Drug overdose deaths in the United States continue to rise during COVID-19 pandemic

Overdose deaths in the United States continue to rise during the COVID-19 pandemic, driven largely by deaths from synthetic opioids and illegal fentanyl, according to a preliminary study. report released on November 17 by the Centers for Disease Control and Prevention (CDC).

There was a record 100,306 fatal drug overdoses for the 12 months ending April 2021, up 28.5% from the 78,056 deaths during the same period ending April 2020, according to the estimates released by the CDC. This dismal new record was also more than double the 49,387 estimated drug overdose deaths in the 12 months ending in April 2015, the CDC reported.

Opioid overdoses continued to cause the vast majority of these deaths, accounting for 76,673 deaths in the 12 months ending April 2021, up 35% from the previous year. Deaths from cocaine and psychostimulants such as methamphetamine have also increased, the CDC said.

“A perfect storm”

“The pandemic has brought about a perfect storm of events which each has contributed to the increase in overdose death rates,” said William Soares, MD, director of harm reduction services in the emergency medicine department at Baystate Medical Center in Springfield, Massachusetts.

Stay-at-home orders have led to deep social isolation, high unemployment and increased stress in the home – all of which have contributed to the relapse of many recovering people, says Dr Soares. The pandemic has also limited access to drug treatment for people trying to quit using drugs or to maintain abstinence.

Beyond that, fear of the virus led many people who normally used drugs with others in public places to use them alone at home, leaving them less likely to receive life-saving treatment in the event of an overdose. Drugs in circulation have also become increasingly potent and more likely to lead to overdoses and deaths, Soares adds.

“The increase in overdose deaths during the pandemic is likely associated with the continued increase in fentanyl mixed with other illicit drugs, the increase in drug use caused by more stress from many sources, and a reduced access to drug treatment during the pandemic, ”said Lyna Zhang Schieber. , MD, DPhil, CDC epidemiologist.

This preliminary death tally released by the CDC excludes some counties, cities and states that have yet to provide complete data, although the estimated deaths attempt to account for missing records. The estimated number of drug overdose deaths has declined in a few states – New Hampshire, New Jersey, and South Dakota – and has also climbed 50% or more in some states, including Louisiana, Mississippi, Tennessee, Kentucky, West Virginia and Vermont.

Still, the trend reflects the alarming spikes in overdose deaths reported earlier in the pandemic. The CDC, for example, also reported record overdose deaths in May 2020. Then, as now, those deaths were largely due to rising opioid overdose death rates and cocaine.

Problems bigger than the pandemic

Controlling the pandemic through increasing vaccination rates, booster shots and masks is certainly an important part of increasing stability and getting back to normal life, says Soares. But that alone will not be enough to dramatically reduce the number of overdose deaths.

“The increase in deadly substances, including fentanyl and methamphetamines, in the drug supply increases the likelihood of death every time a person uses drugs, regardless of COVID-19,” Soares said.

“In order to reduce deaths, we need to focus on increasing the availability of behavioral health drugs and treatments, reducing regulatory and financial barriers that hamper the treatment of substance use disorders and promoting harm reduction strategies including widespread access to naloxone, drug use supplies and safe spaces where an overdose can be recognized and treated if a person uses drugs, ”adds Soares.

Pandemic shutdowns that reduced access to care may have been lifted in many parts of the country, but the demand for drug treatment is still far greater than the supply of providers willing and able to provide this life-saving care. , according to Stefan Kertesz, MD, the University of Alabama at Birmingham, and the Birmingham Veterans Affairs Medical Center.

US government restrictions

Federal, state, and local governments have restrictions in place that limit who can prescribe drugs for opioid use disorders, where patients can get those treatments, how many drugs patients can get at one time and what lab tests or clinic visits may be needed for refills.

Some restrictions were relaxed during the pandemic. Federal Addiction and Mental Health Services Administration (SAMHSA) relaxed rules requiring daily clinic visits for the anti-addiction drug methadone, allowing some to get a 28 or 14 day supply at a time. And the federal Drug Enforcement Administration (DEA) changed prescribing rules for the anti-addiction drug buprenorphine to allow telehealth visits to physicians to prescribe the drug and allow refills without requiring patients to first pass a drug test.

While changes like this have allowed some patients to access treatment that would otherwise have been interrupted during the pandemic, many people with substance use disorders may still not have access to care because that they do not have access to the Internet or a cell phone. or a computer, to use telehealth services, according to Dr. Kertesz. On top of that, not all clinics maintain telemedicine services as in-person appointments reopen, a development that prevents new barriers to access such as the need for transportation and more. free time to travel to and from clinics.

“To make a bigger dent in a horrific tragedy, we need to make several changes,” Kertesz said.

Historic decision on the role of pharmacies in times of crisis

Separately, a federal jury found on Tuesday that drugstore chains CVS, Walgreens and Walmart had contributed to opioid overdoses and deaths in Trumbull and Lake counties, Ohio.

“For decades, drugstore chains have watched the pills that rolled their doors cause damage and failed to take action required by federal law,” county attorneys said in a statement.

Pharmacies have said they will appeal the historic verdict.


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