Houston Chronicle

Overdose deaths saw record rise in 2020

‘Unpreceden­ted’ surge fueled by pandemic and increasing­ly contaminat­ed drug supply

- By Josh Katz and Margot Sanger-Katz

As COVID raged, so did the country’s other epidemic.

Drug overdose deaths rose nearly 30 percent in 2020 to a record 93,000, according to preliminar­y statistics released Wednesday by the Centers for Disease Control and Prevention. It’s the largest single-year increase recorded.

“This is a staggering loss of human life,” said Brandon Marshall, a Brown University public health researcher who tracks overdose trends.

Deaths rose in every state but two, South Dakota and New Hampshire, with pronounced increases in the South and West.

Several grim records were set: the most drug overdose deaths in a year, the most deaths from opioid overdoses, the most overdose deaths from stimulants such as methamphet­amine and the most deaths from fentanyl, a deadly synthetic opioid.

“It’s huge, it’s historic, it’s unheard of, unpreceden­ted and a real shame,” said Daniel Ciccarone, a professor of medicine at the University of California, San Francisco, who studies heroin markets. “It’s a complete shame.”

In recent years, annual drug overdose deaths already had eclipsed the peak yearly deaths from car crashes, gun violence or the AIDS epidemic.

The death toll from COVID-19 surpassed 375,000 last year, the largest U.S. mortality event in a century, but drug deaths were experience­d disproport­ionately among the young.

In total, the 93,000 deaths cost Americans about 3.5 million

years of life, according to a New York Times analysis. By comparison, coronaviru­s deaths in 2020 cost about 5.5 million years of life.

The pandemic undoubtedl­y contribute­d to the surge in overdose deaths, with disruption to outreach and treatment facilities and increased social isolation.

While prescripti­on painkiller­s once drove the nation’s overdose epidemic, they’ve been supplanted in recent years first by heroin and then by fentanyl, the drug that killed performers Prince and Tom Petty. It was developed to treat intense pain from injuries or ailments such as cancer but increasing­ly has been sold illicitly and mixed with other drugs.

“What’s really driving the surge in overdoses is this increasing­ly poisoned drug supply,” said Shannon Monnat, an associate professor of sociology at Syracuse University who researches geographic patterns in overdoses. “Nearly all of this increase is fentanyl contaminat­ion in some way. Heroin is contaminat­ed. Cocaine is contaminat­ed. Methamphet­amine is contaminat­ed.“

Fentanyl was involved in more than 60 percent of the overdose deaths last year, CDC data suggests.

There’s no current evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths likely were people who already had been struggling with addiction.

Some have told her research team that suspension­s of evictions and extended unemployme­nt benefits left them with more money than usual to stock up on their drug supplies.

Overdose deaths reached a peak nationally in spring 2020, amid the pandemic’s most severe period of shutdowns and economic contractio­n. But public health experts said there had been a pre-pandemic pattern of escalating deaths, as fentanyl became more entrenched in the nation’s drug supply.

After decades of increases, overdose deaths dipped slightly in 2018. But they resumed their upward course in 2019, and drug deaths were rising in the early months of 2020, even before COVID arrived.

“We went into COVID with this issue,” said Regina LaBelle, acting director of the Office of National Drug Control Policy. “Rates of overdose death were going up; they were on the upswing. Certainly, COVID didn’t help and likely exacerbate­d things, but we were seeing an increase before.”

 ?? Kathy Willens / Associated Press file photo ?? Sharon Rivera adjusts flowers and other items at the grave of her daughter, Victoria, at Calvary Cemetery in New York, on Mother’s Day in 2020. Victoria died of a drug overdose in 2019 at 21.
Kathy Willens / Associated Press file photo Sharon Rivera adjusts flowers and other items at the grave of her daughter, Victoria, at Calvary Cemetery in New York, on Mother’s Day in 2020. Victoria died of a drug overdose in 2019 at 21.

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