Opioid Overdoses Are Major Cause Behind Life Expectancy Decline, CDC Report Says

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The average life expectancy in the U.S. dropped in 2016, largely because of an increase in deaths from drug overdoses, according to a report out today from the Centers for Disease Control and Prevention (CDC). And opioids seem to be largely to blame.

In 2016, the average lifespan was 78.6 years in the U.S., a drop of one-tenth of a year from 2015. This marks the second year in a row that life expectancy has fallen, and the first two-year decline since the early 1960s.

A companion CDC report, also out today, reveals that 63,600 people died from drug overdoses in 2016—21 percent more than in 2015.

That’s a large enough jump that “it’s affecting the profile for overall mortality,” says Robert Anderson, Ph.D., chief of the mortality statistics branch at the CDC’s National Center for Health Statistics.

Here’s what you need to know about these drug overdose deaths, and how to keep yourself and your loved ones safe.

The Impact of Illegal Opioids

In the new report, heart disease and cancer remained the top two causes of death. But unintentional injuries—with drug overdoses comprising roughly one-third of that category, according to Anderson—replaced lung disease as the third leading killer of people in the U.S.

The biggest spike in deadly overdoses was from so-called synthetic opioids, notably fentanyl (Sublimaze, Duragesic, others, and generic), where the death rate doubled between 2015 and 2016.  (Drug overdose deaths due to heroin rose by 19 percent and deaths from "natural" and "semisynthetic" opioids—like morphine—have risen by 3 percent annually since 2009.)

Fentanyl, which is at least 50 times more potent than morphine, is sometimes used as a short-term treatment for hospitalized patients in the first few days after surgery. The drug is also prescribed for people who have severe chronic pain, according to Kathryn Hawk, M.D., assistant professor of emergency medicine at Yale School of Medicine.

But in recent years, fentanyl-related deaths have largely been caused by illegally manufactured and imported fentanyl, not the prescribed drugs, say experts.

During this time, stricter opioid prescribing policies and practices might have helped push some people toward illegally produced fentanyl (and heroin), Anderson says.

In addition, illicit drugs are frequently laced with fentanyl or fentanyl-like drugs, raising the risk of an overdose from any street drug. “Very little of this is being driven by pharmaceutical-company-manufactured fentanyl,” Hawk says.

Protect Against Opioid Abuse

While drug overdose death rates due to legal opioid use may be slowing, overuse of opioids of all types remains a significant threat, say experts.

“There are still plenty of people receiving opioid prescriptions, some appropriately, but many who don’t need them,” says Orly Avitzur, M.D., Consumer Reports’ medical director. “An accidental overdose should be a concern for anyone who has these medications in their home.”

Follow these steps for safety:

Use opioids for the shortest possible amount of time. The longer you take an opioid pain medication, the greater the likelihood of developing an addiction. The CDC recently recommended that doctors prescribe no more than three days’ worth of opioids after surgery or injury.

If you’re having surgery, discuss a pain management plan in detail with your doctor before you leave the hospital. A recent study of C-section recipients found that those who did so went home with fewer pills, and used fewer pills, than those who didn’t. And ask your doctor to start you with the lowest dose possible and don't take more than recommended.

Take care when using other meds too. If your doctor prescribes an opioid, ask about potential interactions with any other medications you’re taking. For instance, taking opioids while you’re also taking benzodiazepines—typically used for anxiety and seizure prevention—such as alprazolam (Xanax and generic), diazepam (Valium and generic), and lorazepam (Ativan and generic) can raise the risk of dangerous side effects. Drinking alcohol while taking an opioid can also hike overdose risk.

Consider other pain-management methods. For chronic pain, opioids shouldn’t your the first (or only) option, and may not even be effective in some instances, such as for low back pain.

Exercise, physical therapy, or cognitive behavioral therapy may be options. Over-the-counter medications such as acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), or naproxen (Aleve and generic) may also help. (For more on when not to use opioids, see our report on chronic pain.)

Have naloxone on hand. Both the CDC and the Food and Drug Administration say that doctors who prescribe an opioid should also ensure that their patients receive naloxone, an emergency medication that can reverse an opioid overdose. Ask your doctor about naloxone if you need to take an opioid—in many states you can get it from a pharmacy without a prescription.

Keep meds safe. Secure any opioids or other prescription medications in a locked cabinet or container. That way children can’t accidentally get their hands on them, and they can’t be misused or stolen. And if you have leftover pills, dispose of them safely by taking them to a proper drop-off site (you can search for one here.)

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