fentanyl overdose on the rise

U.S. News: by Gaby Galvin, Staff Writer

Fentanyl has surpassed heroin as the top drug involved in U.S. overdose deaths, according to new data from the Centers for Disease Control and Prevention.

Driven largely by the synthetic opioid that’s 50 times more potent than heroin, the number of fatal drug overdoses in America climbed from 41,340 in 2011 to 63,632 in 2016 – a 54 percent increase – the CDC data show. A November report from the agency showed the death toll has risen even higher since then, reaching 70,237 last year, and that drug deaths are a leading cause of falling life expectancy in the U.S. in recent years.

Broad classifications can make it difficult to tally deaths associated with any specific drug, so for the new report, researchers searched the text of death certificates from 2011 to 2016 to come up with the totals.

“Figures should be considered the minimum number or rate for that … drug category because there could be additional deaths in which the drug was involved, but the drug was not reported in the literal text on the death certificate,” the report said.

Some drug categories in the report include related substances, with the fentanyl category including chemicals used to make it as well as analogues. Carfentanil, for example, is a fentanyl analogue 100 times more potent than fentanyl itself. Researchers also cautioned against comparing numbers across years, as reporting of specific drugs involved in a death improved over the period studied.

While fatal overdoses frequently involve multiple drugs, these 10 were identified to some degree in the greatest numbers of overdose deaths in 2016, according to the CDC data.

10. Diazepam

Category: Benzodiazepines
No. of Deaths: 2,022

Diazepam – a prescription drug that can be used to treat anxiety, seizures, alcohol withdrawal and other conditions – was involved in 3.2 percent of drug overdose deaths in 2016. Researchers did not cite specific variations, but common brands include Valium and Diastat.

9. Hydrocodone

Category: Opioids
No. of Deaths: 3,199

Prescription painkiller hydrocodone was involved in 5 percent of drug overdose deaths. Brand names containing the drug include Norco, Vicodin and Lorcet.

8. Methadone

Category: Opioids
No. of Deaths: 3,493

Methadone, a prescription drug used to treat pain, was involved in 5.5 percent of overdose deaths in 2016. It also is one of three drugs approved by the Food and Drug Administration to treat opioid dependence, easing withdrawal and helping to reduce cravings.

7. Morphine

Category: Opioids
No. of Deaths: 5,014

Morphine was part of 7.9 percent of overdose deaths in 2016. Researchers cautioned that similarities between morphine and heroin could lead to misclassification, resulting in potential “underestimation of the number of deaths involving heroin and overestimation of the number of deaths involving morphine.”

6. Oxycodone

Category: Opioids
No. of Deaths: 6,199

The share of overdose deaths involving oxycodone fell from a reported 13.5 percent in 2011 to 9.7 percent in 2016. Yet the painkiller still was part of 6,199 drug deaths in 2016, up from 5,587 in 2011. Oxycodone is sold via brand names Oxycontin, Roxicodone, Xtampza ER and Oxaydo.

5. Alprazolam

Category: Benzodiazepines
No. of Deaths: 6,209

Alprazolam, commonly sold as Xanax, is used to treat anxiety and panic disorders and was involved in 9.8 percent of overdose deaths. Almost all of these deaths also involved another drug, such as fentanyl, heroin or oxycodone.

4. Methamphetamine

Category: Stimulants
No. of Deaths: 6,762

Methamphetamine was involved in 10.6 percent of drug deaths. Between 2011 and 2016, the rate of overdose deaths involving meth more than tripled, from 0.6 to 2.1 deaths per 100,000 standard population.

3. Cocaine

Category: Stimulants
No. of Deaths: 11,316

Cocaine was involved in 17.8 percent of drug deaths in 2016, with nearly three-quarters of cocaine-related fatal overdoses also involving at least one other drug. Cocaine consistently ranked second or third among the country’s top drugs in fatal overdoses between 2011 and 2016.

2. Heroin

Category: Opioids
No. of Deaths: 15,961

Heroin, the most common drug involved in overdose deaths between 2012 and 2015, was involved in 25.1 percent of drug deaths in 2016. The rate of overdose deaths involving heroin more than doubled in recent years, from 1.5 deaths per 100,000 population in 2011 to 5.1 in 2016.

1. Fentanyl

Category: Opioids
No. of Deaths: 18,335

Fentanyl was involved in 28.8 percent of drug overdose deaths in 2016, up from 4 percent in 2011. About a third of fentanyl-related deaths also involved heroin, while a quarter involved cocaine.

Fentanyl’s rise seems to reflect the trajectory of the nation’s opioid crisis. It placed 10th among drugs involved in fatal overdoses in 2011, with opioid pain reliever oxycodone topping the list for that year.

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