Drug Overdose Deaths Rise, Disparities Widen

"Drug overdose data show troubling trends and widening disparities between different population groups. In just one year, overdose death rates (number of drug overdose deaths per 100,000 people) increased 44% for Black people and 39% for American Indian and Alaska Native (AI/AN) people. Most people who died by overdose had no evidence of substance use treatment before their deaths. In fact, a lower proportion of people from racial and ethnic minority groups received treatment, compared with White people. Some conditions in the places where people live, work, and play can widen these disparities. For instance, areas with greater income inequality—a larger income gap between the rich and the poor—have higher rates of overdose deaths. Comprehensive, community-based prevention and response efforts should incorporate proven, culturally responsive actions that address disparities in drug overdose deaths and the inequities that contribute to them.

• Increasing access to proven treatment for all people who have substance use disorder(s) is a critical part of their care and recovery.
• Harm reduction services can further reduce overdoses and save lives. Harm reduction services can include naloxone, fentanyl test strips, and referral to substance use disorder treatment. Syringe services programs can serve as a valuable way to reach people who inject drugs and provide them with overdose prevention education and opportunities to link to substance use disorder treatment.

Drug overdose death disparities are widening at the same time as a record-breaking 92,000 lives were lost to drug overdoses during 2020. More must be done to prevent overdoses and deaths..."
Overdose Deaths 

Now Is the Time to Stop Drug Overdose Deaths

"In the United States, drug overdoses have claimed over 932,000 lives over the past 21 years, and the drug overdose crisis continues to worsen. In 2020, the rate of drug overdose deaths accelerated and increased 31% from the year before. Synthetic opioids, such as illicitly manufactured fentanyl, continue to contribute to the majority of opioid-involved overdose deaths.

To save lives from drug overdose, the Centers for Disease Control and Prevention (CDC) launched four education campaigns to reach young adults (ages 18-34) who use drugs. The campaigns provide information that can save the lives of people who use drugs or are struggling with substance use disorders and highlight actions the public can take to help prevent overdose.

Specifically, the campaigns provide critical information about these topics:

• Dangers of fentanyl
• Risks and consequences of mixing drugs
• Life-saving power of naloxone to reverse an opioid overdose
• Importance of reducing stigma to support treatment and recovery

More about CDC’s education campaigns to stop drug overdoses:

The Dangers of Fentanyl

Fentanyl’s increased presence in the drug supply is a key contributor to the increase in overdose deaths. Fentanyl can be up to 50 times stronger than heroin and up to 100 times stronger than morphine, so even small amounts of fentanyl can cause an overdose.

Many illegal drugs, including counterfeit prescription opioid pills, heroin, cocaine, methamphetamine, and ecstasy, can be mixed or laced with fentanyl with or without a person’s knowledge, as they would not be able to see, taste, or smell the fentanyl.

CDC’s campaign on fentanyl provides information about:

• Illicitly manufactured fentanyl
• Dangers of fentanyl
• Fentanyl’s roles in overdoses in the United States

To learn more about CDC’s campaign on fentanyl, visit Fentanyl Facts.

Risks of Polysubstance Use

People who use drugs may use multiple substances together or within a short time period. The use of more than one drug, also known as polysubstance use, is common and can be intentional or unintentional. Whether intentional or not, mixing drugs is never safe because the effects from combining drugs may be stronger and more unpredictable than those of one drug alone and can even be deadly.

For example, mixing stimulants—like ecstasy and cocaine—increases the risk of stroke and heart attack, while mixing opioids with other depressants—like benzodiazepines (“benzos”) and/or alcohol—can slow breathing, which could lead to severe brain damage or death

CDC’s campaign on polysubstance use provides information about:

• The dangers of polysubstance use
• What to do if you think someone is overdosing

To learn more about CDC’s campaign on polysubstance use, visit Polysubstance Use Facts.

Reversing Opioid Overdoses with Naloxone

Naloxone is a nonaddictive medicine that can reverse an opioid overdose if administered in time. Carrying naloxone and using it on someone who is overdosing on opioids could immediately help save a life. One study found that in most cases of overdose deaths, a bystander was nearby who could have helped prevent the death.

In most states, Good Samaritan lawsexternal icon to protect those who are overdosing and anyone assisting them in an emergency from arrest and criminal prosecution on drug-related charges. Naloxone is available in all 50 states; Puerto Rico; and Washington, DC, and often without a prescription.

