BACKGROUND: Alcohol alone can cause harmful side effects, and the same is true for opioids. When taken in combination, alcohol and opioids, both of which have a sedative effect on the body, can be lethal. Even taking opioids as prescribed with a small amount of alcohol can lead to dangerous side effects. With the increase in opioid overdose deaths, North Carolina began assessing the number of deaths involving both an opioid and alcohol.
METHODS: Unintentional medication/drug poisoning deaths were identified from Vital Records death certificate data using ICD–10 underlying cause-of-death codes X40–X44. Opioid poisoning deaths are medication/drug poisoning deaths with a multiple cause-of-death code of T40.0, T40.1, T40.2, T40.3, or T40.4. Opioid poisoning deaths that involve alcohol have an additional multiple cause-of-death code of X45, Y15, T51, X65, or R780.
RESULTS: The rate of unintentional medication/drug poisoning deaths involving both an opioid and alcohol has increased from 0.24 per 100,000 residents in 2000 to a rate of 1.2 per 100,000 residents in 2015. In 2000, 9.4% of all unintentional opioid deaths involved alcohol compared to 12.4% in 2015. The authors are in the process of assessing any differences between prescription opioid deaths involving alcohol and heroin deaths involving alcohol.
CONCLUSIONS: Rates of unintentional medication/drug overdose involving both an opioid and alcohol have steadily increased in North Carolina over the last 16 years. While percent of opioid deaths involving alcohol varied over the study period, since 2012 at least 10% of opioid deaths have involved alcohol. Our results indicate that alcohol involvement in opioid overdose deaths is a consistent problem and that there is a need for increased awareness of the dangers of taking an opioid in combination with alcohol.