The Opioid Epidemic Might Be Much Worse Than We Thought

A drug user prepares heroin, placing a fentanyl test strip into the mixing container to check for contamination.

A drug user prepares heroin, placing a fentanyl test strip into the mixing container to check for contamination. AP Photo

 

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A new paper suggests that death certificates dramatically undercounted the number of people dying from opioid overdoses.

It can be hard to comprehend the true scope of something as disastrous as the opioid epidemic. Perhaps that’s why it’s been compared with falling 747s and crashing cars. But in fact, knowing exactly how many people have perished is crucial to stopping the deaths.

That’s why Elaine Hill and Andrew Boslett, economists at the University of Rochester, were so concerned when they found that many potential opioid deaths aren’t counted as such. In the fall of 2018, Hill and Boslett were studying how deaths from overdoses of opioids, such as heroin or OxyContin, were influenced by the decline of coal mining and the rise of shale gas fracking. But when they began looking at death records of Americans who had died of drug overdoses, they noticed that in more than 20 percent of the cases, the record said the type of drug could not be specified, perhaps because an autopsy had not been performed. In other words, the person had died of a drug overdose, but the death record didn’t say which drug.

Hill and Boslett realized that such a high rate of unknowns wouldn’t work for the phenomenon they were trying to study. “Our lab wants to make as strong of a claim as possible, given evidence that maybe an economic shock … had an effect on drug-overdose rates,” Boslett says. “We want to know that the estimates we’re using on local drug-overdose rates are correct, or as correct as possible.”

Olga Khazan is a staff writer at The Atlantic.

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