Sedative use linked to majority of SLO County’s drug-related deaths, study finds

As the epidemic of opioid addiction plagues the nation, a first-of-its kind report by the San Luis Obispo County Health Agency found that the use of sedatives — anti-anxiety medications, antihistamines and sleeping aids — is linked to the vast majority of local drug-related deaths.

The report released last month examined concentrations of different types of legal and illegal drugs found in the systems of San Luis Obispo County residents who died over a three-year period and whose bodies were examined through toxicology screenings by the county Sheriff-Coroner’s Office.

Of the 6,699 deaths that occurred in the county between April 1, 2015, and March 31, 2018, the Coroner’s Office requested toxicological analysis in 732 of those cases to assist with determining the cause of death.

According to the report, 679 people — about 93 percent of the screened cases — tested positive for opioids such as oxycodone or heroin; stimulants such as methamphetamine, cocaine and ephedrine; and sedatives, such as benzodiazepines, antihistamines and sleeping pills, or any combination of the three.

Such deaths are classified as drug-related, where drugs are present in the decedent’s system, but not necessarily the cause of the death. County epidemiologist Ann McDowell said that of the county’s 679 drug-related deaths, 186 — roughly a quarter — were actually caused by a drug overdose.

Of the 679 deaths with positive toxicology screens, 183 (27 percent) tested positive for opioids alone or in combination of other drugs, and 141 (20 percent) tested positive for stimulants alone or with other drugs. But sedatives were found in 658 people — 96 percent — either alone or with other drugs.

Sedatives were the most commonly found drug type among the toxicology samples; 57 percent of the cases tested positive for sedatives only, and an additional 28 percent were found in combination with an opiate.

Of the 658 who tested positive for sedatives, 26 percent had toxic levels of the drugs in their blood.

The report notes that what’s considered a toxic dose may be lethal to a casual user, but some users may build up tolerance to drugs so that a typically lethal level may not necessarily be toxic to them.

The report also found that both stimulants and opiates were commonly found with sedatives; only 1 percent of the drug-related deaths involved only opiates or stimulants.

“We have an opioid epidemic, that’s clear. But it’s interesting (to note) the high proportion of (sedative-related deaths) as well, and in combination with other drugs. ” McDowell said. “It appears we need to caution people.”

In its report, the Health Agency also examined demographics of the drug-related death cases within the three-year period. Of the 679 drug-related deaths, 440 (65 percent) were male and 239 were female.

It found that males were significantly more likely to have stimulants and sedatives in their systems, while females were more likely to have stimulants and opioids in their system.

Opioids were found to be abused almost equally by men (53 percent) and women (47 percent).

Age-wise, a majority (33 percent) of the drug-related deaths fell into the 55- to 64-years-old category, followed by 45 to 54 years old (25 percent) and 65 to 74 (23 percent).

Alcohol also plays a significant factor in premature deaths of county residents, and about 25 to 30 percent of drug-related deaths involved alcohol use.

McDowell said that the report represents a baseline study that the county can use in the future to evaluate fluctuations in the types of drugs that contribute to mortality in San Luis Obispo County.

Unlike opiates, whose use the U.S. Department of Health and Human Services says has become an epidemic across the country, and stimulants, many of which are illegal, sedatives can be easily overlooked in terms of their health risk, McDowell said, as many are everyday, over-the-counter substances.

“Sedative use is so pervasive,” McDowell said. “And it’s contributing to deaths.”

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This story was originally published August 25, 2018 at 1:08 PM.