Overdose deaths from synthetic opioids increase while overall opioid deaths decline

Overall deaths due to opioid overdose decreased from 2017 to 2018, but deaths from synthetic opioids, such as fentanyl, increased during that time period, according to CDC data.

CDC researchers used data from the National Research Statistics System to examine changes from 2017 to 2018 in age-adjusted deaths that involved all opioids and opioid subcategories according to demographics, urbanization levels by county, U.S. Census region, and state. Opioids were categorized as natural (morphine and codeine), semisynthetic (oxycodone, hydrocodone, hydromorphone, and oxymorphone), prescription (methadone, natural, and semisynthetic opioids), and synthetic (methadone, tramadol, and fentanyl), with heroin being its own category. The results of the study were published by Morbidity and Mortality Weekly Report on March 20.

In 2017, 70,237 deaths in the U.S. were due to drug overdose, and of these, 68% involved an opioid. In 2018, 67,367 people died of a drug overdose, a 4.1% decrease from 2017, and 46,802 (approximately 70%) involved opioids. From 2017 to 2018, a decrease of 2.0% was seen in opioid-involved death rates, from 14.9 per 100,000 population to 14.6 per 100,000 population. Overdose deaths related to prescription opioids and heroin decreased by 14% and 4%, while overdose deaths involving synthetic opioids increased by 10%. Rates of opioid-involved deaths decreased from 2017 to 2018 among women, among patients ages 15 to 34 years and those ages 45 to 54 years, and non-Hispanic white patients, as well as in the Midwest and the South. Increases were seen in this time period among people 65 years of age and older and non-Hispanic black patients and Hispanic patients, as well as in the Northeast and the West.

The authors concluded that the decrease in opioid-related deaths from 2017 to 2018 was related mostly to decreases in deaths involving prescription opioids and that the rise in deaths related to synthetic opioids was probably linked to increased availability of illicitly manufactured fentanyl, including fentanyl analogs. They also noted that their findings indicate a need for interventions tailored to different high-risk groups that address social determinants of health, among other factors, and called for continued urgent action. “A comprehensive, multisectoral surveillance, prevention, and response approach remains critical for sustaining and expanding preliminary successes in reducing opioid-involved overdose deaths and specifically curtailing synthetic opioid-involved deaths and other emerging threats,” they wrote.