The number of drug overdose deaths in the US increased by 21% last year, according to new statistics – with synthetic-opioid fatalities more than doubling in number.
The National Center for Health Statistics, a division of the Centers for Disease Control and Prevention, (CDC) estimates that drug overdoses killed 64,070 people in the US last year, a rise of 21% over the 52,898 drug overdose deaths recorded in 2015.
The epidemic of drug overdoses is killing people at almost double the rate of both firearm and motor vehicle-related death.
The statistics posted on the CDC website are the latest available on the gathering opioid crisis. The agency says they will be updated on a monthly basis.
Much of the increase in fatalities is blamed on the synthetic opioid fentanyl, which is typically used for pain management during surgery or in end-of-life settings and has a marked depressive effect on the respiratory system.
Along with other synthetic opioids, it is blamed for 20,145 deaths last year, significantly above the 15,446 attributed to heroin or the 14,427 attributed to opioid pills alone. The figure for synthetic opioids in 2015 was 9,945.
According to analysis published in the CDC’s 31 Auguse edition of Morbidity and Mortality Weekly, “approximately half of the increase in deaths involving heroin after 2013 is attributable to increases in deaths involving use of both heroin and fentanyl”.
The CDC journal concluded that the opioid overdose epidemic resulted in the deaths of approximately 300,000 people in the US during 1999–2015, including 33,000 in 2015.
“The first wave of deaths began in 1999 and included deaths involving prescription opioids. It was followed by a second wave, beginning in 2010, and characterized by deaths involving heroin. A third wave started in 2013, with deaths involving synthetic opioids, particularly illicitly manufactured fentanyl (IMF). IMF is now being used in combination with heroin, counterfeit pills, and cocaine.”
A Drug Enforcement Agency intelligence brief published in July called fentanyl a “global threat”.
Last week, White House drugs czar Michael Botticelli backed calls for a ban on the high-strength opioid painkillers widely blamed for creating a pain-management crisis that led to increased demand for heroin, now overwhelmingly smuggled from Mexico, and fentanyl, now largely imported from labs in China, according to DEA analysis.
The latest CDC figures show that the rate of increase in deaths from natural or semi-synthetic opioid pills was much less steep than that for synthetic opioids, rising from 12,726 in 2015 to 14,427 last year.
The national data also showed an increase in deaths attributed to stimulants such as cocaine – up from 6,986 to 10,619 – and psychostimulants such as methamphetamine, up from 5,922 to 7,663, year-on-year.
Underscoring the overall shift, Ohio last week reported that overdose deaths in 2016 rose 33% to 4,050 from 3,050 in 2015, or roughly 11 a day. It attributed the rise to fentanyl and carfentanil, an analgesic 5,000 times more powerful than heroin used to sedate elephants.
By contrast, the state said that heroin-related deaths were leveling off, and deaths from prescription painkillers fell for fifth straight year.
Other states, including hard-hit Massachusetts, report that opioid-related overdose deaths are declining, even as fatal fentanyl overdoses (termed T40.4 by CDC nosologists) continue to increase.
In May, Massachusetts reported that fentanyl had overtaken heroin as the cause of most overdose deaths. In the last three months of 2016, heroin was present in only a third of deaths that had a toxicology screen. A year earlier, heroin was the leading cause of overdose death. Of 1,899 recorded opioid related deaths last year, 69% tested positive for fentanyl.
The national figures showed striking regional differences in the rate of increase in overdose deaths. For deaths attributed to fentanyl, states and jurisdictions including Maryland, New York City and Virginia recorded significant increases.
Of the 22 reporting jurisdictions included in the release, some states, including Nebraska, Washington and Wyoming, recorded reductions in drug overdose deaths of up to 8%.
The statistical agency warns that the latest figures only reflect the percentage of death records available for analysis. Since drug overdose deaths are often initially reported with no specific toxicology, final numbers will be released at a later date.