Nevada Records Show 'Opioid-Related' Deaths Usually Involve Illicit Drugs or Mixtures

Deaths attributed solely to pain pills are rare in Clark County.


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People who want to attack the "opioid crisis" by restricting access to pain medication often cite recent increases in opioid-related deaths as evidence that doctors have seriously underestimated the dangers that drugs like hydrocodone and oxycodone pose to patients. Yet those trends are driven mainly by heroin and illicit fentanyl, and even when pain pills are involved they are usually combined with other drugs. A recent report by KLAS-TV, the CBS station in Las Vegas, highlights that reality by examining every death that the Clark County coroner tied to opioids from the beginning of 2017 through April 18 of this year.

Most of the "opioid-related" deaths during this period (221 of 430, by my count*) involved heroin or fentanyl, and more than three-quarters (328 of 430) involved multiple drugs. The additional substances include alcohol, benzodiazepines, cocaine, and methamphetamine as well as other opioids. Other jurisdictions also report that drug mixtures are typical in opioid-related deaths. In New York City, for example, 97 percent of drug-related deaths involve more than one substance.

Just 11 percent of the opioid-related deaths in Clark County (47 of 430) involved a single prescription opioid. Fourteen of those cases involved methadone, which can be prescribed for pain but is better known as a treatment for heroin addiction. Seven are listed as suicides, and 21 involved complicating factors such as cancer, morbid obesity, heart disease, chronic obstructive pulmonary disease, and (in one case) a gunshot wound to the chest. Excluding methadone, suicides, and complicating conditions leaves nine cases where the only cause listed is a commonly prescribed pain medication: hydrocodone (five cases), oxycodone (two), hydromorphone (one), and oxymorphone (one). That's 2 percent of the opioid-related deaths.

Clark County's records do not tell us whether those opioids were prescribed for the people who took them, let alone whether they were bona fide patients. But it's clear that the risk for any given patient is very low. In Nevada, KLAS reporters George Knapp and Matt Adams note, "99.98 percent of all opioid prescriptions do not result in overdoses." Similarly, a 2015 study of opioid-related deaths in North Carolina found 478 fatalities among 2.2 million residents who were prescribed opioids in 2010, an annual rate of 0.022 percent.

[*I excluded three deaths where phencyclidine (PCP) was the only drug mentioned and one that was attributed to mitragynine, the chief active ingredient in kratom. I counted morphine mentions as heroin mentions, since the body quickly converts heroin into morphine and heroin use is the most likely explanation when morphine shows up in an autopsy.]

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  1. I don’t suppose a PSA explaining what not to mix when you’re partying would be in order? I don’t think this “drugs make you suck” has really worked out as a message, and I say that as a former DARE student of the year.

    1. That might. Might not. Plus, your standard fare drug warriors will claim you’re just encouraging drug use by acknowledging it’s happening.

      I think these types of PSA’s have limited effect. But I dont think it would hurt.

  2. ” The additional substances include alcohol, benzodiazepines, cocaine, and methamphetamine as well as other opioids. Other jurisdictions also report that drug mixtures are typical in opioid-related deaths. ”

    Just taking a guess here, but I suspect you average AG with an itchy trigger finger to sue the pharmaceutical companies won’t be swayed by these nuances. The logic will probably be that if they weren’t able to get the legal drugs so easily, them the death rates will drop.

    1. Why do I hear echoes of ‘gun control solutions’ here?…

  3. So your saying I shouldn’t do speedballs?

    signed John Belushi.

  4. 03/11/2018 Suicide Combined Drug Toxicity: Heroin, Methamphetamine, Clonazepam, Oxycodone and Carisoprodol

    I knew them; CoD on Death Certificate was listed as “Suicidal use of multiple drugs”

    I haven’t seen the toxicology report, so I don’t know what amounts of each drug was present in their system.
    It’s possible they did just decided to take a bunch of different things to kill themselves.

  5. Don’t forget Jacob,

    When Heroin is metabolized in the liver, it breaks down into TWO morphine molecules. It is basically just two morphine molecules linked by an acetyl group.

  6. This isn’t news, nor is it particularly a Nevada issue. Fentanyl has been the up-and-coming additive to heroin which is driving our rapid increase in deaths from drug overdoses. The constant ‘death by prescription drugs’ only tells part of the story.. It’s those who have become accustomed to access to Phramaceuticals like Oxycodone that go elsewhere when theyr are ‘weaned’ off the medication.. They can’t afford the $60 a tablet street price, so go for $5 a hit street heroin, which is often times adulterated with Fentanyl. The CDC is and has been aware of this trend for years.. Here’s their chart: https://bit.ly/2L8PzqK

  7. I was diagnosed with COPD 5 years ago and was taking Spiriva and Advair plus nose sprays to slow down progression. My symptoms have always been shortness of breath, and dizziness. I am a 54 year old male. the Spiriva wasn’t really working and I could not tolerate them for long due to severe side effects, so this year our family doctor started me on Natural Herbal Gardens COPD Herbal mixture, We ordered their COPD herbal treatment after reading alot of positive reviews, i am happy to report with the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 9 weeks use of the Natural Herbal Gardens COPD natural herbal formula. My COPD is totally reversed! Their official web page is www . naturalherbalgardens . com After the herbal treatment I also finally was able to give up smoking after 20 years. I ‘m thankful to nature

    1. Was that spam or a clickbait ad?
      And its relevance to the article is…. ????

  8. No mention still that death from heroin alone is rare. The contraindications is what becomes deadly such as ingesting heroin and that favored drug-Alcohol!
    How many years have we had to hear that this or that famous singer or that rock star OD’d on heroin without mention of other drugs that were present?

    What is really happening in this made-up “epidemic’ seems to have the earmarks similar to the tobacco lawsuit. Just need innocent victims. Who will they be?

  9. Oh, dear, you mean the people who have been lying for decades about pot, who lied about crack, who lied about meth, are lying about pain pills? I’m shocked. Speechless.

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