CDC’s campaign on naloxone provides information about:

• The lifesaving benefits of naloxone
• How to use naloxone
• Who should carry naloxone
• Naloxone availability in the United States.."
  Overdose deaths 

Cocaine and Psychostimulant-involved Overdose Deaths Disproportionately Affect Racial and Ethnic Minority Groups

"National Youth Substance Use Prevention Month is a time to recognize the importance of addressing health equity to help end the drug overdose epidemic.

Health inequities can contribute to negative health outcomes, including increased overdose deaths, among racial and ethnic minority populations including Black, American Indian/Alaska Native, and Hispanic persons. Clinicians, public health professionals, policy makers, and other community members can work together to promote health equity, reduce poor health outcomes, and prevent health disparities.

 

October marks National Youth Substance Use Prevention Month, a time for Americans to renew our commitment to end the drug overdose epidemic that has claimed nearly 850,000 lives over the last 20 years. Research shows that drug overdose deaths involving stimulants like cocaine and psychostimulants with abuse potential (e.g., methamphetamine) have increased significantly and are disproportionately affecting racial and ethnic minority populations.

• From 2004 to 2019, death rates for overdoses involving cocaine were generally higher among Black persons than other racial and ethnic groups, and death rates for overdoses involving psychostimulants were generally higher among American Indian/Alaska Native (AI/AN) persons than among other racial and ethnic groups.
• From 2013 to 2019, most racial and ethnic groups experienced increases in rates of overdoses involving both cocaine and opioids and rates of overdoses involving both psychostimulants and opioids.

Which drugs are considered psychostimulants with abuse potential?

• Methamphetamine, which is an illegal stimulant that can be smoked, snorted, injected, or orally ingested
• MDMA, also known as ecstasy, which is an illegal stimulant and is usually taken orally
• Prescription stimulants, which are prescribed for conditions such as attention deficit hyperactivity disorder (ADHD) or depression, and can be taken orally, snorted, or injected

Cocaine

Cocaine is a highly addictive, illegal stimulant that can be snorted, smoked, or dissolved and injected into a vein. Note that deaths involving cocaine are usually categorized separately from psychostimulants with abuse potential.

Why are stimulant-involved overdose deaths increasing? Why are racial and ethnic minority populations more affected than others?

Overall factors that may be influencing the surge in stimulant-involved death rates include increases of:

• Supply of methamphetamine
• Use of stimulants and opioids together
• Presence of fentanyl in other illicit drugs, also known as “contamination” or “lacing” of other drugs

While these factors may have contributed to the increase of stimulant-involved overdose deaths, disparities in stimulant-involved overdose deaths among Black and AI/AN persons are not fully explained by substance use patterns. For instance, recent data show that while rates of past-year cocaine use among Black and White persons are not significantly different, cocaine-involved overdose death rates among Black persons were more than twice as high as those among White persons in 2019.
Overdose death disparity 

A Day to Remember International Overdose Awareness Day

"Remembrance Increasingly Includes Lives Lost to Overdoses Involving Benzodiazepines

August 31 marks International Overdose Awareness Dayexternal icon every year. It’s a day to remember and grieve those we’ve lost, and to strengthen resolve to end overdose injuries and deaths.

In 2020, over 93,000 people lost their lives to drug overdose. The fight against the drug overdose epidemic is continually evolving, and benzodiazepines constitute an emerging and dangerous front.

What are Benzodiazepines?

Benzodiazepines (also known as “benzos” and “downers”) are sedatives commonly prescribed to treat insomnia, anxiety and other conditions.

They work by slowing down the central nervous system and decreasing brain activity. The effects typically last between 6 hours to over 24 hours. Benzodiazepines are also produced and distributed illicitly.

Prescription benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), and illicit benzodiazepines include etizolam, flualprazolam, and flubromazolam. It is important to use benzodiazepines only in the amount, frequency, and manner prescribed by a doctor.

Benzodiazepines may cause a variety of adverse reactions:

• Slowed reaction times
• Loss of motor control
• Slurred speech
• Dizziness
• Drowsiness
• Constipation
• Memory problems
• Restlessness
• Delirium
• Aggression
• Depression
• Hallucinations
• Paranoia.."
  Overdose 

Save Lives Now

"Overdose Deaths Have Increased During COVID-19 

The worsening of the drug overdose epidemic, along with the impact of COVID-19 prevention protocols, such as social distancing and quarantine, makes it more difficult for public health agencies and social services to treat those most at risk of overdose. Urgent actions for innovative strategies within the public health community are required to facilitate continued access to treatment.

