Credit: Abinoam Jr.

Drugs cause a third of all accidental deaths in Allegheny County

Every year in Allegheny County, more people die of accidental drug overdose than in traffic accidents and homicides combined. Approximately 93 percent of all Allegheny County unintentional poisoning deaths were caused by drug poisoning in 2011, accounting for 22 percent of all morgue cases in the county.

Last year, overdose deaths reached an all-time high in neighboring Westmoreland County. And in the first week of 2013 alone, the Westmoreland County coroner’s office was called to investigate seven suspected drug overdoses.

Nationally, the number of overdose deaths, which is over 37,000 annually, has doubled in the last 10 years according to data from the Center for Disease Control. In the United States, someone dies from an overdose—from either legal or illegal drugs—every 19 minutes.

“As a neurosurgeon working in a busy level 1 trauma hospital, I had an idea that the problem was growing–but the numbers still boggle the mind,”  commented Dr. Sanjay Gupta, CNN’s chief medical correspondent.

“…I had an idea that the problem was growing, but the numbers still boggle the mind.”

According to the CDC’s National Center for Health Statistics, drugs were the cause of 32.8 percent, or 237, of the 649 accidental deaths in Allegheny County, as well as 14.3 percent of the 126 suicides in 2010. Nearly half (104) of the drug-related deaths were caused by “accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens].”

The remaining drug related deaths were attributed to “accidental poisoning by and exposure to other and unspecified drugs, medicaments and biological substances,” or causes with such low frequencies that reporting them would compromise anonymity. However, this does not mean these deaths were not due to narcotics overdose, just that it wasn’t recorded on the death certificate

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Overall, western Pennsylvania still has a relatively “traditional” pattern of drugs of abuse compared to national trends–meaning in our region, the predominant drugs that contribute to overdose deaths are heroin and cocaine, according to Allegheny County Chief Medical Examiner Dr. Karl Williams.

And the heroin in Western Pennsylvania is more potent than ever. According to law enforcement officials, heroin in the region is 70-90 percent pure, a startling increase from the purity rates of the 1980s, which were around 10-15 percent, Dr. Neil Capretto, medical director at Gateway Rehabilitation Center, reported at the Allegheny County Overdose Prevention Coalition (ACOPC) Conference, held in July 2012.

Prescription opioids, with brand names like Vicodin and Percoset, are also increasingly popular locally.  The issue of overdose deaths from prescription opioids has been declared a national epidemic.

“Overdose deaths from opioids are preventable. We have the antidote: safe, highly effective, Naloxone.”

In a release, the Allegheny County Health Department stated, “To combat the growing number of drug overdose deaths, it is necessary to expand drug prevention and treatment efforts to include education on immediate life-saving tools.”

One such tool is naloxone, an opioid inverse agonist used to counter the effects of opiate overdose. Paramedics routinely use naloxone (brand name: Narcan) to immediately reverse the effects of opiate overdose.

At the ACOPC conference, Alice Bell, overdose prevention program director at Prevention Point Pittsburgh, said each of the 261 overdose deaths in Allegheny County in 2011 involved one or more substances that would respond to the drug naloxone.

“Overdose deaths from opioids are preventable,” Bell said. “We have the antidote: safe, highly effective naloxone.”

In a study released at the beginning of this year, researchers at the University of Washington developed a mathematical model to estimate the impact of distributing naloxone more widely to opioid drug users and their acquaintances, which shows that it can save lives cheaply. They found that if naloxone were available to 20 percent out of a million heroin users, some 9,000 deaths would be prevented over the users’ lifetimes. Their basic research model, which they say uses “markedly conservative assumptions,” indicates that one life would be saved for every 164 naloxone kits handed out. More optimistic assumptions suggest that one life could be saved for every 36 kits distributed—which would prevent as many as 43,000 fatal overdoses.

In 2005, Prevention Point Pittsburgh (PPP) started a naloxone prescription program at one of its two needle exchange sites. Since then, over 800 individuals have received naloxone and PPP has recorded over 650 successful peer overdose rescues.

“With naloxone, there is no downside,” Bell said.  “If there are no opioids in the person’s system, it does not have a harmful effect.”

PPP has developed an 11-minute training video, “Opioid Medication Safety: The Role of Naloxone” on opioid safety and how to use naloxone.

In June of last year, the American Medical Association endorsed community-based naloxone programs.

Another tool to help prevent overdose death is the enactment of  “Good Samaritan” laws, which offer legal protection to people who give reasonable assistance to those who are injured, ill, or in peril due to a drug overdose.

According to a 2012 article in The Atlantic, “Studies show that most deaths occur one to three hours after a drug user has ingested or injected, presenting witnesses with an opportunity to seek medical help. But only between 10 percent and 56 percent of people who witness an overdose call for assistance. Most hesitate because they fear arrest and drug charges.”

In 2007, New Mexico became the first state to enact Good Samaritan Laws. Washington State followed in 2010. And since September 2011, eight more states–New York, Connecticut, Illinois, Colorado, Rhode Island, Massachusetts, Florida and California–have all passed Good Samaritan laws.

Currently, Pennsylvania has an overdose bill pending in its legislature.

Recommended Resources

Harm Reduction Coalition

Project Lazarus

Allegheny County Offers Tips On How to Prevent and Respond to Drug Overdose (Press Release; April 2012)

Overdose Prevention Alliance