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  • Newly released data shows U.S. drug overdose deaths have hit record highs.
  • Synthetic opioids, primarily fentanyl, play a leading role in the crisis, according to the data.
  • Pandemic stress may have also increased synthetic opioid use.

The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) released data on Nov. 17 showing that overdose deaths rose by 28.5 percent from April 2020 to April 2021.

More than 100,000 people died over this 12-month period in the United States, coinciding with the current pandemic crisis.

Overdose deaths increased in all U.S. states except four.

According to the CDC, the numbers are “provisional,” meaning they include overdose cases still under investigation, and offer a first look at how COVID-19 restrictions implemented in most states from mid-to-late March 2020 affected mental health.

“We are facing a public health emergency in the United States as deaths from, usually unintentional, opiate overdoses rise,” Dr. Timothy Sullivan, chair of psychiatry and behavioral sciences at Staten Island University Hospital in New York, told Healthline.

Fentanyl availability a significant factor

NHCS data revealed that synthetic opioids, primarily fentanyl, are a leading cause of drug overdose deaths.

This drug class caused almost 65 percent of all drug overdose deaths between April 2020 and April 2021, a nearly 50 percent rise from the previous year.

“With opioid fatalities rising, it is important to look at how this is happening and what can be done to change it,” said Dr. Scott Krakower, attending psychiatrist in child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, New York.

Krakower pointed out that increasing availability of fentanyl has played a significant role in the rising overdose death toll.

“This could be due to prescribers’ comfort with giving this agent in conjunction with more ‘black market’ access and manufacturing of this product,” he noted.

What is fentanyl?

Pharmaceutical fentanyl is a synthetic (artificially made) opioid. It’s used to treat severe pain, such as from advanced cancer. It’s 50 to 100 times more powerful than morphine, according to the CDC.

However, most recent cases of fentanyl-related harm, overdose, and death in the United States are linked to illegally made fentanyl.

According to the Drug Enforcement Administration (DEA), illegally made fentanyl is primarily made outside the United States and brought into the country through the southern border.

The DEA cautions that as little as 2 milligrams of fentanyl can be fatal, depending on factors that include tolerance and body weight.

Pandemic stress worsened drug crisis

Sullivan said the pandemic has created conditions that exacerbated the risk of heavy substance use, including social isolation, job loss, and domestic strife. However, he admitted this wasn’t the biggest factor.

“Experts agree that the most prevalent and serious factor has been the increasing and widespread availability of illegal fentanyl,” he said.

According to Krakower, the ways to slow and eventually reverse this trend involve:

  • better educating our communities about the dangers of fentanyl
  • providing easy access to naloxone overdose rescue kits, which have been shown to save lives
  • finding novel ways to identify and engage at-risk people with treatment

“What is very frightening with fentanyl is how quickly one can become addicted and need increasing amounts of the agent with minimal relief of pain,” Krakower said.

He added that while certain situations may require fentanyl and other opioids to manage severe pain, “earlier intervention through alternative pain-relieving methods may prove to have better efficacy.”

Krakower explained this could include steroid injections, acupuncture, massage, and other techniques.

Difficulty getting medication to treat opioid addiction

Sullivan emphasized that medication-assisted treatments (MATs), such as methadone, Suboxone, and related treatments, save lives and need to be used more.

“Yet these treatments are clouded by stigma,” he said. “We have to make access to these medications easier.”

Sullivan said these medications are necessary to treat people with long-term opioid addiction.

A long-term opioid addiction can change brain function over time, explained Sullivan, and create psychological states and behaviors that are often very difficult to control.

“Many are unable, despite support from families and caregivers, to become sustainably sober,” he said. “They need to know that MAT is available to them, and they need to believe they can take this treatment without shame or a sense of failure, in order to reclaim their lives.”

The bottom line

Newly released data shows U.S. drug overdose deaths have hit record highs, with synthetic opioids like fentanyl playing a leading role in the crisis.

Experts say some of this is due to healthcare professionals overprescribing the drug, but most is due to illegally produced synthetic opioids entering the country.

They also say that while opioids like fentanyl can change brain function and make addiction recovery difficult, medication-assisted treatments are available and effective.

 



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