Drug Overdose Deaths Increased During the COVID-19 Pandemic

Preliminary data indicates that the increases in drug overdose deaths appear to have accelerated during the COVID-19 pandemic.

By the Numbers

• Preliminary data show that 81,230 overdose deaths occurred in the United States from June 2019 through May 2020, the highest number of overdose deaths ever recorded in a 12-month period.
• Synthetic opioids (likely illicitly manufactured fentanyl) appear to be the primary driver of the increases in overdose deaths.
• Overdose deaths involving cocaine increased by 26.5 percent. These deaths are likely linked to co-use of cocaine with illicitly manufactured fentanyl or heroin.
• Overdose deaths involving psychostimulants, such as methamphetamine, increased by 34.8 percent.

Preventing overdoses and deaths is critical

Medical and public health professionals, first responders, harm reduction organizations, and other community partners each have a critical role to play in overdose prevention. As the overdose epidemic continues to evolve, expand, and accelerate, the following are critical to preventing overdoses and deaths from overdose:

• Naloxone, which can reverse an opioid overdose, if administered in time
• Early detection of overdose outbreaks in communities
• Early interventions for people who are at highest risk for overdose
• Expand prevention and response activities

Health Alert Network (HAN) Advisory

CDC issued a HAN advisory to alert public health departments, healthcare professionals, first responders, harm reduction organizations, laboratories, and medical examiners and coroners to:

• Substantial increases in drug overdose deaths across the United States
• A concerning acceleration of the increase in drug overdose deaths
• Changing geographic distribution of overdose deaths involving synthetic opioids
• Significant increases in overdose deaths involving psychostimulants, such as methamphetamine
• Recommendations for communities when responding to the evolving overdose crisis.."
  Drug overdose 

Fighting Opioid Overdose

"The opioid overdose epidemic is devastating families and communities across America. Whether you’re a professional working in preventing drug abuse or treating addiction, or a healthcare provider, first responder, or law enforcement officer the opioid epidemic is likely affecting you, someone you love, or your community. No matter who you are, our goal is the same—to end the opioid overdose epidemic currently ravaging the United States...

Do you know about the opioid overdose epidemic?

According to the most recent CDC data, we know that most drug overdose deaths in the United States involve an opioid. Some numbers to know are:

• Opioids were involved in more than 33,000 deaths in 2015.
• Sixty three percent of drug overdose deaths in 2015 involved an opioid.
• Every day, 91 Americans die from an opioid-related overdose.
• The number of overdose deaths involving opioids has quadrupled since 1999.
• Heroin-related overdose deaths increased by 21 percent from 2014 to 2015.
• In 2015, 12,989 people died from a heroin-related overdos..."

Opiods

Drug Overdode Deaths by State: 2013 and 2014

"CDC analyzed recent multiple cause-of-death mortality data from the National Vital Statistics System to track current trends and shifting characteristics of drug overdose deaths. Opioids—primarily prescription pain relievers and heroin—are the main driver of overdose deaths. Opioids were involved in 28,647 deaths in 2014 and opioid overdoses have quadrupled since 2000.

Significant increases in drug overdose death rates were seen in the Northeast, Midwest and South  Census Regions. In 2014, the five states with the highest rates of death due to drug overdose were West Virginia, New Mexico, New Hampshire, Kentucky and Ohio. States with statistically significant increases in the rate from 2013 to 2014 included Alabama, Georgia, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Mexico, North Dakota, Ohio, Pennsylvania and Virginia..."
Drug overdose

Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014

"The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). CDC analyzed recent multiple cause-of-death mortality data to examine current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths. During 2014, a total of 47,055 drug overdose deaths occurred in the United States, representing a 1-year increase of 6.5%, from 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014. The rate of drug overdose deaths increased significantly for both sexes, persons aged 25–44 years and ≥55 years, non-Hispanic whites and non-Hispanic blacks, and in the Northeastern, Midwestern, and Southern regions of the United States. Rates of opioid overdose deaths also increased significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000 in 2014, a 14% increase. Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data. These findings indicate that the opioid overdose epidemic is worsening. There is a need for continued action to prevent opioid abuse, dependence, and death, improve treatment capacity for opioid use disorders, and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl..."
Overdose deaths