Monday, July 30, 2018

Growth in TX meth/cocaine overdoses far outpacing opiods

Grits has written how Texas' drug-overdose problem related to meth and other stimulants is a bigger challenge here than the opioid crisis that's gripping many eastern states. So I was interested to see an op ed from the Austin Statesman by Erich Schneider finally address Texas' specific situation. Concerning opioids, here's where we stand:
Centers for Disease Control (CDC) data shows that opioid-related deaths in Texas have indeed risen slightly – from 4.37 to 4.55 deaths per year per 100,000 residents – between 2006 and 2016. But in 2006, the Texas rate stood at 85 percent of the national average; in 2016, we were at just 35 percent of a tragically higher nationwide death rate.
The bigger growth occurred among overdoses by cocaine, meth, and stimulant users:
Over the same interval, Texas deaths related to cocaine, methamphetamine and other psychoactive stimulants have risen from 3.86 to 4.82 per 100,000. While some deaths were due to combinations of drugs and contribute to both statistics, it seems these classes of drugs are comparably lethal. Yet, they claim fewer lives than alcohol: CDC estimated that 27.9 deaths per 100,000 Texas residents were attributable to alcohol in 2014.
So that's a four percent increase in the rate of opioid deaths over the last decade, and a 25 percent increase in cocaine/meth-related deaths. And alcohol-related deaths are a FAR greater problem than illegal drugs.

By contrast, "Ohio, for example, is facing an opioid-related death rate of 31.9 per 100,000 residents – a staggering figure that rises above even our own state’s alcohol-attributable death rate." So clearly, they're facing a radically different situation than we are.

As Grits has iterated repeatedly, the main reason we haven't seen the same spike in opioid deaths is the predominance of black-tar heroin in this market that does not mix easily with fentanyl:
One factor that has driven the explosion of opioid deaths in the past few years is a spike in the availability of fentanyl, a synthetic opioid as powerful as it is deadly. To use fentanyl is to play with fire, and addicts often do so unwittingly, since fentanyl might have been added to their heroin. Those who survive develop a fierce attachment to its potency, so fentanyl appears to be here to stay. And many pill-users move to heroin once their habit becomes too difficult to support by other means. 
There’s one catch: Fentanyl is usually distributed as a powder. For that reason, it doesn’t mix well with the Mexican black tar heroin that predominates in the Western U.S., including Texas. It mixes easily, though, with the South American powder heroin used on the East Coast. 
It is no coincidence that so many of the lives lost over the past few years have been in the East. Dividing the states into those lying east and west of the Mississippi River provides a vivid illustration. In 2006, there was no large-scale geographic pattern to the nascent opioid epidemic. Deaths averaged 5.21 per year per 100,000 people in the Western states and 5.14 in the East. By 2016, the death rate in the Western states had ticked upward to 6.97, while in the East it had soared to 17.4. The deadly presence of fentanyl on the east side of the heroin divide is evident.
The author makes a welcome pitch for making policy based on data instead of media hype:
instead of clamoring for funding solely to fight the opioid wars here — when the numbers show that other places are in more dire need of it — let’s take another look at which drugs are actually killing people in Texas, including alcohol, and create a broad-based strategy that will save more lives.
Grits agrees, but would add that most of the policies needed to reduce overdose deaths aren't specific to a particular drug type. For the most part, solutions on overdose deaths are the same no matter which drugs we're talking about.


Anonymous said...

Well said.
Wouldn't it be great if HHSC or other funding streams only sent Opiod $ to areas where there is actually a documented or data verified CRISIS?
5 cases per 1,000 across a 2 year period hardly qualifies as a CRISIS.

Anonymous said...

Passionate advocates can quote statistics dispassionately? Since when?

Anonymous said...

Very valid point that the growth of Meth and that is where money WITH accountability for it use need be applied. Re: ...statistics dispassionately vs. passionate advocates, take a look at grant requests for these types of funds and how the funds are actually utilized and you will get a quick education on crafty use of statistics.
Texas HHSC audit billion dollar error in contracts article that was published in the Texas Tribune last month. Long before sending more money down the pike, I hope there is a top to bottom audit how ALL Texas HHSC funds and how the funds are being used.