Prescription Drug Overdose in the United States: Fact Sheet

Overview

Definitions

Drug: Any chemical compound used for the diagnosis or treatment of disease or injury, for the relief of pain, or for the feeling it causes. A drug is either a pharmaceutical (including both prescription and over-the-counter products) or illicit.

Overdose: When a drug is eaten, inhaled, injected, or absorbed through the skin in excessive amounts and injures the body. Overdoses are either intentional or unintentional. If the person taking or giving a substance did not mean to cause harm, then it is unintentional.

Misuse or abuse: The use of illicit or prescription or over-the-counter drugs in a manner other than as directed.2

Deaths from drug overdose have been rising steadily over the past two decades and have become the leading cause of injury death in the United States.1 Every day in the United States, 120 people die as a result of drug overdose,8 and another 6,748 are treated in emergency departments (ED) for the misuse or abuse of drugs.2 Nearly 9 out of 10 poisoning deaths are caused by drugs.8

The Problem

Drug overdose was the leading cause of injury death in 2012. Among people 25 to 64 years old, drug overdose caused more deaths than motor vehicle traffic crashes.1
The drug overdose death rate has more than doubled from 1999 through 2013.8
In 2013, 35,663 (81.1%) of the 43,982 drug overdose deaths in the United States were unintentional, 5,432 (12.4%) were of suicidal intent, and 2,801 (0.06%) were of undetermined intent.8
In 2011, drug misuse and abuse caused about 2.5 million emergency department (ED) visits. Of these, more than 1.4 million ED visits were related to pharmaceuticals.2
Between 2004 and 2005, an estimated 71,000 children (18 or younger) were seen in EDs each year because of medication overdose (excluding self-harm, abuse and recreational drug use).4
Among children under age 6, pharmaceuticals account for about 40% of all exposures reported to poison centers.5

Most Common Drugs Involved in Overdoses

In 2013, of the 43,982 drug overdose deaths in the United States, 22,767 (51.8%) were related to pharmaceuticals.8
Of the 22,767 deaths relating to pharmaceutical overdose in 2013, 16,235 (71.3%) involved opioid analgesics (also called opioid pain relievers or prescription painkillers), and 6,973 (30.6%) involved benzodiazepines.8 (Some deaths include more than one type of drug.)
In 2011, about 1.4 million ED visits involved the nonmedical use of pharmaceuticals. Among those ED visits, 501,207 visits were related to anti-anxiety and insomnia medications, and 420,040 visits were related to opioid analgesics.2
Benzodiazepines are frequently found among people treated in EDs for misusing or abusing drugs.2 People who died of drug overdoses often had a combination of benzodiazepines and opioid analgesics in their bodies.6

Costs

In the United States, prescription opioid abuse costs were about $55.7 billion in 2007.7 Of this amount, 46% was attributable to workplace costs (e.g., lost productivity), 45% to healthcare costs (e.g., abuse treatment), and 9% to criminal justice costs.7

Risk Factors for Drug Overdose

Among those who died from drug overdose in 2012:

Men were 59% more likely than women to die;
Whites had the highest death rate, followed by American Indians/Alaska Natives and then blacks;
The highest death rate was among people 45-49 years of age; and
The lowest death rates were among children less than 15 years old because they do not abuse drugs as frequently as older people.1

Among people who misused or abused drugs and received treatment in emergency departments in 2011:

56% were males;
82% were people 21 or older.2

Additional Information

Treating for Two. Safer Medication Use in Pregnancy

CDC Vital Signs:

Understanding the Epidemic

Prevention & Treatment

Policy Information

Information for Clinicians

Physicians for Responsible Opioid Prescribing: Cautious, Evidence-based Opioid Prescribing

Additional Data Sources

CDC WONDER (Wide-ranging Online Data for Epidemiologic Research)WONDER an easy-to-use, menu-driven system that makes the information resources of the Centers for Disease Control and Prevention (CDC) available to public health professionals and the public at large. It provides access to a wide array of public health information.
CDC Data & StatisticsThe CDC Data & Statistics web site features interactive tools, surveys, publications, databases, and more.

References

Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2014) Available from URL: http://www.cdc.gov/injury/wisqars/fatal.html.
Substance Abuse and Mental Health Services Administration. Highlights of the 2011 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. The DAWN Report. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2013. Available from URL: http://www.samhsa.gov/data/2k13/DAWN127/sr127-DAWN-highlights.htm
Paulozzi LJ. Prescription drug overdoses: a review. Journal of Safety Research, 2012;http://dx.doi.org/10.1016/j.jsr.2012.08.009
Schillie SF, Shehab, N, Thomas, KE, Budnitz DS. Medication overdoses leading to emergency department visits among children. Am J Prev Med 2009;37:181-187.
Mowry JB, Spyker DA, Cantilena LR, Bailey JEFord M. 2012 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 30th annual report. Clin Tox 2013;51:949-1229.
Centers for Disease Control and Prevention. National Vital Statistics System mortality data. (2012) Available from URL: http://www.cdc.gov/nchs/deaths.htm.
Birnbaum HG, White AG, Schiller M, Waldman T, Cleveland JM, and Roland CL. Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain Medicine 2011; 12: 657-667.
Centers for Disease Control and Prevention. National Vital Statistics System mortality data. (2015) Available from URL: http://www.cdc.gov/nchs/deaths.htm.