Opioids and substance use
Substance use disorders occur when regular use of alcohol and/or drugs impacts daily functioning,
including health problems, disability, and inability to meet main responsibilities at home, work,
or school.1
In Utah, alcohol is the most commonly abused substance. Over 16,000 individuals receive publicly funded treatment for substance use. More Utahns die from unintended prescription drug overdoses than motor vehicle accidents.2
Deaths attributable to prescription opioid overdoses have more than tripled since 1999.4 The rate of opioid overdose deaths has been rising for Americans regardless of age or race. Utah is particularly affected by prescription opioids. Utah unintentional deaths attributable to prescription pain medication increased over 500% during 1999-2007.5 Most Utahns who die a drug-related death suffer from chronic pain and take prescribed pain medications.6
This epidemic of opioid poisonings is strongly related to widespread and rising prescription opioid misuse and abuse. An estimated 12 million Americans over age 12 misused prescription opioids during the year 2010.4 In a 2008 Behavioral Risk Factor Surveillance Survey, 24.5% of Utahns reported using some type of prescribed opioid during the previous year.7 Prescription opioid therapy, chronic non-cancer pain, high dose prescription opioids, and multiple prescriptions/pharmacies have been implicated as risk factors for overdose death.4,5
The DSAMH provides the following services:
For more information on services please access the DSAMH website, http://dsamh.utah.gov/substance-use-disorders/.
Nationally, the most common reasons that people who need and seek treatment do not receive it are: they have no health insurance and cannot afford the cost; they are not ready to stop using; they did not know where to go for treatment; they had health coverage but did not cover treatment or did not cover cost; or they had no transportation or it was inconvenient.10
1. Substance Use Disorders, downloaded on 6/1/2015 from
http://www.samhsa.gov/disorders/substance-use.
Why It's Important
Leading causes of death are at least partially caused by the abuse of alcohol, tobacco, or other drugs. Chronic liver disease, unintentional injuries, and suicide are associated with alcohol use; chronic lower respiratory disease and influenza and pneumonia are associated with tobacco use; heart disease, malignant neoplasms, and cerebrovascular disease are associated with both alcohol and tobacco use; and unintentional injuries and suicide are associated with the use of other drugs.In Utah, alcohol is the most commonly abused substance. Over 16,000 individuals receive publicly funded treatment for substance use. More Utahns die from unintended prescription drug overdoses than motor vehicle accidents.2
2. Substance Abuse, downloaded on 6/1/2015 from
http://hs.utah.gov/agencies/substance-abuse/.
What Is Known
According to the Utah Division of Substance Abuse and Mental Health (DSAMH) over 16,000 individuals were served in substance use disorder treatment in 2014. More men than women received services. The age group with the highest rate of admissions was ages 25-34 years. When looking at per capita rates of people per 1,000 population, American Indian/Alaskan Native individuals had the highest rate of substance use disorder treatment, with Black/African American individuals having the second highest rate per capita. Most people admitted for substance abuse disorder treatment lived on their own and were unemployed. Almost 75% had a high school education level or less than high school level. Over 50% had never been married.3Deaths attributable to prescription opioid overdoses have more than tripled since 1999.4 The rate of opioid overdose deaths has been rising for Americans regardless of age or race. Utah is particularly affected by prescription opioids. Utah unintentional deaths attributable to prescription pain medication increased over 500% during 1999-2007.5 Most Utahns who die a drug-related death suffer from chronic pain and take prescribed pain medications.6
This epidemic of opioid poisonings is strongly related to widespread and rising prescription opioid misuse and abuse. An estimated 12 million Americans over age 12 misused prescription opioids during the year 2010.4 In a 2008 Behavioral Risk Factor Surveillance Survey, 24.5% of Utahns reported using some type of prescribed opioid during the previous year.7 Prescription opioid therapy, chronic non-cancer pain, high dose prescription opioids, and multiple prescriptions/pharmacies have been implicated as risk factors for overdose death.4,5
3. DSAMH 2014 Annual report,
http://dsamh.utah.gov/pdf/Annual%20Reports/2014%20Annual%20Report%20Final%20Web%201_27_15.pdf.
4. Opioid overdoses in the United States. Journal of pain and palliative care pharmacotherapy. 2012;26(1):44-7. PubMed PMID: 22448941. Epub 2012/03/28. eng.
