WASHINGTON – Drug overdose deaths continued to rise to record levels in 2021, nearly 108,000, according to preliminary new data released Wednesday by the Centers for Disease Control and Prevention.
The nearly 15 percent increase followed a much sharper rise of nearly 30 percent in 2020, a relentless crisis that engulfed federal and state drug policy officials. The number of deaths from drug overdoses is growing every year, but since 2018 since the 70s of last century.
An increasing proportion of deaths come from fentanyl overdoses, a class of potent synthetic opioids that are often mixed with other drugs, and methamphetamine, a synthetic stimulant. Public health officials who are fighting the influx of the two drugs said many of the deaths appear to be the result of combining the two.
Drug overdoses, which have long exceeded the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter of Americans last year than Covid-19.
Deaths involving synthetic opioids – mainly fentanyl – rose to 71,000 from 58,000, while those related to stimulants such as methamphetamine, which has become cheaper and more lethal in recent years, have risen to 33,000 from 25,000. as fentanyl is a white powder, it can be easily combined with other drugs, including opioids such as heroin and stimulants such as methamphetamine and cocaine, and can be stamped into counterfeit anti-anxiety pills such as Xanax. Such mixtures can be fatal if drug users do not know they are using fentanyl or are unsure of the dose.
Deaths from both classes of drugs have increased in recent years.
But there is growing evidence that mixing stimulants and opioids – in combinations known as “speedballs” and “gofballs” – is also becoming more common. Dan Chicaron, a professor of family and public medicine at the University of California, San Francisco, who studies drug markets, has just begun a multi-year study of the combination of opioids and methamphetamine.
“There is an intertwined synthetic epidemic like we have never seen before,” he said. “We have never seen a powerful opioid like fentanyl mixed with such a powerful methamphetamine.”
The opioid crisis
From powerful pharmaceuticals to illicit synthetic products, opioids are fueling a deadly drug crisis in America.
Figures released on Wednesday are considered provisional and are subject to change as the government reviews more deaths. But they added more definition to the crisis, which escalated sharply during the pandemic.
In recent weeks, the White House has announced President Biden’s first national drug control strategy and plan to combat methamphetamine, unveiled last week by his drug king, Dr. Rahul Gupta, the first doctor to monitor the National Drug Control Service. of White House politics. Overdose deaths involving methamphetamine tripled between 2015 and 2019 in people aged 18 to 64, according to the National Institutes of Health.
Mr Biden was the first president to adopt harm reduction, an approach criticized by some as allowing drug users but praised by addiction experts as a way to keep drug users alive while providing access to treatment. and support.
Instead of insisting on abstinence, the approach aims to reduce the risk of death or infectious disease by offering sterile equipment – by changing needles, for example – or tools to check medicines for fentanyl. Tapes that can detect fentanyl are becoming an increasingly valuable resource for local health professionals, and some states have recently moved to decriminalize them, even when others resist.
The reasons for the continuing increase in overdose are complex and difficult to unravel, experts said. But government officials and some addiction experts have said the overdose jump that began before the pandemic cannot be blamed solely on the disruption that comes with it or the significant increase in the number of Americans using drugs.
Social exclusion and economic dislocation, which were widespread during the pandemic, are prone to drug relapses and could contribute to an increase in overdose. The exclusion in early 2020 has also forced 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. Regina Labelle, an expert on addiction policy at Georgetown University, said early research found that loosening the rules for allowing methadone treatment at home was beneficial, along with increasing telemedicine treatment.
“The difference in what we see now is not how many people use it,” said Dr. Ann Zink, Alaska’s chief health officer, who noted the largest increase in overdose deaths in any state in the nation. , according to data released on Wednesday.
Instead, she said, fentanyl supplies skyrocketed in shipments that were difficult to track, penetrating even the most isolated parts of the state. Of the 140 fentanyl overdose deaths reported by the state in 2021, more than 60 percent also included methamphetamine, and nearly 30 percent were heroin-related.
Fentanyl, which is produced in a laboratory, can be cheaper and easier to produce and distribute than heroin, which makes it more attractive to dealers and traffickers. But because it is strong and sold in different formulations, small differences in quantity can mean the difference between the usual dose of the drug user and the one that turns out to be lethal. It is especially dangerous when used unknowingly by drug users who do not normally take opioids. The proliferation of fentanyl in the nation’s ever-increasing supply of drugs has continued to plague even countries with strong addiction treatment services.
Often synthesized in Mexico from precursor chemicals made in China, fentanyl has long penetrated the heroin markets in the Northeast and Midwest. But recent data show that he has found strong detentions in both the south and the west.
“The fentanyl economy is just pushing other drugs out of the market,” said Dr. Joshua Scharfstein, vice dean of the Bloomberg School of Public Health at Johns Hopkins University. “It’s just so cheap to buy fentanyl and turn around and put it in anything.”
A recent study of illegal pills confiscated by anti-drug authorities found that a significant proportion of what is marketed as OxyContin, Xanax or the attention deficit hyperactivity disorder drug Adderall now contains fentanyl. The proliferation of these counterfeit pills may explain the recent sharp increase in overdose deaths among teenagers who are less likely to inject drugs than older people.
Pat Allen, director of the Oregon Health Service, said that, as was the case in other states with rising deaths from overdoses, the clear difference in 2021 was the ubiquity of fentanyl. Children as young as 12 are considered at high risk of taking counterfeit pills containing fentanyl, and high school students overdose on them, believing they are opioid painkillers or anti-anxiety drugs. The state worked to send naloxone kits to schools, similar to a program it uses in fast food restaurants where people overdose in bathrooms.
Mr Allen said he had seen a worrying phenomenon among those who overdosed: they thought the risk of fentanyl was low, although the actual risk was “significantly higher”.
“We’ve had an addiction problem in Oregon that we’ve known about for a long time,” he said. “This takes away the existing addiction problem and makes it much more dangerous.”
In 2021, overdose accounted for one of the leading causes of death in the United States, similar to the number of people who died of diabetes and Alzheimer’s disease, and approximately a quarter of the number of people who died from Covid-19, the third leading cause of death. death, according to the CDC
In Vermont, 93 percent of opioid deaths in 2021 were related to fentanyl, according to Kelly Doherty, the state’s deputy health commissioner.
“In the early stages of the pandemic, we attributed the increase in disruption to life,” she said. But now, she added, a different explanation seems clear: “What is actually the main driver is the presence of fentanyl in drug supplies.”
The state’s famous addiction treatment model and its aggressive use of drug-assisted treatment programs, she said, are not enough to combat the ease and speed with which people overdose on fentanyl.
“You can have the most stable treatment system,” she said, “and not everyone will take advantage of it when they need to or before they eventually overdose.”
And fentanyl appears in counterfeit pills, Ms. Doherty said, including at OxyContin.
She said Vermont officials had launched new public announcements about fentanyl.
“Just accept that it’s everywhere,” she said.
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