CNN: Opioid Overdoses Kill More People Than... Food?

"Odds of dying from accidental opioid overdose in the US surpass those of dying in car accident"

CNN, January 14, 2019

You might think that this same old sensationalist headline, which we've been seeing for years, might be wearing thin by now. You would be wrong. Journalists still feel the need to compare opioid overdose deaths to those from automobile accidents, as if the two have anything to do with each other. They don't. But they do provide yet another opportunity to shove the same old sensationalist, attention-grabbing headlines in our faces. The latest numbers are found in a new report issued by the National Safety Council (emphasis mine):

"Examining a variety of federal and state data the NSC found the lifetime odds of dying from an accidental opioid overdose were 1 in 96. For motor vehicle accidents the odds were 1 in 103 and 1 in 114 for falls. The lifetime odds of suicide were greater, at 1 in 88."

There are a number of ways to interpret these data - all equally valid:

1. Opioid deaths are rising
2. Automobile deaths are declining. 
3. Both
4. The "opioid epidemic" will become (relatively) less problematic if more people die from slipping and falling or from auto accidents. We should encourage more slips and falls. 
5. The "opioid epidemic" will become (relatively) more problematic if more people die from suicide. We should discourage suicides. 
6. Do you see how dumb this is?

(In case you don't, you can read about how the FDA is considering restrictions on the anti-diarrheal drug Imodium, even though it is as likely to kill you as a coconut falling on your head.)

Here's an accurate (albeit still meaningless) headline for the same story:

"Because of a surge in heroin and fentanyl use, opioid drug deaths now surpass those of auto accidents for the first time"

But it's not just dumb; it's harmful. These comparisons continue to perpetuate the same false narrative - that there are SO many prescription opioid analgesics floating around out there that people are scarfing them down like Raisinettes and subsequently dropping dead. This is just as false now as it was two years ago (See The Opioid Epidemic In 6 Charts Designed To Deceive You). It is heroin and (more so) illicit fentanyl and its analogs that are killing tens of thousands of Americans every year, not pills. And it's not even close (Figure 1).

Figure 1. Opioid deaths, 2011-2016. Note that deaths from prescription opioids have remained constant while those from fentanyl and heroin - the real killer - have skyrocketed. Source: National Vital Statistics Report

Data from 2016 indicate that approximately 60,000 Americans died from drug overdoses. But this does not mean they died from opioid overdoses. The figure includes all drugs, legal or otherwise, such as aspirin, antidepressants, and anticoagulants. The number of deaths from opioids - legal and illegal - was about half that. And when you subtract the illegal injectables and fatal cases of multiple drugs a rough estimate of the number deaths from the prescription analgesic drugs only was about 5,000 - 8.3% of the total.

So lets now adjust the odds from the NSC report. While the odds of death from heroin/fentanyl remain high the odds of dying from Vicodin or Percocet become roughly 1 in 1,157. All of a sudden we are no longer in the same neighborhood as auto accidents, suicides, or falls. 

Source: NVSS

Let's try a few different headlines that actually reflect reality. 

"You are more likely to drown than die from a Vicodin overdose."

"Odds of dying from Percocet are twice that of choking on food. Stop eating. Now."

"Bicycling is almost one-third as dangerous as Vicodin. Even with the helmet!"

Let's finish with some real numbers. Deaths per year in the US (2016):

Tobacco - 480,000

Alcohol - 88,000

Drug overdoses - 64,000

Opioid-related overdoses - 42,000

Suicide - 45,000

Auto accidents - 40,000

Prescriptions opioid overdoses (when taken with other drugs) - 19,000

Prescriptions opioid overdoses (when taken alone) est. 5,000-10,000

Bicycle and bicycle-related - 6,000

Headlines are powerful and can be misleading, perhaps intentionally so.  If you want to know the truth you better read the whole story. Or stop in for a visit - ACSH.org