Escalating Mortality From Opioid-Related Deaths With Concurrent Gastrointestinal Complications in the United States, 2010-2020: A Population-Based Analysis

John K Appiah; Richeal Asante; Chukwunonso B Ubanatu; George S Blewusi; Ewurabena Plange-Kaye; Emmanuel K Asiedu

doi:10.7759/cureus.86489

Escalating Mortality From Opioid-Related Deaths With Concurrent Gastrointestinal Complications in the United States, 2010-2020: A Population-Based Analysis

Cureus. 2025 Jun 21;17(6):e86489. doi: 10.7759/cureus.86489. eCollection 2025 Jun.

Authors

John K Appiah¹, Richeal Asante¹, Chukwunonso B Ubanatu¹, George S Blewusi², Ewurabena Plange-Kaye³, Emmanuel K Asiedu⁴

Affiliations

¹ Internal Medicine, Geisinger Health System, Wilkes-Barre, USA.
² Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
³ Dentistry, Columbia University, New York City, USA.
⁴ Internal Medicine, Mother and Child Hospital, Accra, GHA.

Abstract

Background The opioid crisis has evolved beyond overdose deaths to include complex medical complications. Gastrointestinal (GI) complications represent a significant but underexplored aspect of opioid-related mortality. This study aimed to characterize trends in opioid-related deaths with concurrent GI complications in the United States from 2010 to 2020. Methods We conducted a retrospective, population-based analysis using mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database and the Global Burden of Disease (GBD) Study 2021. Opioid-related deaths were identified using ICD-10 codes T40.0-T40.4 and T40.6 (opium, heroin, other opioids, methadone, and synthetic and unspecified narcotics) in combination with K25-K28 (peptic ulcers), K56.0-K56.7 (intestinal obstruction), K59.0 (constipation), and K92.0-K92.2 (GI hemorrhage). Background GI mortality rates were obtained from GBD. Crude and age-adjusted mortality rates were calculated, and trends were analyzed using descriptive statistics. Results From 2010 to 2020, opioid-related deaths with GI complications increased by 218.6%, from 22,040 deaths (7.15 per 100,000) to 70,222 deaths (21.31 per 100,000). Males experienced disproportionately higher mortality rates (16.31 per 100,000) compared to females (7.76 per 100,000). West Virginia demonstrated the highest mortality rate (37.85 per 100,000), followed by Ohio (23.48 per 100,000) and Maryland (23.19 per 100,000). The steepest increases occurred between 2015 and 2017, with an unprecedented surge in 2020. Conclusions Opioid-related deaths with concurrent GI complications represent a rapidly escalating public health crisis, with mortality rates more than tripling over the study decade. The disproportionate impact on males and concentration in Appalachian and Rust Belt states suggest that targeted interventions are urgently needed.

Keywords: epidemiology; gastrointestinal complications; mortality; opioids; public health surveillance.