The U.S. is said to be suffering from a crisis in deaths from opioid overdoses, prompting legislative and other efforts to clamp down on physician prescribing of these drugs. However, this effort is likely misdirected, and targeting legal prescriptions is thus unlikely to reduce overdose deaths, according to a careful review of official government data by John D. Lilly, M.B.A., D.O., in the spring issue of the Journal of American Physicians and Surgeons. Full Article: http://www.jpands.org/vol23no1/lilly.pdf

Until 2013, deaths attributed to synthetic opioids were fairly stable, but a sharp upward trend began then, with an increase of 635% from 2014 to 2016.

The National Institute on Drug Abuse (NIDA) uses the International Classification of Diseases, 10th revision (ICD-10), to identify causes of death, but NIDA’s overlapping categories can be confusing. Using data from the Centers for Disease Control and Prevention (CDC) Wonder data base, Dr. Lilly sorts out the deaths associated with illicit fentanyl. The main sources of illicit fentanyl are Mexico and China. It is often mixed with heroin.

Notably, the spike in deaths has occurred while opioid prescribing is being heavily discouraged and placed under increasingly severe constraints. Dr. Lilly concludes that these policies are apparently driving opioid misusers from legally prescribed drugs to illicit drugs, which are far deadlier because of high potency and unreliable dosing.

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.