Overdose Deaths Continue Rising, With Fentanyl and Meth Key Culprits

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Noah Weiland
Margot Sanger-Katz

buy subutex 2mg online without prescription overnight delivery.By Noah Weiland and Margot Sanger-Katz

May 11, 2022



WASHINGTON

— After a catastrophic increase in 2020, deaths from drug

overdoses rose again to record-breaking levels in 2021, nearing 108,000,

the result of an ever-worsening fentanyl crisis, according to

preliminary new data published on Wednesday by the Centers for Disease Control and Prevention.

The increase of nearly 15 percent followed a much steeper rise of

almost 30 percent in 2020, an unrelenting crisis that has consumed federal and state drug policy officials. Since the 1970s, the number of drug overdose deaths has increased every year except 2018.

A growing share of deaths continue to come from overdoses involving fentanyl,

a class of potent synthetic opioids that are often mixed with other drugs, and methamphetamine, a synthetic stimulant. State health officials battling an influx of both

drugs said many of the deaths appeared to be the result of combining the two. buy subutex 2mg online without prescription overnight delivery

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Drug overdoses,

which long ago surged above the country’s peak

deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.

Deaths involving synthetic opioids — largely fentanyl — rose to 71,000

from 58,000, while those associated with stimulants like methamphetamine,

which has grown cheaper and more lethal in recent years, increased to 33,000 from 25,000.

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 stamped into counterfeit pills for anti-anxiety drugs like Xanax. Such mixtures can prove lethal if drug users are unaware they are taking fentanyl or are unsure of the dose.

Deaths from both classes of drugs have been rising in recent years.

But there is growing evidence that mixing stimulants and opioids — into

combinations known as “speedballs” and “goofballs” — is becoming more common, too.

Dan Ciccarone, a professor of family and community medicine at the

University of California, San Francisco, who studies drug markets,

has just begun a multiyear study of the combination of opioids and meth.

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“There’s an intertwined synthetics epidemic the likes of which we’ve never seen,” he said. “We’ve never seen a powerful opioid such as fentanyl being mixed with such a potent methamphetamine.”

The numbers released on Wednesday are considered provisional, and may change as the government reviews more death records. But they showed that a crisis that escalated

sharply during the first year of the pandemic does not appear to be letting up.

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Regina LaBelle, an addiction policy expert at Georgetown University,

said that while the nearly 108,000 estimated deaths were without precedent,

the smaller increase relative to 2020 was a “hopeful sign.”

“One year doesn’t make a trend,” she said. “We’re going to have to look at a few years in a row.”

The White House in recent weeks announced President

Biden’s first national drug control strategy, and a plan to combat meth

use was unveiled last week by his drug czar, Dr. Rahul Gupta, the first medical doctor to oversee the White House Office of National Drug Control Policy. Overdose deaths involving meth almost tripled between 2015 and 2019 in people 18 to 64, according to the National Institutes of Health.

From powerful pharmaceuticals to illegally made synthetics, opioids are fueling a deadly drug crisis in America.

“It is unacceptable that we are losing a life to overdose every five minutes around the clock,” Dr. Gupta said in a statement on Wednesday.

Mr. Biden is the first president to embrace harm reduction,

an approach

that has been criticized by some as enabling drug users, but praised by addiction experts as a way to keep drug users alive while providing access to treatment and support.

Instead of pushing abstinence, the approach aims to lower the risk of

dying or acquiring infectious diseases by offering sterile equipment — through needle exchanges, for example — or tools to check drugs for the presence of fentanyl. Strips that can detect fentanyl have become increasingly valuable resources for local health officials, and some states have moved recently to decriminalize them, even as others resist.

Recent settlements with prescription opioid manufacturers and distributors will soon bring new resources to states battling the overdose epidemic.

The causes of the continued increase in overdoses are complex and hard to untangle, experts said. But state health officials and some addiction experts said the spike in overdoses,

which began before the pandemic, could not be blame solely on the disruptions that came with it, or on a major increase in the number of Americans using drugs.

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Social isolation and economic dislocation, which have been widespread during the pandemic, do tend to cause relapses in drug use, and could have contributed to rising overdoses. Shutdowns early in 2020 also caused some addiction treatment providers to temporarily close their doors. But the pandemic alone does not explain the recent trend.

Policy changes made during the pandemic may have helped prevent more deaths. Ms. LaBelle, the Georgetown addiction expert, said early research had found that loosening rules to permit take-home methadone treatment had been beneficial, along with an increase in treatment via telemedicine.

“The difference in what we’re seeing now is not how many people are using,” said Dr. Anne Zink, the chief health official in Alaska, which saw the largest overdose death percentage increase of any state in the nation, according to the data released on Wednesday.

Instead, she said, the fentanyl supply had skyrocketed, in shipments that were difficult to track, penetrating even the most isolated parts of the state. Of the 140 fentanyl overdose deaths the state recorded in 2021, over 60 percent also involved meth, and nearly 30 percent involved heroin.

Drug overdoses, which long ago surged above the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.
Drug overdoses, which long ago surged above the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.Credit…Spencer Platt/Getty Images
Drug overdoses, which long ago surged above the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.

Fentanyl, which is made in a lab,

can be cheaper and easier to produce and distribute than heroin, enhancing its appeal to dealers and traffickers. But because it is strong and sold in varying formulations, small disparities in quantity can mean the difference between a drug user’s usual dose and one that proves deadly. It is particularly dangerous when it is consume unwittingly by drug users who do not usually take opioids. The spread of fentanyl into an ever-growing portion of the nation’s drug supply has continued to flummox even states with strong addiction-treatment services.

Often synthesized in Mexico from precursor chemicals made in China, fentanyl long ago permeated the heroin markets of the Northeast and the Midwest. But recent data shows it has established a strong hold in the South and the West as well.

In Vermont, which saw one of the biggest increases in overdose deaths last year, 93 percent of opioid deaths were fentanyl-relate, according to Kelly Dougherty, the state’s deputy health commissioner.

“In the beginning stages of the pandemic,

we were attributing the increase to life being disrupt,” she say. But now, she added, a different explanation seems clear: “What is really the primary driver is the presence of fentanyl in the drug supply.”

The state’s celebrated “hub and spoke” model of addiction treatment and its aggressive use of medication-assisted treatment programs, she said, were not enough to contend with the ease and speed with which people overdose on fentanyl.

“You can have the most robust treatment system,” she said, “and not everybody is going to avail themselves of it when maybe they should, or before they end up overdosing.”

And fentanyl is showing up in counterfeit pills, Ms. Dougherty said, including in OxyContin.

She said Vermont officials had taken up new public messaging regarding fentanyl.

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