Recognition and response to opioid overdose deaths—New Mexico, 2012

Abstract

Purpose Drug overdose deaths are epidemic in the U.S. Prescription opioid pain relievers (OPR) and heroin account for the majority of drug overdoses. Preventing death after an opioid overdose by naloxone administration requires the rapid identification of the overdose by witnesses. This study used a state medical examiner database to characterize fatal overdoses, evaluate witness-reported signs of overdose, and identify opportunities for intervention. Methods We reviewed all unintentional drug overdose deaths that occurred in New Mexico during 2012. Data were abstracted from medical examiner records at the New Mexico Office of the Medical Investigator. We compared mutually exclusive groups of OPR and heroin-related deaths. Results Of the 489 overdose deaths reviewed, 49.3% involved OPR, 21.7% involved heroin, 4.7% involved a mixture of OPR and heroin, and 24.3% involved only non-opioid substances. The majority of OPR-related deaths occurred in non-Hispanic whites (57.3%), men (58.5%), persons aged 40–59 years (55.2%), and those with chronic medical conditions (89.2%). Most overdose deaths occurred in the home (68.7%) and in the presence of bystanders (67.7%). OPR and heroin deaths did not differ with respect to paramedic dispatch and CPR delivery, however, heroin overdoses received naloxone twice as often (20.8% heroin vs. 10.0% OPR; p < 0.01). Conclusion OPR overdose deaths differed by age, health status, and the presence of bystanders, yet received naloxone less often when compared to heroin overdose deaths. These findings suggest that naloxone education and distribution should be targeted in future prevention efforts.

Opportunities to Prevent Overdose Deaths Involving Prescription and Illicit Opioids, 11 States, July 2016–June 2017

“…The proportions of decedents with evidence of recent release from an institution and of a previous overdose were higher among deaths involving illicit opioids. Similar to earlier findings ( 9 ), approximately half of the decedents overdosed when bystanders were present. Although distribution of naloxone to laypersons has rapidly expanded and been determined to be effective, ††† broader distribution and education about overdose signs and symptoms are needed.…”

Recognition and stigma of prescription drug abuse disorder: personal and community determinants

“…The sequence from misuse of prescription drugs to illicit drug use has been identified as a key pathway to addiction that has contributed to the opioid overdose crisis [6]. Raising public knowledge and reducing stigma about PDA can also improve health outcomes and reduce substance misuse [7].…”

An Effective Intervention: Limiting Opioid Prescribing as a Means of Reducing Opioid Analgesic Misuse, and Overdose Deaths

“…In one examination of the effectiveness naloxone revealed that heroin and prescription overdoses occurred equally in the presence of others, received equal paramedic dispatch and CPR delivery, but that heroin overdoses received naloxone rescue at twice the rate as prescription opioid overdoses (20.8% heroin vs. 10% prescription opioid). 58 The opioid crisis in the United States has become more complex in recent years with a dramatic increase in the number of overdose deaths involving illicit opioids. This surge in illicit opioid deaths has also led some to argue that prescription opioids are no longer central to the opioid crisis and that further efforts to restrict prescribing would have limited benefit and drive many medical systems to severely limit or prohibit opioid prescribing.…”