The Washington PostDemocracy Dies in Darkness

CDC: Prescription painkiller deaths drop for the first time in a decade

According to new data from the Centers for Disease Control and Prevention, the rate of drug overdose deaths more than doubled from 6.1 per 100,000 people in 1999 to 13.1 in 2012. Opioid painkillers -- hydrocodone, oxycodone, and the like -- accounted for a substantial share of the increase. And in recent years, heroin deaths have risen.

There's good news and bad news in these numbers. The good news is that opioid deaths actually fell in 2012 for the first time as authorities have cracked down on prescription drug abuse. The total drug overdose death rate is also down slightly. On the other hand, users who've developed a opiate habit may be switching over to heroin as painkillers become more expensive and harder to get. The increase in the heroin death rate seems to reflect that reality.

As I've noted before, overall heroin use rates are really, really low. So talk of a "heroin epidemic" is a bit overblown, and the danger is that overreaction leads to dumb legislation that could make the problem even worse.

On the other hand, heroin use rates are currently so low that they literally have nowhere to go but up. And heroin is considerably more lethal than just about any recreational drug out there. So even small upticks in use are going to lead to noticeably more overdose deaths.

There's a real public health conundrum at work here. Policymakers failed across the board to realize that making prescription painkillers harder to get would be a boon for the heroin market. Now, in order to keep heroin deaths from rising sharply, they're going to have to get creative.

A program currently underway in Vancouver offers one innovative solution: make the drug available to addicts via prescription. The idea is that heroin made in a lab, at a standardized purity and potency, is safer than the stuff you buy from a guy in an alley somewhere. And studies have shown that treating addicts this way is cheaper and leads to better outcomes than giving them methadone. Or simply throwing them in jail, for that matter.

But there's currently no such program in the United States.