By Cara Murez HealthDay Reporter
health day reporter

FRIDAY, July 29, 2022 (HealthDay News) — Experts predict opioid overdoses will increase in rural and urban areas due to the deadly practice of mixing highly addictive narcotics with other drugs.

The next wave of opioid overdoses “will be worse than ever,” said researchers from Northwestern Medicine in Chicago who studied trends and used a predictive model to determine where deaths would increase.

“I am sounding the alarm because, for the first time, there is convergence and escalation in acceleration rates for every type of rural and urban county,” said corresponding author Lori Post. She is director of the Buehler Center for Health Policy and Economics at Northwestern University Feinberg School of Medicine.

“Not only is the opioid death rate at an all-time high, but the acceleration in that death rate signals explosive exponential growth that is even greater than an already historic high,” Post said in a statement. release from Northwestern.

For the study, researchers used data from the US Centers for Disease Control and Prevention’s WONDER database for 3,147 counties and county-equivalent areas to study geographic trends in opioid-related deaths between 1999 and 2020.

The team was trying to determine if geography was involved in past waves and to theorize about any future waves.

The study found that opioid overdose deaths in 2020 were increasing faster in rural areas than in cities. Between 2019 and 2020, overdose death rates increased for the first time in six types of rural and urban counties, Post said.

“We have the highest escalation rate for the first time in America, and this fourth wave will be worse than it has ever been before,” Post explained. “It’s going to mean massive death.”

The research team reviewed toxicology reports and found that people were using fentanyl (a synthetic opioid that is 50 to 100 times more potent than morphine) and carfentanil (a synthetic opioid about 100 times more potent than morphine). fentanyl) in combination with methamphetamines and cocaine.

This deadly cocktail can make it harder to rescue someone who has overdosed on an anti-overdose drug like naloxone.

“The more potent the drugs, the harder it is to revive a person,” explained study co-author Alexander Lundberg, an assistant professor of emergency medicine at Feinberg. “The use of polysubstances complicates an already dire situation.”

Post said: “It seems those who died of an opioid overdose were playing pharmacist and trying to manage their own dosage. It’s a bigger problem because you have people abusing cocaine and meth with an opioid, so you have to deal with two things at once, and fentanyl is horribly volatile.

The study authors said solutions could include methadone centers, which offer drug-assisted addiction treatment. These are more common in urban areas. Rural areas don’t have drug treatment options, Post said, adding that what works in big cities probably isn’t as helpful for rural areas.

“Nobody wants to be a drug addict. It doesn’t matter if you’re taking Percocet because you broke your back mining or you’re a high school kid who died because it got into Grandma’s medicine cabinet. We need to look immediately at opioid addiction and overdose prevention,” Post said.

“The only way forward is to increase awareness to prevent opioid use disorder and provide culturally appropriate and non-stigmatizing drug treatment in rural communities,” she added.

The results were published online July 28 in Open JAMA Network .

More information

The US Department of Health and Human Services has more on the opioid epidemic.

SOURCE: Northwestern Medicine, press release, July 28, 2022