New Data on US Opioid Overdose Deaths

Megan Brooks

March 19, 2020

Opioid overdose deaths in the United States involving prescription opioids and heroin decreased from 2017 to 2018, while deaths involving synthetic opioids (excluding methadone) increased, new data from the US Centers for Disease Control and Prevention (CDC) show.

"Decreases in overdose deaths involving prescription opioids and heroin reflect the effectiveness of public health efforts to protect Americans and their families," CDC Director Robert Redfield, MD, said in a news release.

"While we continue work to improve those outcomes, we are also addressing the increase in overdose deaths involving synthetic opioids. We must bring this epidemic to an end," Redfield added.

The data were published online March 19 in the Morbidity and Mortality Weekly Report.

Increase in Synthetic Opioid Deaths

CDC epidemiologist Nana Wilson, PhD, and colleagues analyzed changes in age-adjusted overdose death rates from 2017 to 2018 by demographic characteristics, county urbanization levels, US Census region, and state.

Drug overdoses resulted in 67,367 deaths in the United States in 2018, a 4.1% decrease from 2017. Opioids were involved in 46,802 of these drug overdose deaths, or about 70%.

From 2017, to 2018, US overdose death rates involving all opioids, prescription opioids, and heroin fell 2%, 13.5%, and 4.1%, respectively, while deaths involving synthetic opioids (other than methadone) jumped by 10%.

In 2018, nearly half of all drug overdose deaths involved synthetic opioids (31,335 of the total). Proliferation of illicitly made fentanyl or fentanyl analogues in the illicit drug supply likely drove the increase in deaths involving synthetic opioids (excluding methadone) from 2017 to 2018, the researchers say.

Deaths due to synthetic opioids increased during the study period in males and females, people aged 25 years and older, non-Hispanic whites, non-Hispanic blacks, Hispanics, and non-Hispanic Asian/Pacific Islanders, they report.

Increases in synthetic opioid deaths were seen in large and small urban areas in the Northeast, the South, and the West but remained stable in the Midwest. The four states with the highest increases in synthetic opioid overdose deaths were Arizona, California, Washington, and Missouri.

Wilson said it's important to note that although opioid overdoses decreased from 2017 to 2018, they "still remain high. Efforts must be strengthened to maintain and accelerate decreases in deaths involving prescription opioids and heroin and to prevent continued increases in overdose deaths involving synthetic opioids."

The CDC continues to work with federal agencies to support the US Department of Health and Human Services' Five-Point Strategy to combat the opioid crisis. The strategy focuses on preventing opioid misuse, treating patients who are currently addicted to opioids, and preventing opioid overdose.

"To sustain decreases and continue to prevent and respond to drug overdoses, specifically those involving synthetic opioids, it is critical to have a coordinated response," Debra Houry, MD, MPH, director of the CDC's National Center for Injury Prevention and Control, said in the release.

"Medical personnel, emergency departments, public health and public safety officials, substance abuse treatment providers, community-based organizations, and members of the community all play a role in addressing this complex and fast-moving epidemic," she added.

The authors have disclosed no relevant financial relationships.

MMWR Morb Mortal Wkly Rep. Published online March 19, 2020. Full text

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