Overdose deaths continue to rise, with fentanyl and meth leading culprits


WASHINGTON — Drug overdose deaths continued to rise to record levels in 2021, approaching 108,000, according to new preliminary data released Wednesday by the Centers for Disease Control and Prevention.

The nearly 15 percent increase followed an even steeper rise of nearly 30 percent in 2020, a relentless crisis that has consumed federal and state drug policy officials. The number of deaths due to drug overdose has been rising every year but in 2018 since the 1970s.

An increasing proportion of deaths have come from overdoses that include fentanyl, a class of strong synthetic opioids often mixed with other drugs, and methamphetamine, a synthetic stimulant. State health officials who are battling the influx of the two drugs said many of the deaths appeared to be the result of a combination of the two.

Drug overdoses, which have long jumped above the nation’s peak deaths from AIDS, car accidents and firearms, killed nearly a quarter of Americans last year as did Covid-19.

Deaths due to synthetic opioids – largely fentanyl – rose to 71,000 from 58,000, while deaths related to stimulants such as methamphetamine, which grew Cheaper and more lethal In recent years, it has risen from 25,000 to 33,000. Because fentanyl is a white powder, it can be easily combined with other drugs, including opioids like heroin and stimulants like meth and cocaine, and can be combined into pills that imitate anti-anxiety drugs like Xanax. These mixtures can be fatal if drug users are not aware of their use of fentanyl or are unsure of the dose.

deaths from Both Drug classes are on the rise in recent years.

But there is mounting evidence that mixing stimulants and opioids – in combinations known as “speed balls” and “goof balls” – is also becoming more common. Dan Cicarone, 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 is an artificial, interwoven epidemic that we have not seen before,” he said. “We’ve never seen an opioid as strong as fentanyl mix with such a strong methamphetamine.”

The numbers released Wednesday are provisional, and may change as the government reviews more death records. But they added further definition to the crisis, which escalated sharply during the pandemic.

In recent weeks, the White House announced President Biden’s first announcement National drug control strategyAnd plan To combat methamphetamine abuse, unveiled last week by drug czar Dr. Rahul Gupta, the first physician to oversee the White House Office of National Drug Control Policy. Overdose deaths involving methamphetamine 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, approach which has been criticized by some as empowering drug users, but has been praised by addiction experts as a way to keep drug users alive while providing access to treatment and support.

Rather than pushing for abstinence, this approach aims to reduce the risk of death or infectious disease by offering sterile equipment—through exchange needles, for example – or tools to screen medications for the presence of fentanyl. Strips that can detect fentanyl are becoming an increasingly valuable resource for local health officials, and some states have recently moved to incriminate themeven with others Withstands.

Experts said that the reasons for the continued increase in overdoses are complex and difficult to solve. But state health officials and some addiction experts have said the surge in overdoses, which began before the pandemic, cannot be blamed solely on the disorders that came with it, or on the massive increase in the number of Americans using drugs.

Social isolation and economic disruption, which have been prevalent during the pandemic, tend to cause relapses in drug use, and may contribute to overdoses. The closure in early 2020 also caused some addiction treatment providers to temporarily close their doors. But the epidemic alone does not explain the recent trend.

Policy changes made during the pandemic may have helped prevent more deaths. Regina Labelle, an addiction policy expert at Georgetown University, said that in early time Research Relaxing the rules to allow methadone therapy to be taken at home was found to be beneficial, along with increasing treatment by telemedicine.

“The difference in what we’re seeing now is not how many people are using,” said Dr. Ann Zinke, the chief health official for Alaska, which has seen the largest increase in overdose deaths of any state in the country.

Instead, she said, supplies of fentanyl rose dramatically, in shipments that were difficult to trace, and penetrated even the most isolated parts of the state. Of the 140 fentanyl overdose deaths the state recorded in 2021, More than 60 percent It also included methamphetamine, and about 30 percent of them took heroin.

It can be fentanyl, made in a laboratory Cheaper and easier to produce and distribute of heroin, which enhances its attractiveness to dealers and traffickers. But because it is potent and sold in different formulations, slight differences in the amount can mean the difference between a drug user’s usual dose and one that proves fatal. It is especially dangerous when it is inadvertently used by drug users who do not normally take opioids. The spread of fentanyl into an ever-increasing portion of the country’s drug supply has continued to overwhelm countries with robust addiction treatment services.

Often made in Mexico from chemical precursors made in China, fentanyl has long penetrated the heroin markets of the Northeast and Midwest. But recent data shows that it has established strong control in the south and west as well.

“The economics of fentanyl has just pushed other drugs off the market,” said Dr. Joshua Sharfstein, deputy dean of the Bloomberg School of Public Health at Johns Hopkins University. “Buying fentanyl and wrapping it up and putting it in anything is very cheap.”

a recent study Of the illegal pills seized by drug law enforcement I found that a large portion of what was marketed as OxyContin, Xanax, or ADHD Adderall now contains fentanyl. The prevalence of these fake pills may explain a The last sharp increase Overdose deaths among adolescents, who are less likely to use injecting drugs than older adults.

As in other states that have seen a rise in overdose deaths, the obvious difference in 2021 was the ubiquity of fentanyl, said Pat Allen, director of the Oregon Health Authority. Children under 12 years old Considered in great danger Obtaining counterfeit pills containing fentanyl, and High school students overdoses On them, thinking they are opioid painkillers or anti-anxiety drugs. The state was working on sending naloxone kits to schools, similar to the program it used at fast food restaurants, where people overdosed in bathrooms.

Mr. Allen said he has seen a worrying phenomenon among those who overdosed: They view the risk of fentanyl as low, although the actual risk is “dangerously higher”.

“We have an addiction problem in Oregon that we’ve known about for a long time,” he said. “This takes the current addiction problem and makes it more serious.”

In 2021, overdoses reached one of the leading causes of death in the United States, similar to the number of people who died of diabetes and Alzheimer’s disease, and nearly a quarter of the number of people who died of Covid-19, the third leading cause of death, according to Center for Disease Control

In Vermont, 93 percent of opioid deaths in 2021 were related to fentanyl, according to Kelly Dougherty, deputy state health commissioner.

“In the early stages of the epidemic, we were attributing the increase to disruption of life,” she said. But now, she added, a different explanation seems obvious: “What is really the primary driver is the presence of fentanyl in the drug supply.”

The country celebrated Model “pivot spoke” of addiction treatment and its extensive use of Medication-assisted treatment programsIt wasn’t enough, she said, to deal with the ease and speed with which people overdose on fentanyl.

“You can have a stronger treatment regimen, and not everyone will benefit from it when they should, or before they end up overdosing,” she said.

Ms Dougherty said fentanyl appears in counterfeit pills, including the drug OxyContin.

She said Vermont officials have come up with new public messaging about fentanyl.

“Just assume it’s all over the place,” she said.

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