Trends in licit and illicit drug-related deaths in Florida from 2001 to 2012

• Florida drug-related mortality was evaluated by time trends, demographics, and correlations.
• The majority of drug-caused deaths were accidental and the half involved polydrug use.
• Overall decline was observed in benzodiazepines- and opioids-caused deaths in 2011–2012.
• Heroin-caused mortality concurrently increased, along with morphine and hydromorphone.
• Increased mortality rates of amphetamines, zolpidem, and inhalants were of additional concern.

BackgroundFlorida, the epicenter of the recent prescription drug epidemic in the United States, maintains a statewide drug mortality surveillance system. We evaluated yearly profiles, demographic characteristics, and correlation between drug trends to understand the factors influencing drug-induced mortality.MethodsAll drug-related deaths reported to the Florida Medical Examiners Commission during 2001–2012 were included (n = 92,596). A death was considered “drug-related” if at least one drug was identified in the decedent. Depending on its contribution to death, a drug could be listed as a causative agent or merely present, but not both.ResultsRate of drug-caused deaths was 8.0 per 100,000 population in 2001, increasing to 17.0 in 2010 and then decreasing to 13.9 in 2012. Benzodiazepines had the highest mortality rate in 2010, although <10% were solely due these drugs. Opioid-caused mortality rate also peaked in 2010 and started to decline (−28%) in 2010–2012. The heroin-caused mortality rates were negatively correlated with opioids and benzodiazepines (ρ’s ≥ −0.670; P ≤ 0.034). Ethanol- and cocaine-mortality rates stabilized to 3.0–3.1 and 2.8–3.0 per 100,000 over 2009–2012, respectively. Amphetamines, zolpidem, and inhalants-caused deaths were on the rise with rates of ≤0.6 per 100,000.ConclusionsOverall declines in benzodiazepine- and opioid-caused deaths in 2011–2012 may have been related to Florida's attempts to regulate prescription drug abuse. This period, however, was also marked by a rise in heroin-caused mortality, which may reflect growing use of heroin as an alternative. Increases in amphetamines, zolpidem, and inhalants-induced mortality are an additional public health concern.