5. Lanier WA, Johnson EM, Rolfs RT, Friedrichs MD, Grey TC. Risk factors for prescription opioid-related death, Utah, 2008-2009. Pain Med. 2012 Dec;13(12):1580-9. PubMed PMID: 23137228. Epub 2012/11/10. eng.
6. Paulozzi LJ, Kilbourne EM, Shah NG, Nolte KB, Desai HA, Landen MG, et al. A history of being prescribed controlled substances and risk of drug overdose death. Pain Med. 2012 Jan;13(1):87-95. PubMed PMID: 22026451. Epub 2011/10/27. eng.
7. Porucznik CA, Johnson EM, Sauer B, Crook J, Rolfs RT. Studying adverse events related to prescription opioids: the Utah experience. Pain Med. 2011 Jun; 12 Suppl 2:S16-25. PubMed.
4. Opioid overdoses in the United States. Journal of pain and palliative care pharmacotherapy. 2012;26(1):44-7. PubMed PMID: 22448941. Epub 2012/03/28. eng.
5. Lanier WA, Johnson EM, Rolfs RT, Friedrichs MD, Grey TC. Risk factors for prescription opioid-related death, Utah, 2008-2009. Pain Med. 2012 Dec;13(12):1580-9. PubMed PMID: 23137228. Epub 2012/11/10. eng.
6. Paulozzi LJ, Kilbourne EM, Shah NG, Nolte KB, Desai HA, Landen MG, et al. A history of being prescribed controlled substances and risk of drug overdose death. Pain Med. 2012 Jan;13(1):87-95. PubMed PMID: 22026451. Epub 2011/10/27. eng.
7. Porucznik CA, Johnson EM, Sauer B, Crook J, Rolfs RT. Studying adverse events related to prescription opioids: the Utah experience. Pain Med. 2011 Jun; 12 Suppl 2:S16-25. PubMed.
Who Is at Risk
According to the Utah Division of Substance Abuse and Mental Health (DSAMH) over 16,000 individuals were served in substance use disorder treatment in 2014. More men than women received services. The age group with the highest rate of admissions was ages 25-34 years. When looking at per capita rates of people per 1,000 population, American Indian/Alaskan Native individuals had the highest rate of substance use disorder treatment, with Black/African American individuals having the second highest rate per capita. Most people admitted for substance abuse disorder treatment lived on their own and were unemployed. Almost 75% had a high school education level or less than high school level. Over 50% had never been married.8
8. DSAMH 2014 Annual report,
http://dsamh.utah.gov/pdf/Annual%20Reports/2014%20Annual%20Report%20Final%20Web%201_27_15.pdf.
How To Reduce Risk
There is a large body of evidence on effective strategies to prevent excessive alcohol use and alcohol-related harm. In the past decade, this evidence base has been the subject of numerous systematic expert reviews to assess the quality and consistency of the evidence for particular strategies; and to make recommendations based on this evidence. These expert reviews have recently been summarized by the NMDOH. The following list summarizes the evidence-based prevention strategies; and to make recommendations based on this evidence. In Utah, DSAMH supports the Communities that Care prevention coalition to provide prevention services.9The DSAMH provides the following services:
- Statewide, 13 local substance abuse authorities offer services to individuals and their families
- Services include education, prevention, early intervention, treatment and recovery support
- Multiple prevention programs are available to individuals of all ages, families, schools, and communities
- 50 drug courts are operated statewide, offering nonviolent, drug abusing offenders with intensive, court-supervised drug treatment as an alternative to jail or prison
For more information on services please access the DSAMH website, http://dsamh.utah.gov/substance-use-disorders/.
Nationally, the most common reasons that people who need and seek treatment do not receive it are: they have no health insurance and cannot afford the cost; they are not ready to stop using; they did not know where to go for treatment; they had health coverage but did not cover treatment or did not cover cost; or they had no transportation or it was inconvenient.10
9. DSAMH 2014 Annual report,
http://dsamh.utah.gov/pdf/Annual%20Reports/2014%20Annual%20Report%20Final%20Web%201_27_15.pdf
10. Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. Downloaded on 6/18/2015 from http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf.
10. Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. Downloaded on 6/18/2015 from http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf.
How It's Tracked
Mental Health data can be obtained from both mortality as well as morbidity data sources:- Mortality data provides on 100% alcohol- and drug-induced deaths and drug overdoses.
