By Alex Bryant, EMS1 Contributor
Drug overdoses are the leading cause of accidental deaths in the U.S., according to the American Society of Addiction Medicine. The opioid epidemic is of particular concern right now. The more attention opioids are getting, the more commonly they are researched. Google searches for opioids have increased steadily since the start of 2016. FireRescue1 used Google Trend data to see exactly which opioids, opiate classes and related drugs have been most commonly searched in the last year. The numbers are scaled on a range of 0 (least amount of search interest) to 100 (most amount of search interest).
The 10 most searched opioid drugs and classes in the U.S.:
1. Alprazolam
Alprazolam isn’t an opioid, but a mild tranquilizer, known commercially as Xanax, used in the treatment of panic attacks and related symptoms. However, because of its calming effect, it is very often used alongside opiates to reduce distress. Recreationally it can be combined with depressants such as heroin to increase the drug’s psychological effects. alprazolam is the 14th most prescribed drug in the U.S. as of 2014 with 49.4 million prescriptions nationwide, according to the IMS Institute.
Searches for alprazolam have been much higher than searches for opioids as a drug class over the past five years, except for one large spike in June of 2016 after an epidemic of fentanyl-laced heroin hit New Haven, Connecticut and made national headlines.
2. Heroin
Heroin is an illegal opiate that is made from the opium poppy plant. While popular media usually portrays heroin being injected, it can also be snorted or smoked. Heroin is one of the most commonly-used illegal drugs in the United States.
Heroin is the top search in Michigan, Ohio, Pennsylvania, Delaware, Massachusetts, Vermont, New Hampshire and Maine. All eight states are ranked in the top half of states for drug overdose deaths.
3. Tramadol
Used to treat moderate-to-severe pain, tramadol is a narcotic-like pain reliever and was classified as a Schedule-4 drug by the FDA in 2014. As of 2014, tramadol was the 19th most prescribed drug in the U.S., with 44.2 million, up over 14 million over five years, according to the IMS Institute.
Tramadol is the third-most searched drug over the past year but has higher search volume than heroin in 19 of 50 states. It’s also been the top search in South Dakota over that time period, where in 2016 over 3 million days worth of tramadol refills were prescribed by doctors.
4. Oxycodone
For years, oxycodone was considered relatively safe by the medical community, but research has found that it can be extremely addictive. Overuse is relatively easy as patients typically gain a tolerance to oxycodone quickly, and abuse can lead to severe withdrawals if stopped, or death if overdosed by shutting down the respiratory system.
The interest on oxycodone is highest in Arizona and New Mexico states that border Mexico and where counterfeit pharmaceuticals and drug abuse is among the highest in the country.
5. Hydrocodone
Hydrocodone is the second-most prescribed drug in the United States as of 2014, with 119.2 prescriptions dispensed, according to the IMS Institute. Because of its widespread availability, it is one of the most abused drugs in the nation. It is often compared to oxycodone for its effects and risk of dependency, but until 2014 was not considered in the same class as oxycodone, when it was upgraded to a schedule II drug. Search for hydrocodone is highest in Arkansas by a wide margin, where in April the governor signed a law strengthening the monitoring of prescriptions. This measure was taken specifically with prescription and abuse of hydrocodone and oxycodone in mind.
6. Analgesic
Analgesic is a family of drugs that are used to achieve analgesia pain relief. Several of the drugs in this class include over-the-counter drugs like acetaminophen, ibuprofen and aspirin. However, it also includes many drugs on this list, including tramadol, buprenorphine, oxycodone, morphine, hydrocodone, methadone and fentanyl. Analgesic is more searched for than heroin in South Dakota, Nebraska and Arkansas. It’s generally highest in states with the largest opioid crises and is more searched than tramadol in Hawaii.
7. Methadone
While methadone is highly regulated and has similar effects to other opioids, it is actually used as a way to help decrease dependency on other narcotics by many health systems. That doesn’t prevent it from being deadly though, as it accounted for over one-quarter of opioid poisoning deaths in 2011. Searches for methadone are among the highest in the country in New England, as well as West Virginia, the top state for opioid overdose deaths.
8. Morphine
Morphine acts directly on the central nervous system to decrease feeling and limit pain. It is typically administered within a medical facility for severe and/or acute pain, such as dealing with a heart attack or during labor. While morphine is on the World Health Organization’s list of Essential Medicines, it can also be abused. Five states have higher search interest for morphine than hydrocodone: Maine, New Hampshire, Massachusetts, New Jersey and Delaware. All of which are in the top half of states for drug overdose deaths in 2015.
9. Fentanyl
Fentanyl is one of the most powerful opiates on the planet, with the National Institute on Drug Abuse estimating that it is 50 to 100 times more powerful than morphine. Fentanyl is typically used for pain control during medical procedures and is closely monitored in healthcare environments. However, when used as a recreational drug, its potency has caused over 5,000 overdoses in North America since 2013. Fentanyl showed a strong spike in June of 2016 after a massive overdose epidemic with the drug hit New Haven, Connecticut. During this news cycle, fentanyl was more searched for than even alprazolam.
10. Buprenorphine
An analgesic that can be administered in a doctor’s office or given as a prescription, buprenorphine is a semi-synthetic, opioid partial agonist. This means that while buprenorphine can produce some of the most common opioid effects, there is less euphoria and a lower ceiling on opioid effects, meaning a lower potential for misuse than stronger opioids like heroin or methadone. Buprenorphine has generally lower search volume than most other drugs on this list. However, it is an extremely much more popular search in West Virginia than any other state by a two-to-one margin over the last 12 months.
Over the past 5 years, these drugs and drug classes have seen a growth in search interest, with several taking on new life as the opioid crisis has come to the forefront. The rate of prescription drug deaths has grown from 1999 to 2008 in correlation with the number of prescriptions. We’d expect that as this crisis continues to stay in the news cycle, the searches won’t slow down, either.
