6 or greater suggested that aggregate prevalence of clinically significant anxiety and depression increased only modestly overall among US adults in 2020 compared with 2017 to 2019. The Opioid Crisis, Health, Healthcare, and Crime: A Review Of Quasi-Experimental Economic Studies Research This study reviews quasi-experimental studies that examine the relationship between opioids and health and healthcare, and crime outcomes in the U.S. We May Not Have Been as Anxious, Depressed in Pandemic's First Year as Once Thought News Findings from the Batten School's Christopher Ruhm and colleagues at Harvard question the accuracy of the CDC’s Household Pulse survey on mental health. How to target opioid funding to states that need it most News According to new research from Batten’s Christopher J. Ruhm, the federal government’s opioid grant funding structure favors the least populous states, which are not always the states with greatest need. In an op-ed for The Hill, Ruhm suggests several ways to improve the targeting of federal grants that aim to assist states with opioid problems. Stay Up To Date with the Latest Batten News and Events Subscribe
Christopher J. Ruhm Christopher J. Ruhm is a professor of public policy and economics at the Frank Batten School of Leadership and Public Policy. Ruhm’s recent research has focused on the role of government policies in helping parents with young children balance the competing needs of work and family life, and on examining how various aspects of health are produced – including the growth and sources of drug poisoning deaths in the United States, the rise in obesity and the relationship between macroeconomic conditions and health. Read full bio
Estimated Prevalence of and Factors Associated With Clinically Significant Anxiety and Depression Among US Adults During the First Year of the COVID-19 Pandemic Research How much did clinically significant anxiety and depression increase among US adults during the first year of the COVID-19 pandemic? In this survey study of more than 1.4 million respondents in the US Behavioral Risk Factor Surveillance System survey, responses to a screening question calibrated to a 4-item Patient Health Questionnaire score of 6 or greater suggested that aggregate prevalence of clinically significant anxiety and depression increased only modestly overall among US adults in 2020 compared with 2017 to 2019.
The Opioid Crisis, Health, Healthcare, and Crime: A Review Of Quasi-Experimental Economic Studies Research This study reviews quasi-experimental studies that examine the relationship between opioids and health and healthcare, and crime outcomes in the U.S.
We May Not Have Been as Anxious, Depressed in Pandemic's First Year as Once Thought News Findings from the Batten School's Christopher Ruhm and colleagues at Harvard question the accuracy of the CDC’s Household Pulse survey on mental health.
How to target opioid funding to states that need it most News According to new research from Batten’s Christopher J. Ruhm, the federal government’s opioid grant funding structure favors the least populous states, which are not always the states with greatest need. In an op-ed for The Hill, Ruhm suggests several ways to improve the targeting of federal grants that aim to assist states with opioid problems.