- The Centers for Disease Control and Prevention (CDC) funded the development of the Alcohol-Related Disease Impact (ARDI) methodology that applies attributable fractions to underlying causes of death to arrive at the estimated number of deaths that were alcohol-related.11
- Adult prevalence data come from Behavioral Risk Factor Surveillance System (BRFSS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
- Youth prevalence data come from Youth Risk and Resiliency Survey (YRRS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
- Hospital Discharge Data (HDD) for inpatient and ED visits relating to substance abuse disorders.
11. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI).
Downloaded from
https://nccd.cdc.gov/DPH_ARDI/default/default.aspx on Jan 5, 2015.
Binge Drinking (5+ drinks for men, 4+ drinks for women) - Adults (BRFSS)
- Binge Drinking - Crude Rates
- Binge Drinking - Age-adjusted Rates
- Frequency of Binge Drinking - Mean
- Intensity of Binge Drinking - Mean
Heavy Drinking - Adults (BRFSS)
Current Alcohol Use - Adults (BRFSS)
Drinking and Driving - Adults (BRFSS)
Alcohol Use and Pregnancy (PRAMS)
Substance Abuse Among Youth (YRBS)
- Rode With a Driver Who Had Been Drinking Alcohol
- Drove After Drinking Alcohol
- Current Alcohol Use
- Episodic Heavy Drinking
- Offered, Sold, or Given an Illegal Drug on School Property
Emergency Department Encounters for Primary Care Sensitive Conditions: Alcohol Related and/or Drug Related
Adverse Childhood Experiences (ACEs) - Adults (BRFSS)
- August 2023 Utah health status update: Fatal fentanyl facts--opioid health status report for Utah
- Alcohol Use Fact Sheet
- October 2019 Spotlight: Opioid Public Data Dashboard Coming Soon
- Opiate Overdose Outreach Pilot Program Legislative Report
- September 2019 Spotlight: Misapplication of the CDC Guidelines on Prescribing Opioids
- September 2019 Spotlight: Opioid Crisis Planning
- Special Edition Spotlight: Opioid Epidemic, Medical Cannabis and Medicaid Expansion: Impacts to American Indian/Alaska Native communities in Utah
- July 2019 Spotlight: Medicaid Coverage of Residential Treatment for Substance Abuse Disorder
- May 2019 Spotlight: Addressing the Co-epidemics of Substance Abuse and Disease Transmission in Utah
- DataByte: Opioid and Other Pain Medication Use in Utah
- Utah Opioid Overdose Fatality Review Recent Release Report
- Utah Opioid Overdose Fatality Review Hot Spots Report
- February 2019 Utah Health Status Update: Opioid Overdose Deaths by Occupation Groups in Utah, 2012-2017
- February 2019 Breaking News: Utah Medicaid Adopts Additional Limits on Opioid Prescriptions
- February 2019 Community Health Spotlight: Utah Coalition for Opioid Overdose Prevention (UCO-OP)
- January 2019 Utah Health Status Update: Current Marijuana Use in Utah
- Utah Health Improvement Plan (UHIP) Priority Update: Reducing Prescription Drug Misuse, Abuse and Overdose
- Gabapentin and Prescription Opiods Report 2018
- June 2018 Utah Health Status Update: Hepatitis C Prevention as Part of a Harm Reduction Strategy
- Excessive Alcohol Use in Utah
- March 2018 Breaking News: Excessive Alcohol Use and Related Harms
- January 2018 Utah Health Status Update: Utahns, Being Among the Healthiest People in the Nation - Progress Review
- November 2017 Community Health Spotlight: Utah Syringe Exchange Program
- October 2017 Utah Health Status Update: Fentanyl Abuse in Utah and Risks to First Responders
- September 2017 Utah Health Status Update: Initial Diagnosis of Opioid Naive Patients
- Prescription Opioid Deaths Factsheet
- November 2016 Health Status Update: Prescribing Practice in Utah
- November 2016 Breaking News: Fentanyl and Naloxone
- November 2016 Community Health Spotlight: Syringe Exchange Programs
- Addictive Behaviors (from Utah State Health Assessment 2016 Report)
- September 2016 Utah Health Status Update: Tobacco and Alcohol Use Among Utah Youth - 2015
- Opioid Prescribing Practices in Utah
- Prescription Opioid Deaths Factsheet
- September 2015 Utah Health Status Update: Industry and Occupation Impact on Health
- Utah's Healthiest People Priorities Report
- Adult Use of Prescription Opioid Pain Medications--Utah, 2008 (MMWR Vol. 59 No. 6, February 19, 2010)