WASHINGTON – Drug overdose deaths continued to rise to record highs in 2021, approaching 108,000, according to new preliminary data released Wednesday by the Centers for Disease Control and Prevention.
The nearly 15% rise followed a much steeper rise of nearly 30% in 2020, an inexorable crisis that consumed federal and state drug policy officials. The number of drug overdose deaths has increased every year, but in 2018 since the 1970s.
An increasing share of deaths have been caused by overdoses involving fentanyl, a class of potent synthetic opioids that are often mixed with other drugs, and methamphetamine, a synthetic stimulant. State health officials who battled the influx of both drugs said many of the deaths appeared to be the result of combining the two.
Drug overdoses, which long ago surpassed the peak of deaths in the country from AIDS, traffic accidents and firearms, killed about a quarter of Americans last year compared to Covid-19.
Deaths involving synthetic opioids – largely fentanyl – rose to 71,000 from 58,000, while those associated with stimulants such as methamphetamine, which grew cheaper and more lethal in recent years, it has risen to 33,000 from 25,000. Since fentanyl is a white powder, it can be easily combined with other medications, including opioids like heroin and stimulants like methamphetamine and cocaine, and can be molded into counterfeit anxiolytic pills like Xanax. Such mixtures can prove lethal if addicts are unaware that they are using fentanyl or are unsure of the dose.
Dead from both of them drug classes have increased in recent years.
But there is mounting evidence that the mixing of stimulants and opioids – in combinations known as “speedballs” and “goofballs” – is also becoming more common. Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, who studies drug markets, has just begun a multi-year study of the combination of opioids and methamphetamine.
“There’s an epidemic of intertwined synthetics like we’ve never seen before,” he said. “We have never seen a potent opioid like fentanyl mixed with such potent methamphetamine.”
The opioid crisis
From potent pharmaceuticals to illegally produced synthetics, opioids are fueling a deadly drug crisis in America.
The numbers released Wednesday are considered provisional and could change as the government examines more death records. But they added more definition to a crisis that escalated sharply during the pandemic.
The White House in recent weeks has announced the premiere of President Biden national drug control strategyAnd a plan to combat methamphetamine use, unveiled last week by its drug czar, Dr. Rahul Gupta, the first physician to oversee the White House Office of National Drug Control Policy. Deaths from methamphetamine overdose nearly tripled between 2015 and 2019 in people aged 18 to 64, according to the National Institutes of Health.
Mr. Biden is the first president to embrace harm reduction, one approach which has been criticized by some for empowering drug users, but praised by addiction experts as a way to keep addicts alive while providing access to care and support.
Instead of pushing for abstinence, the approach aims to reduce the risk of death or contracting infectious diseases by offering sterile equipment, through exchanges of needles, for example, or tools to check for fentanyl in drugs. Strips capable of detecting fentanyl have become increasingly valuable resources for local health officials, and some states have recently relocated decriminalize themalso like others resist.
The causes of the continued increase in overdoses are complex and difficult to unravel, experts said. But state health officials and some addiction experts have said that the spike in overdose, which began before the pandemic, cannot be attributed solely to the ensuing disruptions or a sharp rise in the number of Americans using drugs.
Social isolation and economic dislocation, which were rife during the pandemic, tend to cause relapses in drug use and may have contributed to the rise in overdoses. The closures in early 2020 also caused some addiction treatment providers to be temporarily closed. But the pandemic alone does not explain the recent trend.
Policy changes made during the pandemic may have helped prevent more deaths. This was stated by Regina LaBelle, an expert on addiction policy at Georgetown University soon Research found that loosening the rules to allow methadone home treatment was beneficial, along with an increase in telemedicine treatment.
“The difference in what we’re seeing now isn’t how many people are using,” said Dr. According to data released Wednesday, Anne Zink, Alaska’s chief health officer, saw the largest increase in the death rate from drug overdose of any state in the nation.
Instead, he said, the supply of fentanyl has skyrocketed, in hard-to-trace shipments, penetrating even the most isolated parts of the state. Of the 140 fentanyl overdose deaths recorded by the state in 2021, over 60 percent it was also about methamphetamine, and nearly 30 percent was about heroin.
Fentanyl, which is made in the laboratory, can be cheaper and easier to manufacture and distribute compared to heroin, increasing its appeal to drug dealers and traffickers. But because it’s strong and sold in different formulations, small differences in quantity can make the difference between an addict’s usual dose and one that proves deadly. It is especially dangerous when used unknowingly by addicts who do not usually take opioids. The spread of fentanyl to an ever-growing portion of the nation’s drug supply has continued to shock even states with strong addiction treatment services.
Often synthesized in Mexico from chemical precursors made in China, fentanyl permeated the Northeast and Midwestern heroin markets long ago. But recent data shows it has established a strong hold in the south and west as well.
“The fentanyl economy just pushed other drugs out of business,” said Dr. Joshua Sharfstein, vice president of Bloomberg School of Public Health at Johns Hopkins University. “It’s so cheap to buy fentanyl, turn around and put it in whatever.”
A recent studies of illicit pills seized by drug authorities have found that a substantial proportion of what is marketed as OxyContin, Xanax, or the drug Adderall for attention deficit hyperactivity disorder now contains fentanyl. The spread of these counterfeit pills can explain a recent strong increase in overdose deaths among adolescents who are less likely to inject drugs than elderly people.
Pat Allen, director of the Oregon Health Authority, said that, as has been the case in other states with an increase in overdose deaths, the clear difference in 2021 was the ubiquity of fentanyl. Children as young as 12 are considered high risk of getting counterfeit pills containing fentanyl, he said, e high schoolers overdose about them, believing they are opioid pain relievers or anxiolytics. The state was working to send naloxone toolkits to schools, similar to a program it used in fast food restaurants, where people overdosed in bathrooms.
Mr. Allen said he has seen an alarming phenomenon among those who overdose: they perceive that the risk of fentanyl is low, even though the actual risk is “severely higher”.
“We had an addiction problem in Oregon that we have known about for a long time,” she said. “This takes that existing addiction problem and makes it a lot more dangerous.”
Overdoses were a leading cause of death in the United States in 2021, similar to the number of people who died from diabetes and Alzheimer’s, and about a quarter of the number of people who died from Covid-19, the third leading cause of death. according to the CDC
According to Kelly Dougherty, deputy health commissioner of the state, Vermont, 93% of opioid deaths in 2021 were related to fentanyl.
“In the early stages of the pandemic, we were attributing the increase to the disruption of life,” he said. But now, he added, a different explanation seems clear: “What is really the main factor is the presence of fentanyl in the drug supply.”
The state is celebrated “hub and spoke” model. addiction treatment and its aggressive use of drug-assisted treatment programshe said, they weren’t enough to deal with the ease and speed with which people overdose on fentanyl.
“You can have the most robust treatment system,” he said, “and not everyone will take advantage of it when they maybe should, or before they overdose.”
And fentanyl is found in counterfeit pills, Ms. Dougherty said, also on OxyContin.
He said Vermont officials gathered new public messages about fentanyl.
“Just assume it’s everywhere,” he said.