Drug Overdose Deaths in the US, Polydrug Use, and Involvement of Prescription Pharmaceutical Drugs

"Of the 36,667 drug overdose deaths with at least one mention of a specific drug, 52% mentioned only one specific drug (18,931 deaths), 26% mentioned two (9,351 deaths), 12% mentioned three (4,521 deaths), 6% mentioned four (2,041 deaths), and 5% mentioned five or more (1,823 deaths). Among drug overdose deaths with at least one mention of a specific drug, the average number of specific drugs mentioned was 1.9.
"Table C shows the percentage of drug overdose deaths with concomitant drugs for drug overdose deaths involving the top 10 drugs in 2014. The percentage of deaths involving concomitant drugs varied by referent drug. For example, the majority of the drug overdose deaths involving methamphetamine did not involve other drugs. In contrast, among deaths involving alprazolam and diazepam, more than 95% involved other drugs.
"The average number of concomitant drugs involved (excluding the referent drug) also varied among the top 10 drugs involved in drug overdose deaths. For example, drug overdose deaths involving diazepam or alprazolam had on average more than two additional drugs involved in death. Drug overdose deaths involving fentanyl, heroin, cocaine, or methamphetamine had on average fewer than two additional drugs involved in death.
"Figure 5 shows the percent distribution of the number of concomitant drugs for overdose deaths involving the top 10 drugs in 2014 (Table 5). For example, for drug overdose deaths involving methamphetamine, 55% had no concomitant mentions, 25% mentioned one other drug, 18% mentioned two to four other drugs, and 1% mentioned five or more drugs. In contrast, for drug overdose deaths involving diazepam, 3% had no concomitant mentions, 22% mentioned one other drug, 62% mentioned two to four other drugs, and 13% mentioned five or more other drugs.
"Table D shows the most frequent concomitant drugs for each of the top 10 drugs involved in drug overdose deaths in 2014.
"• One in five drug overdose deaths involving heroin also involved cocaine.
"• Alprazolam was involved in 26% of the drug overdose deaths involving hydrocodone, 23% of the deaths involving oxycodone, and 18% of the deaths involving methadone.
"• More than one-third (37%) of the drug overdose deaths involving cocaine also involved heroin.
"• Nearly 20% of the overdose deaths involving methamphetamine also involved heroin."

Source: 

Warner M, Trinidad JP, Bastian BA, et al. Drugs most frequently involved in drug overdose deaths: United States, 2010–2014. National vital statistics reports; vol 65 no 10. Hyattsville, MD: National Center for Health Statistics. 2016, pp. 5-6.
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