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(Trends Wide) — Drug overdose deaths in the United States have risen to record levels during the Covid-19 pandemic, and a new report from the US Centers for Disease Control and Prevention details the deadly rise in use. of fentanyl.
CDC typically reports overdose data by broader drug categories. Fentanyl, for example, is grouped with other synthetic opioids such as tramadol and nitazenes. But for the report released Wednesday, researchers took a closer look at the specific drugs listed on the death certificates of people who died of overdoses, highlighting demographic differences.
Nearly 70,000 people in the United States died from drug overdoses involving fentanyl in 2021, a nearly four-fold increase in five years. By 2021, roughly two-thirds of all overdose deaths involved the powerful synthetic opioid, according to the report. Several drugs can be reported on a death certificate, and fentanyl is often found along with others, according to the CDC.
Specific information about the drugs involved in fatal overdoses is essential to assess the effects of drug policy and to guide treatment programs, experts say.
“We need to know exactly what people are dying of in order to know what services they need to stay alive,” said Caleb Banta-Green, a research professor at the Institute for Alcohol, Drug and Addiction at Washington University School of Medicine, who was did not participate in the new report.
Understanding the different sources of drugs, such as prescription tramadol versus illicit fentanyl, and the modes of ingestion are essential factors, he said. They can give additional information about who is using and the relative addiction and overdose potential.
The use of fentanyl and opioids
Pharmaceutical fentanyl is a synthetic opioid intended to help patients, such as those with cancer, manage severe pain. It is 50 to 100 times more powerful than morphine and is usually prescribed as a skin patch or pill. But the most recent cases of fentanyl-related harm, overdose and death in the United States are linked to illegally manufactured fentanyl, according to the CDC.
Fentanyl is significantly more likely to be involved in a fatal overdose than other common drugs, according to the new CDC report.
In 2021, fentanyl was involved in about 22 deaths per 100,000 people, more than twice the age-adjusted death rate from methamphetamine or cocaine overdose, and more than seven times that from heroin.
Fentanyl was the most common drug involved in fatal overdoses across all age groups, race/ethnicity, and gender in 2021.
For people younger than 25 and older than 65, the rate was not significantly different from other drugs. But it was exceptionally high between the ages of 25 and 44.
The rate of fentanyl overdose deaths was highest in the northeastern United States. In the Northwest, however, methamphetamine overdose deaths were similar to those from fentanyl.
This follows long-term trends in the United States, where drug use has followed different patterns in the West and the East, said Dr. Nora Volkow, director of the National Institute on Drug Abuse.
As with fentanyl, methamphetamine overdose death rates increased significantly between 2016 and 2021, according to the CDC report.
Cocaine overdose deaths also increased between 2016 and 2021, while heroin and oxycodone deaths decreased, according to the CDC report.
Overall, the report’s findings aren’t particularly surprising, Volkow said. Fentanyl is overwhelmingly mentioned in reports from emergency rooms, treatment programs, and law enforcement.
“It’s so widespread,” Volkow said.
But the quantitative data corroborate anecdotal reports and offer a way forward.
“These are some very clear statistics that I found very, very useful,” Volkow said. “Understanding these differences is crucial, because you can then target intervention to address risk.”
