GBI: Overdose deaths decrease slightly over last year

COVINGTON -- The Georgia Bureau of Investigation has announced a decrease for the first time in several years in the number of prescription drug overdose deaths.

An analysis of autopsies performed by the GBI Medical Examiner's Office in 152 counties found that there was an 8.6 percent decrease in the number of prescription drug overdose deaths in 2011 when compared to 2010.

These statistics do not include Fulton, Cobb, Gwinnett, DeKalb, Henry, Hall or Rockdale counties, all of which have their own medical examiners who perform autopsies for them.

The GBI lab conducted autopsies on 664 overdose deaths in 2011. Of those, 512 deaths involved only prescription drugs or 77 percent. The analysis also showed that 82 drug overdose deaths in 2011 involved only illicit drugs, or 12 percent, and 70 deaths, or 11 percent, were attributed to a combination of both prescription and illicit drugs.

Dr. Kris Sperry, chief medical examiner for the state of Georgia, said the experts are offering no explanation for the drop.

"We were relatively surprised, quite frankly, as there's nothing we an identify, that we can point to, that has truly had an impact on drug deaths," he said, although he acknowledged physicians, pharmacists and law enforcement are very aware of the problem and have taken steps to make sure prescriptions aren't forged, etc. "Certainly Georgia has finally made the accessibility of drugs tougher. Scheduled narcotics require a written prescription, patients are asked to sign an agreement that only one person will use the medicine, that they'll take it as prescribed, etc. But at the end of the day, the responsibility comes down to the individual patient."

Overdose deaths had been on the increase since 2008 when 638 such deaths were recorded -- 496 of those deaths were due to prescription drugs only; 670 overdose deaths in 2009 -- with 508 due to prescription drugs; and peaking at 729 overdose deaths in 2010 -- with 560 deaths due to prescription drugs only.

The ages most susceptible to overdose deaths are those in the 45- to 54-year-old range, which accounted for 212 of the deaths in 2011. Other ages broke down this way: 15 to 24, 59 deaths; 25 to 34, 130 deaths; 35 to 44, 169 deaths; 55 to 64, 81 deaths; 64 or older, 13 deaths.

Sperry said the 45- to 54-year-old age range typically includes those who may have had pain issues with knees or other surgeries and have taken narcotics for years.

"Most of them have some kind of medical history. They are people who because of chronic pain gradually evolve into drug-seeking behavior, going from one doctor to the next and getting addicted," he said. "It's a terrible situation because it is not something they're intending to do, but they think they know better than the experts."

He said these types of patients often take their medicine in larger amounts and more frequently than is recommended.

"Say their knee is really hurting, they take a pill and two hours later, it's still hurting, so they take another pill or maybe two more, and before you know it, they go lay down in bed and don't wake up," Sperry said.

Mixing drugs was found to be a common denominator in the overdose deaths. There were 71 different drugs found in toxicology tests run on the 664 total overdose deaths, with an average of 2.54 drugs found for each death.

Sperry said Xanax is often prescribed in combination with narcotic pain relievers and most patients don't realize that the combination of the two dramatically enhances the effects.

The top 10 drugs found during autopsies included: Alprazolam (for anxiety, Xanax), 231 deaths; Oxycodone (narcotic pain reliever), 188 deaths; Methadone (narcotic pain reliever), 158 deaths; Hydrocodone (narcotic pain reliever), 133 deaths; Cocaine (stimulant, illicit), 89 deaths; Fentanyl (narcotic pain reliever), 65 deaths; Morphine (narcotic pain reliever), 63 deaths; Diphenhydramine (Antihistamine, Benadryl), 55 deaths; Methamphetamine (stimulant, illicit), 51 deaths; Citalopram (for depression, Celexa), 46 deaths.

There were more white people who fell victim to death by overdose with 603 deaths or 91 percent, while only 9 percent or 61 deaths were found among blacks. The breakdown by male and female was close to half with 45 percent females or 299 deaths and 55 percent males or 365 deaths.

In the manner of the 664 overdose deaths, it was found that 91 percent, or 603, were deemed to be accidental with only 8 percent or 51 deaths attributed to suicide and 1 percent, or 10 deaths, undetermined.

Sperry said the Georgia Crime Lab performs autopsies on average of about two per day that can be attributed to drug overdose. The deaths are referred to them due to the fact that there was no physician in attendance and the patient died at home with no immediate apparent cause of death.

"We automatically look at prescription meds and talk to the family. In nine out of 10 situations when they come to our office, we already have a very high suspicion that they are drug-related because of the pattern that's repeated," he said.