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‘A staggering increase’: Drug overdose deaths top 100,000 for the first time

The largest increases were seen in Vermont, West Virginia and Kentucky.
Photo illustration of opioid pills, fentanyl and syringes.
Chelsea Stahl / NBC News

Drug overdose deaths in the United States surpassed 100,000 in a 12-month period for the first time, the Centers for Disease Control and Prevention said Wednesday, a troubling milestone amid an already devastating period for the country. 

The number of overdose deaths rose 29%, from 78,056 from April 2019 to April 2020, to 100,306 deaths in the same time period the following year. The data, from the CDC’s National Center for Health Statistics, is considered provisional but is a good indication of what the final numbers will show next month.

“It’s a staggering increase for one year,” said Bob Anderson, chief of the mortality statistics branch at the NCHS. 

Vermont saw the biggest rise, with a nearly 70% increase. Large increases were also observed in West Virginia (62%), Kentucky (55%), Louisiana (52%) and Tennessee (50%). Drug overdose deaths went down in just four states: Delaware, New Hampshire, New Jersey and South Dakota. South Dakota saw a nearly 20% decrease in overdose deaths, the greatest by far. 

Deaths due to opioids — mostly synthetic opioids, including fentanyl — accounted for more than 75% of the deaths. Deaths due to psychostimulants, predominantly methamphetamine, also increased. Cocaine accounted for slightly more deaths in 2021 than the year before, and heroin deaths decreased. 

Overdose deaths are often the result of multiple drugs, Anderson said. “They are killing people in combination, fentanyl combined with another drug such as methamphetamine or cocaine.”

The overlap of the ongoing overdose epidemic and the COVID-19 pandemic has left its mark on the U.S. A separate CDC report, published in July, concluded that the combination of Covid and overdose deaths was the reason life expectancy in 2020 plunged by the largest one-year drop since World War II. The researchers estimated that an increase in deaths from accidents or unintentional injuries — one-third of which were drug overdoses — was responsible for 11 percent of the decline in life expectancy. 

Just how much of a role the stress and isolation of the pandemic played in the rising overdose deaths remains to be seen. 

While the two are certainly linked, the pandemic shouldn’t be a scapegoat for an epidemic that was a major concern long before COVID-19, said Dr. Andrew Kolodny, medical director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University.

“Opioid addiction is a chronic, relapsing condition such that the stress or the social isolation and the inability to access support groups could have resulted in relapses in people with opioid addiction, and COVID could have made it harder for people with opioid addiction to access treatment, as well,” Kolodny said.

“But for the past few years, opioid overdose deaths in the United States have skyrocketed. We’ve been in the midst of a severe crisis that’s getting worse and getting worse fast,” Kolodny said.

Drug overdose deaths increased nearly 140% between 2000 and 2014. Opioid deaths rose 200%, CDC data shows. Overdose deaths decreased slightly between 2017 and 2018, giving experts hope that the nation was past its peak, but deaths began trending upward again the following year. 

“For about 26 years, every year in the United States we would set a record for deaths from drug overdose and then the next year we would break that record. There has been this trend, which is in line with an epidemic of opioid addiction,” Kolodny said, noting that deaths began to increase exponentially around 2014. 

While there was a slight decline in the number of people dying of drug overdoses late last year, rates in recent months are once again accelerating, Anderson said. 

“Obviously, if we don’t get a handle on it, we’re going to continue to have increasing deaths, and we’ve now already reached this grim milestone of 100,000. There’s nothing special about it other than we’re moving into six digits instead of five, and that’s a lot of people dying,” he said. “Hopefully these statistics can galvanize action from public health programs and prevention.” 

Sandra Comer, a professor of neurobiology at the Columbia University Vagelos College of Physicians and Surgeons, said she was “shocked and dismayed” by the figures but is hopeful that taking an “all hands on deck” approach that includes expanding access to medications like buprenorphine and methadone, which treat opioid use disorder, and naloxone, which can halt a drug overdose, will help curb drug overdose deaths in a post-pandemic world. 

“Both users and their families are suffering tremendously from this,” Comer said. “There are lots of efforts underway to try to come up with new and improved medications and other types of strategies for getting a handle on this and I think it will make a difference. We need to keep trying.”

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