A Record Number of People Died From Drug Overdoses in the U.S. During the First Year of COVID-19

More than 93,000 people died of a drug overdose in the U.S. last year — a record number that reflects a rise of nearly 30% from 2019, according to new data released by the Centers for Disease Control and Prevention. Officials said the increase was driven by the lethal prevalence of fentanyl as well as pandemic-related stressors and problems in accessing care.

"This is the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999," Dr. Nora Volkow, director of the National Institute on Drug Abuse, told NPR.

An analysis by KQED and Documenting COVID-19, a project run by Columbia University’s Brown Institute for Media Innovation, found that the number of fentanyl overdoses rose sharply from 2019 to 2020 in three Bay Area counties: 170% in Santa Clara County, 68% in San Francisco and 29% in Alameda County.

The national data is provisional as states are still reporting their tallies to the CDC's National Center for Health Statistics. But even with some data not yet complete, the numbers tell a dire story.

Ten states are predicted to have at least a 40% rise in drug overdose deaths from the previous 12-month span, according to the CDC: Vermont, Kentucky, South Carolina, West Virginia, Louisiana, California, Tennessee, Nebraska, Arkansas and Virginia.

Volkow, whose agency is part of the National Institutes of Health, calls the data "chilling." It's another sign, she said, that both the COVID-19 pandemic and the opioid crisis are whipsawing the country with deadly effects.

"This has been an incredibly uncertain and stressful time for many people, and we are seeing an increase in drug consumption, difficulty in accessing lifesaving treatments for substance use disorders and a tragic rise in overdose deaths," Volkow said.

She added that people between the ages of 35 and 44 accounted for the highest number of deaths.

While the provisional data doesn't provide a breakdown by race and ethnicity, other recent studies suggest that at least in Philadelphia and California, the sharpest rise in overdose fatalities last year was among Black residents. And other studies have shown that even before the pandemic, overdose rates in Black communities were rising much faster than among white Americans.

Drug overdoses accounted for roughly one-quarter as many deaths as COVID-19 did in 2020, using the CDC's number of 375,000 pandemic deaths last year.

The provisional 93,331 U.S. drug overdose deaths are a sharp increase from the 72,151 deaths estimated in 2019. Deaths in 2020 from opioids alone — 69,710 — nearly eclipsed the total number of fatal overdoses in the previous year, although deaths involving other drugs such as methamphetamine and cocaine also contributed to the increase.

It's urgent, Volkow said, for governments and agencies to widen access to treatment for people who are suffering from substance use disorders.

As NPR's Brian Mann reported last month, "If current trends continue, illicit drugs will soon kill more Americans every day than COVID-19."

Before 2016, more Americans died from heroin overdoses annually than from powerful synthetic opioids such as fentanyl, according to the CDC. But the number of lives lost to overdoses from synthetic opioids has soared since then.

Roughly 57,000 people died from synthetic opioids (predominantly fentanyl) last year, compared with around 13,000 people who died from heroin overdoses.

Fentanyl's properties are similar to morphine — but it's "50 to 100 times more potent," according to the National Institute on Drug Abuse. It is also frequently cut into other illegal drugs, including cocaine. That dangerous trend has triggered outreach efforts to train people in using naloxone, which can reverse an opioid overdose.

The federal government has been taking steps to address drug addiction and overdoses, said Chuck Ingoglia, President and CEO of the National Council for Mental Wellbeing.

"Congress recently has appropriated lots of new dollars to try to address this," he said. "And it's been interesting to see that the Biden-Harris administration is really prioritizing the full continuum of interventions, everything from harm reduction to increased treatment capacity."

He said the House appropriations bill also includes funding for syringe exchange programs, which he said is the first time the federal government has explicitly called for this "vital component of harm reduction interventions." But unless there is long-term funding to create a system to address drug addiction, Ingoglia said, it may be hard to prevent overdoses in the long run.

NPR health correspondent Rhitu Chatterjee contributed to this report.

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