Margaret Chase Smith
Policy Center

5784 York Complex Bldg. #4
Orono, Maine 04469-5784
Fax: 207-581-1266
mcspolicycenter.umaine.edu

March 7, 2016
To:
Fr:
Cc:

Janet Mills, Attorney General
Marcella Sorg, PhD
Mark Flomenbaum, MD
Margaret Greenwald, MD
Clare Bryce, MD

Re:

Drug deaths January-December 2015 statewide brief update

A “drug death” is identified when one or more drugs are mentioned on the death
certificate as a cause or contributing factor. Most drug deaths in Maine during the
last decade are caused by two or more drugs. In this analysis, deaths known to be
due to pharmaceutical fentanyl and pharmaceutical morphine have been excluded
from totals for illicit fentanyl and heroin. Heroin very often cannot be discriminated
from morphine in toxicology, so many death certificates mention heroin/morphine
as the cause, although we know most of these are probably heroin deaths, based on
other evidence. In this analysis, after known pharmaceutical morphine deaths were
removed, “heroin” and “heroin/morphine” deaths were combined in one “heroin”
total.


In 2015 there were 272 drug-induced deaths statewide, 31% more than in 2014,
which had 208. The increase in drug deaths during 2015 continues a multi-year
rise in deaths due to heroin and non-pharmaceutical fentanyl, sometimes in
combination with each other. During the second half of the year there were 20%
more deaths due to non-pharmaceutical fentanyl and acetyl fentanyl than in the
first half of the year, and 5% more deaths due to heroin in the second half
compared to the first half.



157 (58%) of the 272 total drug deaths were due either to heroin (107 deaths,
39% of all drug deaths) and/or non-pharmaceutical fentanyl or acetyl fentanyl
(87 deaths, 32% of all drug deaths) with a wide variety of co-intoxicant
combinations with other drugs or alcohol. Of the 87 deaths due to fentanyl
and/or acetyl fentanyl, 74 were due to fentanyl and 32 to acetyl fentanyl (19 of
these deaths were due to a combination of fentanyl and acetyl fentanyl).



111 (41%) of the 272 deaths were due to pharmaceutical opioids (drugs used
medically for pain control), usually in combination with other drugs. The
number of these deaths is up slightly from 101 in 2014.

 DEMOGRAPHICS
 Of the 272 deaths, 182 (67%) were male, and 33% female, continuing the same
pattern as previous years.


The ages of the decedents ranged from 18-89, mostly under 60. The average age
was 42, slightly older than in previous years. Of the 272 decedents, 5% were 1824, 13% 25-29, 15% 30-34, 14% 35-39, 10% 40-44, 11% 45-49, 14% 50-54, 9%
55-59, and 6% 60 and over.

GEOGRAPHIC DISTRIBUTION
 Counties with 10 or more deaths
o Androscoggin, 27 deaths, 10% of statewide deaths)
o Cumberland, 86 deaths, 32% of statewide deaths
o Kennebec, 33 deaths, 12% of statewide deaths
o Penobscot, 26 deaths, 10% of statewide deaths
o York, 38 deaths, 14% of statewide deaths
o All other counties had between 1 and 9 deaths in 2015.
 Towns/Cities with 10 or more deaths
o Bangor: 13 deaths (5%)
o Lewiston: 15 deaths (6%)
o Portland 46 deaths (17%)
HEROIN DEATHS (N=107)
 94 (88%) of the 107 deaths due to heroin included at least one other drug or
alcohol mentioned on the death certificate as a cause
 24 (22%) included a pharmaceutical opiate
 36 (34%) included non-pharmaceutical fentanyl or acetyl fentanyl
 30 (28%) included alcohol
 28 (26%) included a benzodiazepine
 23 (22%) included cocaine
NON-PHARMACEUTICAL FENTANYL AND ACETYL FENTANYL DEATHS (N=87)
 Of the 87 deaths due to either non-pharmaceutical fentanyl or acetyl fentanyl,
o 78% of fentanyl/acetyl fentanyl deaths included at least one other drug
or alcohol
 36 (42%) included heroin
 19 (22%) included both fentanyl and acetyl fentanyl
 11 (13%) included a pharmaceutical opiate
 17 (20%) included a benzodiazepine
 20 (23%) included alcohol
 13 (15%) included cocaine

 Total Number of Maine Deaths due to Pharmaceutical
Opioids, Illicit Drugs, and Total Drug Deaths, Alone or
in Combination
300

250

200

150

100

50

0

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Total
34 54 66 60 90 165 153 162 176 167 154 164 179 167 155 163 176 208 272
Pharm Opioid 16 31 34 39 49 124 116 114 113 105 111 115 121 124 108 96 107 104 111
Illicit
8
18 13 15 31 35 47 50 61 59 49 30 22 17 20 43 40 75 163

 Number of Deaths due to Key
Pharmaceuticals Alone or in Combination
90
80
70
60

50
40
30

20
10
0
Oxycodone
Methadone
Benzodiazepines

2009
50
48
56

2010
48
50
57

2011
34
41
39

2012
42
31
47

2013
32
37
63

2014
42
30
70

2015
37
38
77

 Number of Heroin & Non-Pharmaceutical
Fentanyl Deaths 2015 by Age and Sex
200
180
160
140
120
100
80
60
40
20
0

182

90
67

53
4
Sex

14

4

Age 18-24
Male

Age 25-44
Female

10
Age 45+

 Number of Deaths due to Key Illicit Drugs
Alone or in Combination
120
100
80
60
40
20
0

Heroin **
Non-Pharm. Fentanyl,
Acetyl Fentanyl
Cocaine

2009
13

2010
7

2011
7

2012
29

2013
34

2014
58

2015
107

5

6

10

8

9

42

87

9

10

13

13

10

24

34

** Heroin very often cannot be discriminated from morphine by toxicology, so many death certificates mention
heroin/morphine as the cause, although most are probably heroin deaths, based on other evidence. In this analysis, after
known pharmaceutical morphine deaths were removed, “heroin” and “heroin/morphine” deaths were combined in one
“heroin” total.

 Number of Drug Deaths in Five Largest Counties
100
90
80
70
60
50
40
30
20
10
0

2009
2010
2011
2012
2013
2014
2015

Androscoggin
17
15
12
17
14
26
27

Cumberland
45
39
29
49
46
43
86

**Kennebec had fewer than 10 deaths in 2009.

Kennebec**
0
23
18
12
26
20
33

Penobscot
25
19
21
18
21
20
26

York
32
24
19
22
21
37
38

 Heroin and Non-Pharmaceutical Fentanyl
County Death Rates for 2013-2015
Age-Adjusted Rate per 100,000
Cumberland

10.69

York

9.47

Androscoggin

9.08

Kennebec

7.08

Penobscot

5.81
0

2

4

6

8

10

12