More than 63,000 people died from a drug overdose last year – that’s more than the number of deaths caused by AIDS in 1995, according to data from the Centers for Disease Control and Prevention.
Between 2015 and 2016, the number of people who died from a drug overdose involving illicitly-manufactured fentanyl, a synthetic opioid, more than doubled.
Available data shows that heroin contaminated with fentanyl has largely driven the recent increases in opioid-related overdose deaths, Dr. Deborah Dowell from the CDC wrote in an article published this week in JAMA.
“Illicitly manufactured fentanyl is usually added to or sold as heroin,” Dowell wrote. “For every individual using heroin during recent years in the United States, it is likely that the risk of overdose death has increased considerably.”
Fentanyl, which is nearly twice as potent as heroin, is often mixed with heroin and other drugs because a smaller dose can provide an equivalent effect at a lesser cost.
The authors point out that although there is not a lot of data around interventions to prevent overdoses related to fentanyl, there are interventions designed to treat opioid use disorder and those are likely to also lessen overdoses related to fentanyl.
“Unnecessary exposure to prescription opioids must be reduced to prevent development of opioid use disorder in the first place. Despite recent progress, 3 times the amount of opioids were prescribed in 2015 compared with 1999. Among people ultimately entering treatment for opioid use disorder, the proportion starting with prescription opioids rather than heroin has decreased in one study from more than 90% in 2005 to 67% in 2015. However, prescription opioid exposure remains a path to heroin use,” the article says.
Dowell and her co-authors write that there are a number of things that need to be done to help curb the opioid epidemic, including offering medication-assisted treatment in clinics, establishing emergency department protocols to help patients find treatment and using real-time data to identify opioid overdoses more quickly.
In most areas of the U.S., barring a few western states, people who are using heroin should assume the local supply is laced with fentanyl, the team noted.
“The safest strategy is to avoid exposure to heroin and seek effective treatment. People who are unable to do this can reduce risk by avoiding use while alone, and making sure associates have and know how to use naloxone,” Dowell wrote.
“The current opioid crisis has evolved over the past two decades and is unlikely to be resolved soon. Opioid use and abuse has taken the lives of hundreds of thousands of people in the United States and is likely to adversely affect and end many more lives. Concerted, multifaceted action, including reducing exposure to illicitly manufactured fentanyl, will be necessary to reduce the catastrophic toll of opioid-related deaths.”
