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The Hidden Tragedy of the Opioid Crisis

The Hidden Tragedy of the Opioid Crisis
From TIME - October 27, 2017

When President Trump declared the opioid crisis a public health emergency Thursday, he noted that "last year we lost at least 64,000 Americans to overdoses." He is not incorrect. A preliminary analysis for 2016 from the Centers for Disease Control and Prevention estimated the toll at 64,070, up from 52,898 in 2015.

What rarely gets mentioned in these staggering figures is that a significant number of opioid deaths are considered to be suicides. In 2015, 4,837 opioid-related fatalities were coded as "intentional self-poisoning"9% of all deaths. Another 2,553 were of undetermined cause, and 35 were assaults. All the others were considered accidents.

The real number of suicides may be higher. Experts says there are many challenges and inconsistencies when it comes to deciding if any drug-related fatality was intentional.

It can be a tricky call to distinguish an intent to kill oneself from an accidental overdose when the person has died, unless theres some other indication that a person has been engaging in what we call preparatory behavior such as writing a will or stockpiling pills, says Dr. Gregory K. Brown, Director of the Center for the Prevention of Suicide at the Perelman School of Medicine of the University of Pennsylvania.

This is particularly true for those who have struggled with addiction. "People can get into a state where they dont care if they live or die," Brown says.

In 2011, the CDC proposed guidelines for additional data collection in cases of potential self-harm, identifying several reasons why the existing classifications are insufficient. One issue is that coroners and medical examiners do not have a uniform standard of proof for classifying a death as a suicide.

The current data suggests that opiate-related suicides have roughly doubled since 1999, while those considered accidental have increased four-fold:

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