Fentanyl drives US overdose deaths to record highs

America recorded nearly 108,000 substance abuse fatalities last year, an increase of 14.9% compared to 2020

A man holds a vial containing a fatal amount of fentanyl.Jacquelyn Martin (AP)

Police in San Francisco’s neighboring city of Oakland reported finding six kilograms of fentanyl hidden in a car parked in front of a high school on Wednesday, May 11. There was also $139,000 and a package of heroin, weighing just one kilo – the contrasting amounts of the respective drugs reflecting how fentanyl has flooded US streets and spiked deaths among users.

The haul is one of dozens of operations that various law enforcement agencies in the US have undertaken against this synthetic drug, which is responsible for 66% of fatal overdoses in the country, according to official figures released May 12.

Deaths from the use of synthetic opioids – particularly fentanyl, which is 50 times more potent than heroin – rose from 58,000 in 2020 to 71,200 in 2021, an increase of 23%. The death toll from methamphetamines, also soared 34% year on year with 33,000 fatalities in 2021. Together, these substances claimed the most lives last year.

On May 11, the Centers for Disease Control and Prevention (CDC) revealed that 107,602 people died from substance abuse in 2021, an increase of 14.9% compared to 2020. With the exception of 2018, the number of accidental overdose deaths is growing year on year, with more than one million victims recorded since 2000.

“We’ve never seen anything like this,” said Robert Anderson, the CDC’s mortality statistician. The center actually documented 103,500 overdose cases, but cautioned that this is a provisional number and will grow in the coming months once coroners confirm the causes of a number of deaths under review.

Daniel Ciccarone, a University of California drug scholar, has pointed out that the increased supply of fentanyl is due to the fact that, among other things, it is cheaper to produce than heroin. The substance – a white powder prescription drug used to reduce chronic pain in cancer patients – has replaced heroin when supplies of the latter have run short. And its sale is not limited to the US; it has caused deaths in several European countries, especially Estonia, Latvia and Sweden. Canada has also seen an increase in the number of accidental overdoses.

The fentanyl problem was previously confined to certain regions of the US, but this is no longer the case. Between 2014 and 2017, it caused a large number of deaths in the Northwest and Midwest, mostly among white Caucasians. In 2017 and 2018, however, it spread to the West, where it claimed thousands of victims, notably in San Francisco. Black and Latino communities also began to notice an increase in deaths as supply increased; China has ceased to be the main exporter of this substance, with Mexico and India now shifting it in pill form.

But it is not only the black market that is responsible for the overdose epidemic caused by fentanyl. Perdue Pharma, the manufacturer of the opiate OxyContin, has been blamed for promoting the drug as a painkiller and triggering a tsunami of addictions, which started a public health crisis in 2016. The company, owned by the Sackler family, filed for bankruptcy last year after local authorities flooded the courts with more than 2,600 lawsuits.

At the beginning of April this year, the Drug Enforcement Agency (DEA), alerted police forces throughout the country of an increase in the number of mass overdoses. “In just the past two months, there have been at least seven confirmed mass overdose events across the United States resulting in 58 overdoses and 29 overdose deaths,” said Anne Milgram, the head of the DEA, in a letter to law enforcement agencies. “Last year, the United States suffered more fentanyl-related deaths than gun-related and auto-related deaths combined.”

As fentanyl is being used to lace other drugs, agents have found that those who think they are using cocaine, for example, are actually taking the potent opiate. This has also been found to be the case with pills that mimic prescription drugs such as OxyContin, Percocet, Xanax and Vicodin. The DEA explained: “This is creating a frightening nationwide trend where many overdose victims are dying after unknowingly ingesting fentanyl.” The agency warned that the deadly trend could worsen in 2022.

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