Fatal Overdoses Rose Again in 2021, But Rate Is Slowing

Drug overdose deaths in the United States continue to climb, but at a slower pace, federal health officials reported Wednesday.

Early data from the U.S. Centers for Disease Control and Prevention indicate that nearly 108,000 Americans died from drug overdoses in 2021.

“Drug overdose deaths are still increasing,” said report co-author Farida Ahmad, the mortality surveillance lead at the CDC’s National Center for Health Statistics. “We predict that they are about 15% higher than they were a year ago.”

That increase, however, was half of what it was from 2019 to 2020, when overdose deaths took nearly 94,000 lives — an increase of 30%, the researchers reported.

Several factors may be driving the continuing rise in drug overdose deaths, said Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse.

Volkow said that the hardest questions to answer are, “What’s making Americans so vulnerable to taking drugs? Why is this problem so persistent?”

Some reasons are all too clear.

“Drug dealers made a lot of money and there’s no incentive for them to stop,” Volkow said. “As a result of that, we have seen an increase, a very dramatic increase, in the distribution of fentanyl across all of the United States.”

Fentanyl and other analogs of fentanyl are mixed with other drugs so dealers can boost their profits, she said. It’s fentanyl, which is more powerful than the drugs it is mixed with, that is driving the continuing increase in overdose deaths.

“The drug market and the drug supply right now is very, very dangerous, because of the increasing frequency with which it is contaminated with fentanyl,” Volkow said. “You have a much greater risk of overdosing and dying if you take drugs currently than, say, 10 years ago.”

Volkow said that social conditions are often why some people turn to drugs. “Social circumstances, lack of opportunity, those situations are the ones that actually lead someone to take drugs as a way to compensate for their everyday reality because otherwise, they don’t feel they have alternatives,” she said.

As a nation, Americans haven’t made drug prevention a priority and have stigmatized drug users, Volkow noted.

“Instead of taking the opportunity to do an intervention to prevent, just like we do an intervention to prevent diabetes, the health care system has ignored or neglected substance use disorder, and people do not realize that this is something that can be prevented and treated,” she said.

“So, to the extent that we can generate prevention interventions to provide social support and opportunities to people, you will be able to protect people from taking drugs on a regular basis,” Volkow added.

These 2021 provisional data are incomplete and may change. These new data show overdose deaths from opioids increased from about 70,000 in 2020 to nearly 81,000 in 2021.

Overdose deaths from synthetic opioids (mostly fentanyl), psychostimulants such as methamphetamine and cocaine also increased in 2021. The biggest increase in overdose deaths in 2021 was in Alaska, where deaths were up 75%, while overdose deaths in Wyoming did not increase at all in 2021, and deaths in Hawaii declined 2% from the same point in 2020.

Fentanyl accounted for more than 71,200 deaths in 2021, compared with 57,800 in 2020. Methamphetamine claimed nearly 33,000 lives in 2021 compared with more than 24,500 in 2020. Cocaine overdose took more than 25,500 lives in 2021, compared with 19,900 in 2020, the investigators found.

“We have a full-blown overdose crisis in our nation, fueled by fentanyl in the drug supply and exacerbated by the mental health emergency among youth,” said Marcia Lee Taylor, chief external and government relations officer at the Partnership to End Addiction. “As a nation, we have much more work to do to ensure that evidence-based treatment is available in a timely manner to those who need it.”

Specifically, naloxone and fentanyl test strips should be widely available, Taylor said.

“We also need to do a better job supporting people in their recovery, linking them to housing, childcare and other services they might need to sustain their recovery,” Taylor added. “And we need to make sure that we are supporting families to find help for loved ones, to know how to advocate for the best care and to help their loved one maintain long-term recovery.”

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More information

For more on drug overdose deaths, head to the U.S. Centers for Disease Control and Prevention.

SOURCES: Farida Ahmad, MPH, mortality surveillance lead, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention; Nora Volkow, MD, director, U.S. National Institute on Drug Abuse; Marcia Lee Taylor, chief external and government relations officer, Partnership to End Addiction, Los Angeles; U.S. National Center for Health Statistics, Vital Statistics Rapid Release, May 11, 2022