May 3, 2023 - Health

Fentanyl overdose death rate nearly quadrupled from 2016 to 2021

Data: National Center for Health Statistics; Note: Deaths involving more than one drug are included in both totals; Chart: Axios Visuals

The U.S. overdose death rate involving fentanyl nearly quadrupled between 2016 and 2021, according to a report published Wednesday.

The big picture: The growing fentanyl crisis has spurred state and federal lawmakers to target the trafficking of the synthetic opioid, expand access to opioid overdose antidote Narcan, and decriminalize fentanyl test strips to use as a prevention tool.

  • But the sheer scale of the opioid epidemic and how it's evolved into one defined by fentanyl-laced counterfeit pills makes addressing the crisis especially difficult.
  • Adding to those challenges: the system for coding overdose deaths involving synthetic opioids does not distinguish between specific drugs, making it harder to monitor trends
  • The new Centers for Disease Control and Prevention report, however, parses out data for the five opioid and stimulant drugs — fentanyl, methamphetamine, cocaine, heroin, and oxycodone — that most frequently contribute to overdose deaths. This data could be critical in informing the public health response to an epidemic that kills an average of 100,000 Americans per year.

By the numbers: Using death certificates via the National Vital Statistics System, the CDC report found overdose death rates involving oxycodone — an early driver of the opioid epidemic — continued to decline as the death rate from methamphetamine, cocaine and fentanyl increased.

  • The change in the overdose death rate involving heroin wasn't statistically significant, the report notes.
  • Age-adjusted death rates involving fentanyl were the highest among Indigenous people in 2021 at 33.1 deaths per 100,000 people, which was 1.3 times higher than their white counterparts. For Black Americans, the age-adjusted rate of drug overdose deaths involving fentanyl was 31.3 per 100,000 people in 2021.
  • Among those aged 25-31 and 35-44, drug overdose death rates were highest for fentanyl in 2021 at 40.8 and 43.5 deaths per 100,000 people, respectively.
  • The death rate for overdoses involving fentanyl for males was 2.6 times the rate for females.

Worth noting: In recent years, the U.S. has also seen deadlier, more powerful drugs — like “zombie drug” xylazine and synthetic opioid nitazene — enter a supply at a rate that has overwhelmed medical examiner’s offices, many of which don’t test for them.

What we’re watching: Next week, the Food and Drug Administration and Substance Abuse and Mental Health Services Administration will hold a two-day public meeting about the best strategies for initiating opioid addiction treatment.

  • This is in response to how the increase of fentanyl in the drug supply, often mixed with multiple substances, has complicated treatment options.
  • Local governments and lawmakers in several states are separately discussing how far fentanyl distribution and possession penalties should go and whether they’d move the needle in reducing overdose deaths.
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