The tainted drug supply in the United States continues to exact a grim toll as overdose deaths exceeded 107,000 in 2021, according to an estimate released on Wednesday by the Centers for Disease Control and Prevention. Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in a statement that the most recent overdose numbers are “truly staggering.”

The CDC estimate exceeds the previous record for the number of overdose deaths set in 2020 by 15% and represents the equivalent of a death caused by drug overdose in the United States approximately every five seconds. The new record continues a trend of an increasing number of overdose deaths that has plagued the nation for more than twenty years, largely fueled by the nationwide opioid epidemic.

Deaths Involving Synthetic Opioids Also Up

Last year, the number of overdose deaths involving fentanyl and other synthetic opioids surpassed 71,000, a 23% increase over 2020. Deaths involving cocaine also increased by 23%, while deaths involving methamphetamine and other stimulants rose by 34%.

Fentanyl is often used by illicit manufacturers in counterfeit prescription opioids, making the drugs’ dosage and risk of overdose uncertain. CDC officials also noted that other drugs are often cut with fentanyl by unscrupulous dealers, who often leave their customers unaware of the danger.

“The net effect is that we have many more people, including those who use drugs occasionally and even adolescents, exposed to these potent substances that can cause someone to overdose even with a relatively small exposure,” Volkow said, as quoted by the Los Angeles Times.

The nation’s epidemic of overdose deaths continued to rise last year as the coronavirus pandemic isolated those with drug problems and made effective substance misuse treatment and mental health services more difficult to access. Keith Humphreys, an addiction and drug policy researcher at Stanford University, believes that the deadly trend is likely to continue.

“2022 will probably be as horrible as 2021 was, quite possibly worse,” Humphreys told the Washington Post.

The rise in overdose deaths last year varied geographically. Alaska saw the biggest jump in deaths with an increase of 75%, while Hawaii saw a 2% reduction in deaths caused by drug overdoses.

Humphreys said that the United States is likely to see more than a million overdose deaths in the span of a decade without substantive public policy changes. He also noted that the rise of synthetic opioids such as fentanyl will also continue because they can be produced in a lab more easily than traditional plant-based drugs can be grown. The ramifications of the readily available drugs, which can easily be bought through social media apps and other online platforms, remain to be seen.

“There may not be much heroin around in 10 years because everything is fentanyl,” Humphreys said. “What do you do in a world where no one needs a farm anymore to make drugs?”

Harm Reduction Saves Lives

Humphreys said that a single solution will not be the answer to the nation’s epidemic of drug overdoses. But harm reduction measures including increasing access to the drug naloxone, which can reverse the effects of an overdose, can help reduce the death toll.

“I think of naloxone like I do fire extinguishers,” he said. “Generally, they sit on a wall and they’re not needed. But when there’s a fire, there’s nothing like a fire extinguisher.”

Drug policy advocates including Sheila Vakharia, deputy director of research and academic engagement at the Drug Policy Alliance, expressed dismay at Wednesday’s news from the CDC.

“It’s absolutely devastating and heartbreaking that we continue to remain in this position,” Vakharia told NPR. “We are over 20 years in this overdose crisis and there’s no sign of any kind of slowing down of deaths. If anything, things have only seemed to have gotten more dire.”

Last month, the Biden administration announced a plan to address the rising number of overdose deaths, which includes support for harm reduction methods including increased access to naloxone. The new funding is a positive sign from the federal government, according to Vakharia.

“Harm reduction has historically been incredibly underfunded and has been relegated to state and local funding or private funding to sustain itself,” she said.

Vakharia noted that much more can be done to increase harm reduction programs, including support for overdose prevention centers like the one that opened in New York City late last year. Despite the success of the centers internationally, there are only “two legally operating above-the-ground harm reduction overdose prevention centers in the country,” when they could be saving lives across the nation with more support.

“And so I think that all of our efforts moving forward can definitely be further enhanced, can be further amplified and further ramped up,” Vakharia added.

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