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Opioid epidemic spilling over onto roads, study says

Patients who are prescribed opioids and the clinicians who prescribe them have more to be concerned about than steadily rising rates of opio...

Posted: Feb 15, 2019 2:38 PM

Patients who are prescribed opioids and the clinicians who prescribe them have more to be concerned about than steadily rising rates of opioid overdoses, according to a new study.

The research, published Friday in the journal JAMA Network Open, shows that drivers who are on prescribed opioids are twice as likely to be in deadly two-vehicle accidents than those not using the drugs. As the United States struggles with an opioid epidemic, these findings could affect health care providers' decision-making processes, the authors say.

Statistics from the US Center for Disease Control and Prevention show that although the rate of opioids prescribed per 100 people decreased from 72.4% to 66.5% from 2006 to 2016, 214 million opioid prescriptions are written each year.

Study author Dr. Guohua Li, a professor of epidemiology and anesthesiology and the founding director of the Center for Injury Epidemiology and Prevention at Columbia University, said he and co-author Stanford Chihuri, a staff associate in Columbia's Department of Anesthesiology, were motivated to take on this research because "the ongoing opioid epidemic has spilled over to the nation's roadways, with deadly consequences."

For the study, the researchers used data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System, which contains records from throughout the United States on motor vehicle crashes with at least one death within 30 days of the accident. This data is based on "driver-related factors," the unsafe actions of drivers that lead to crashes. A driver with at least one driving error resulting in that fatal crash becomes known as the crash initiator.

The researchers used these driving errors to measure which drivers were at fault for crashes and used toxicology results to look for the presence of opioids.

After looking at 18,321 driver pairs who died in two-vehicle accidents between 1993 and 2016, Li and Chihuri found that 54.7% of deceased drivers who tested positive for prescribed opioids crashed because they were unable to stay in their lane. Additionally, more crash initiators overall tested positive for prescribed opioids, alcohol or both than those who were not initiators.

Previous research has shown that opioids can impair drivers by causing them to be dizzy, drowsy or even sedated. By decreasing alertness and increasing reaction time, opioids cause patients to be at increased risk of crashing while driving. The medications often carry warnings against driving, operating heavy machinery or participating in other potentially dangerous activities while taking them.

The authors acknowledge limitations to the study. Drivers who tested positive for an opioid were not necessarily impaired. Also, the Fatality Analysis Reporting System does not record the dosage of opioids or alcohol. And although driving errors were standardized to understand who was faulted for the accident, this may not be enough information and varies from state to state.

Li and Chihuri conducted a previous study that showed that, before the onset of the opioid epidemic in the 1990s, opioid use was responsible for only about 1% of driver deaths in the United States. As both illicit and prescription opioid use has increased, the number of motor vehicle deaths from opioid use has increased to at least 7%, the study says.

To reverse this trend and ensure that patients do not fall victim to driving under the influence, education and collaboration between patients and clinicians is necessary, the researchers say.

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 587762

Reported Deaths: 7324
CountyCasesDeaths
Hennepin1217771724
Ramsey50848870
Dakota45493446
Anoka41276436
Washington26615280
Stearns22077221
St. Louis17637302
Scott17137124
Wright15873139
Olmsted1316498
Sherburne1157185
Carver1041645
Clay811792
Rice7991106
Blue Earth744441
Crow Wing658688
Kandiyohi650683
Chisago589051
Otter Tail571778
Benton563697
Goodhue474972
Mower463732
Douglas463674
Winona451850
Itasca428053
McLeod420258
Morrison416260
Isanti415364
Nobles407148
Beltrami391058
Steele383915
Polk382268
Becker377950
Lyon359250
Carlton343553
Freeborn340729
Pine326222
Nicollet322743
Brown304040
Mille Lacs300352
Le Sueur288222
Todd280432
Cass269028
Meeker253740
Waseca236222
Martin229731
Roseau207519
Wabasha20473
Hubbard186341
Dodge18313
Renville178643
Redwood172636
Houston171315
Cottonwood164221
Fillmore155310
Wadena154522
Pennington153619
Chippewa151638
Faribault151119
Kanabec143224
Sibley142310
Aitkin133936
Watonwan13189
Rock127819
Jackson121811
Pipestone114726
Yellow Medicine113820
Pope10916
Murray10609
Swift104818
Stevens90211
Marshall87817
Clearwater86116
Koochiching81715
Lake80819
Wilkin80412
Lac qui Parle75022
Big Stone5984
Lincoln5773
Grant5678
Mahnomen5459
Norman5399
Unassigned48693
Kittson48422
Red Lake3957
Traverse3685
Lake of the Woods3213
Cook1590

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 365723

Reported Deaths: 5925
CountyCasesDeaths
Polk57406622
Linn20778334
Scott19903240
Black Hawk15777308
Woodbury15105228
Johnson1444083
Dubuque13347209
Dallas1114698
Pottawattamie11082168
Story1058248
Warren575088
Clinton552792
Cerro Gordo537889
Sioux513474
Webster511493
Marshall482075
Muscatine476299
Des Moines453266
Wapello4288122
Buena Vista424240
Jasper417771
Plymouth400480
Lee374255
Marion361075
Jones297357
Henry290837
Carroll285152
Bremer283360
Crawford265840
Boone263334
Benton255455
Washington253650
Dickinson247843
Mahaska229551
Jackson221142
Kossuth215264
Clay215125
Tama209171
Delaware208740
Winneshiek196834
Page192622
Buchanan190531
Cedar189223
Hardin184943
Fayette184741
Wright184236
Harrison179373
Hamilton179249
Clayton169456
Butler164634
Mills161722
Madison161419
Floyd160142
Cherokee158538
Lyon157541
Poweshiek154733
Allamakee150951
Iowa148224
Hancock147034
Winnebago141631
Cass137854
Calhoun137313
Grundy136233
Emmet134140
Jefferson132335
Shelby130537
Sac130119
Union128133
Appanoose127949
Louisa127849
Mitchell125842
Chickasaw123915
Guthrie120829
Humboldt118826
Franklin118121
Palo Alto112423
Howard104422
Montgomery103238
Clarke99824
Unassigned9770
Keokuk95531
Monroe95129
Ida90234
Adair86332
Pocahontas85322
Monona82830
Davis82524
Osceola78216
Greene77610
Lucas77123
Worth7428
Taylor65712
Fremont6229
Decatur6069
Van Buren55718
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