CDC says ‘increase in overdose deaths is concerning,’ offers recommendations
There were 81,230 drug overdose deaths in the United States in a 12-month period that ended in May — the highest number of overdose deaths ever registered in a similar time frame, according to the CDC.
The data suggest overdose deaths accelerated during the first few months of the pandemic.
“The increase in overdose deaths is concerning,” Deb Houry, MD, MPH, director of the CDC’s National Center for Injury Prevention and Control, said in a press release. “Our priority is to do everything we can to equip people on the ground to save lives in their communities.”
CDC data show that after a 4.1% decline in the number of overdose deaths from 2017 to 2018, the rate increased 18.2% from the 12 months ending in June 2019 to the 12 months ending in May 2020. During this time, drug overdose deaths increased more than 20% in 25 states and the District of Columbia, 10% to 19% in 11 states and New York City, and 0% to 9% in 10 states. Overdose deaths decreased only in four states.
Synthetic opioids were the primary driver of the increase in overdose deaths, the agency said.
In addition, overdose deaths involving cocaine and psychostimulants from the 12 months ending in June 2019 to the 12 months ending in May 2020 increased by 26.5% and 34.8%, respectively. According to the CDC, the growth in psychostimulant deaths is “consistent with the increased availability of methamphetamine in the illicit drug supply and increases in methamphetamine-related treatment admissions.” The agency said the number of deaths involving psychostimulants now surpasses the number of cocaine-involved deaths.
“As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways,” Robert R. Redfield, MD, CDC director, said in the release.
The agency offered the following recommendations for health care providers:
- Discuss with patients overdose and exposure risks from highly potent opioids such as illicitly manufactured fentanyl.
- Prescribe naloxone to patients with a prior history of overdose, opioid use disorder and/or those who use illicit opioids and other drugs that might be combined with illicitly manufactured fentanyl.
- Co-prescribe naloxone to patients with high morphine milligram equivalents and those administered opioids and benzodiazepines.
- Offer overdose prevention education and take-home naloxone at inpatient and outpatient treatment programs, primary care settings, retail pharmacies, counseling and support groups and other community-based settings where these services do not exist.
- Advise patients that, depending on the potency of illicitly manufactured fentanyl and fentanyl analogs, as well as prolonged effects of opioids in some cases, multiple doses of naloxone may be needed for a single overdose event.
- Provide psychosocial treatment for patients who use cocaine and methamphetamine (eg, contingency management either by itself or in tandem with community reinforcement or cognitive-behavioral therapy).
The CDC said that community needs and characteristics are key to determining which recommendations health care providers should follow.
- CDC. Increase in fatal drug overdoses across the United States driven by synthetic opioids before and during the COVID-19 pandemic. https://emergency.cdc.gov/han/2020/han00438.asp. Accessed Dec. 17, 2020.
- Press Release. Overdose Deaths Accelerating During COVID-19, Expanded Prevention Efforts Needed. Issued December 17, 2020.