In the United States, drug overdose deaths soar by nearly 30% in 2020, thanks to synthetic opioids

“This is a startling number, even for those of us who have followed this issue,” said Brendan Saloner, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “Our public health tools have not kept pace with the urgency of the crisis.”

The surge, according to 2020 data, was largely due to an overgrowth of fentanyl, a potent synthetic opioid whose use has spread across the country. The pandemic has amplified the overdose epidemic, resulting in social isolation, trauma and job losses, according to addiction experts and treatment providers. Overdose deaths started to increase in the fall of 2019 with the spread of fentanyl, but really took off from March 2020, when closures due to a pandemic and physical distancing measures were put in place. “It’s really one of those things where 2020 supercharged something that was already madly out of control,” Dr. Saloner said.

Fentanyl, which is 50 times more potent than heroin, is now frequently mixed with other widely used illicit drugs, often without the knowledge of the user. “Fentanyl is poisoning our drug supply,” said Monique Tula, executive director of the National Harm Reduction Coalition, an organization that advocates for people who use drugs and trains harm reduction staff.

An estimated 57,550 people have died of overdoses of synthetic opioids, mainly fentanyl, an increase of more than 54% from 2019, according to Robert Anderson, head of the mortality statistics branch at the National Statistics Center of CDC health. “Fentanyl is definitely the determining factor,” he said. Opioid overdose deaths have increased by almost 37% overall, according to CDC data.

Deaths from methamphetamine and cocaine overdoses have also increased, the CDC said.

“I remember thinking 30,000 was an incredible number,” Dr. Anderson said. “Now there are three times as many of us. It’s crazy. ”The final data on overdose deaths will likely be released in December, he said.

Deaths from drug overdoses form double public health crisis with Covid-19 and show how the human toll of the pandemic extends far beyond the estimated 377,883 deaths in the United States involving this disease in the year last. Covid-19 was the third leading cause of death in the United States in 2020, after heart disease and cancer, according to preliminary mortality data. Unintentional injuries, which include drug overdoses, were the fourth cause.

Overdose deaths are helping to reduce life expectancy in the United States, which may have suffered the largest drop last year since 1943, during World War II.

The CDC is expected to release preliminary life expectancy data for 2020 next week.

Many people who were in or wanted drug treatment could not get it in the first weeks or months of the pandemic, or faced service interruptions or changes, providers say treatment. Job losses or the deaths of family and friends have created stress and trauma, while office and business closures have reduced social interactions, depriving some of the coping mechanisms on which they are counting. Some people found themselves homeless, on the streets, where they had difficulty accessing treatment, Tula said.

“It’s about isolation, life disruption, and possibly exacerbation of mental health symptoms,” said Adam Maslowski, outpatient clinic coordinator at treatment provider Phoenix House in Long Island City, NY, who switched to telehealth services at the start of the pandemic. but also maintained a walk-in clinic open.

“A lot of people like Zoom, but there is something about face to face contact,” he said. The provider has been offering in-person and virtual care since last summer.

While whites account for the majority of drug overdose deaths, they have increased in recent years among blacks.

In Minnesota, the drug overdose death rate among blacks was nearly double that of whites in 2019, according to a report from the Minnesota Department of Health. Mary DeLaquil, author of the report and department epidemiologist, said that while that data is not yet available for 2020, she does not expect any improvement. “I feel pretty confident saying it’s not going to go down in 2020,” she said. “In Minnesota and nationally, we are seeing an increase in drug overdoses at all levels.”

Tiffany Sales had taken and quit drugs her entire adult life when she walked into a casino bathroom early one morning in the first week of January this year in Atlantic City, New Jersey, her hometown. The 52-year-old former dealership operator was later found dead with a crack pipe in her hand, her sister, Lisa C. Oliver, said.

Ms Sales had weaned off drugs several times and held supervisory positions when she was clean, said Dr Oliver, an instructional designer for a healthcare system and grief counselor who lives in Atlanta. Normally in sporadic contact with members of her family, Ms. Sales had reached out at the start of the pandemic. “She left a voicemail saying, with everything going on, I want to keep in touch,” Dr Oliver recalls.

The rising death toll indicates the need for urgent and comprehensive measures to deal with the crisis, public health and treatment experts have said. States, cities and counties should use the money they are supposed to receive in legal settlements against opioid manufacturers and distributors for treatment and prevention programs, including investments to help reduce disparities in communities of color, Ms. Tula said.

The priority now should be helping people at high risk for overdose, said Dr Saloner. Then more steps should be taken to make it easier to access treatment for people who need it, he said. They include making treatment available at pharmacies and community clinics, and removing limits on the number of patients that providers can prescribe with drugs for opioid use disorders.

“We have to try all of these things,” he said. ” It’s too late. “

Write to Betsy McKay at [email protected]