Drug Overdose Rates in the U.S.: Variance by Region, Age, and Gender

By Jeany Miller

Many people, both in and out of the healthcare context, ask why drug overdose death rates are now so high. Evidence strongly suggests that these deaths are related to the increasing use of opioid painkillers among people during the working years of life. Studies from the Centers for Disease Control and Prevention (CDC) also reveal that wide differences exist among states in their per capita use of opioid analgesics. To illustrate, residents in Maine in 2007 used four times more opioid painkillers than residents in South Dakota.

Drug Overdose Rates by Region

Data from the CDC shows that states in the Appalachian region and the Southwest have the highest death rates from drug overdose. The state with the most drug overdose deaths was West Virginia, while South Dakota reportedly had the lowest rate. The disparity between them was almost seven-fold. The Ohio Department of Health (ODH) revealed in 2009 that the leading cause of accidental death was no longer traffic crashes, but rather unintentional poisoning. In most cases, this was the result of drug overdose.

Joe Trolian, executive director of the Mental Health and Recovery Services Board of Richland County, Ohio, explains, "We have a serious problem with opiate addiction. This is not just down and out people from the wrong side of town. This is high school students that died in the family recreation room, athletes who thought they could take just one more pill, older adults who mix drugs and alcohol."

Conversely, the CDC reports that in 2007, states such as California and New York had some of the lowest overall death rates because of low opioid use. This contrasts with reports from the 1990s in which these states had some of the highest overall death rates, largely because of high heroin and cocaine overdoses.

The Age and Gender Factors with Drug Overdose

Other evidence suggests overdose death rates are connected to specific groups of people. The strongest evidence to support this comes from investigations of overdose deaths by state medical examiners.

"Such studies consistently report that a high percentage of people who die of prescription drug overdoses have a history of substance abuse, that many mix prescription drugs with illicit drugs and that some alter the prescription drugs by crushing and snorting them or dissolving and injecting them," states Dr. Paulozzi, MD, MPH.

The CDC states that age-adjusted rates of drug overdose death for whites have exceeded those of African Americans since 2003. The two groups most likely to die from drug overdose are men and middle-aged people. Since 1999, male death rates have doubled while female rates have tripled. These numbers reveal that drug use has risen dramatically among both sexes. According to the CDC, 18,029 male and 9,626 female drug overdose deaths occurred in 2007. Male rates exceeded female rates in nearly every age group, which is consistent with historical reports in which men have had higher rates of substance abuse than women. The highest death rates for both sexes were in the 45 to 54 age group. Rates declined dramatically after the age of 54. After age 64, the male and female rates became comparable. A study of 295 deaths related to drug overdoses in West Virginia revealed these statistics:

Men accounted for 67.1 percent of the deaths
91.9 percent were persons aged 18 through 54 years
63.1 percent had used pharmaceuticals that contributed to their deaths without documented prescriptions
21.4 percent had five or more clinicians prescribe controlled substances for them in the year prior to death
94.6 percent had at least one indicator of substance abuse

Sources: http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdf

http://www.hhs.gov/asl/testify/2008/03/t20080312b.html

http://www.sciencedaily.com/releases/2008/12/081209221509.htm

http://www.healthpolicyreview.org/daily_review/2009/04/drug-overdose-now-no-1-cause-of-accidental-deaths-in-ohio.html