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Overdose Deaths from Fentanyl Rise Steadily

While many Americans are ready to leave the twin pandemics of COVID-19 and opioid overdose behind, statistics show that, at least for deaths from overdose, the situation is getting worse, not better. And the increase, according to the latest statistics from the Centers for Disease Control and Prevention, is not due to prescription opioids, but to greater use of fentanyl, methamphetamine, and cocaine.

According to the CDC, “there were an estimated 107,622 drug overdose deaths in the United States during 2021, an increase of nearly 15% from the 93,655 deaths estimated in 2020.” While the increase was only half of what it was between 2019 and 2020, it represents the second straight year of increase, coinciding with the COVID-19 pandemic, and follows a 3-year plateau in annual deaths between 2017 and 2019.

Fentanyl was responsible for 57,834 overdose deaths in 2020, and 71,238 deaths in 2021, an increase of 23% in a single year. That trend follows from data first released in the Quest Diagnostics Health Trends Report, “Drug Misuse in America,” released in the fall of 2021. In that report, Quest researchers showed that positivity rates increased by 35% for non-prescribed fentanyl (from 4.3% prior to the pandemic to 5.8% during the pandemic) and 44% for heroin (from 0.9% to 1.3%). Non-prescribed fentanyl was also widely detected in results of tests for other drugs, including amphetamines, prescription opioids, and cocaine.

Perhaps even more troubling, for patients receiving medications for opioid use disorder, the percent of tests indicating presence of non-prescribed fentanyl rose from 26.7% at the end of 2019 to 40.5% in early April of 2020, the early days of the COVID-19 pandemic.

Data for the Health Trends Report was drawn from nearly 5 million deidentified laboratory tests performed by Quest Diagnostics from 2011 through 2020 for patients in all 50 states and the District of Columbia.

“As recently as 2018, it appeared that drug overdoses were on the decline for the first time in over a decade,” wrote the authors of that report, Jay G Wohlgemuth, MD, Harvey Kaufman, MD, and Creighton Drury. “Sadly, this improvement was short-lived. Amid the pandemic’s days of self-isolation, delayed medical care, economic dislocation, and mental distress, drug misuse surged.” Dr Wohlgemuth is senior vice president, R&D and Medical, and chief medical officer for Quest Diagnostics. Dr Kaufman is senior medical director and director, Health Trends Research Program for Quest Diagnostics. Mr. Drury is chief executive officer of Partnership to End Addiction.

The widespread use of other illicit drugs is also reflected in the new fatal overdose statistics. Between 2020 and 2021, deaths from psychostimulants (chiefly methamphetamine) rose by 34% (from 24,576 to 32,856), and deaths from cocaine rose by 23% (from 19,927 to 24,538). Meanwhile, deaths from prescription opioids fell by about 1%, from 13,722 to 13,503, possibly reflecting efforts to reduce prescription opioid misuse through education, state monitoring programs, and other activities.

States with the largest increase in fatal overdoses include Alaska, Idaho, and South Dakota, while other states, including Virginia, West Virginia, and Ohio, saw a decline in deaths. 

The complete data can be seen on the CDC’s website here: Users of the Firefox browser may have difficulty with some features of the data display.

Centers for Disease Control and Prevention, National Center for Health Statistics. “U.S. Overdose Deaths in 2021 Increased Half as Much as in 2020 – But Are Still Up 15%”, May 11, 2022.

Centers for Disease Control and Prevention. “Death Rate Maps & Graphs. Drug Overdose Deaths Remain High.”

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