Fatal Opioid Overdoses Skyrocket During COVID-19 Lockdowns

By Jessica Pyhtila, PharmD, BCGP, BCPS

The CDC recently published an advisory stating that overdoses from synthetic opioids, generally fentanyl, and psychostimulants have significantly increased during COVID-19 mitigation attempts. The largest increase in overdose deaths so far was observed from March through May 2020, coinciding with the onset of most COVID-19 lockdowns and mitigation efforts.

The 81,230 deaths reported by the CDC that took place between May 2019 and May 2020 represent the highest number of annual drug overdoses on record and is an 18.2% increase over the previous year. This comes on the heels of a 4.1% decrease in drug overdose deaths from 2017 to 2018. Synthetic opioids like fentanyl are the main drivers of the increase, with synthetic opioid deaths increasing 38.4% over the previous year. Notably, however, some jurisdictions including California, Oregon, Nevada and Wisconsin have reported more than a 50% increase in their synthetic opioid deaths during that timeframe. Among states that reported synthetic opioid overdose data, New Hampshire and Hawaii were the only states to report an overall decrease in synthetic opioid overdose deaths.

Psychostimulant overdose deaths, largely due to methamphetamine, climbed 34.8% over the past year. The number of overdose deaths from psychostimulants now exceeds the number of overdose deaths from cocaine, which also spiked dramatically. The CDC also notes that a 26.5% increase in cocaine overdoses occurred in the 2019–2020 reporting period. Some data indicates that these deaths may be due to mixing cocaine with illicit opioids, intentionally or unintentionally as street drugs may be cut with fentanyl without users’ knowledge.

The CDC recommends that healthcare providers take several steps to help patients reduce the risk of overdose. These include, but are not limited to:

— Educating patients about the increasing risks of consuming fentanyl in the illicit drug supply chain

— Prescribing naloxone to at-risk patients

— Educating patients that multiple naloxone doses may be required, and that naloxone wears off

— Consider referring patients dependent on opioids to medication-assisted treatment regimens

— Help patients and caregivers develop post-overdose action plans

References:

Centers for Disease Control and Prevention. “Increase in Fatal Drug Overdoses Across the United States Driven by Synthetic Opioids Before and During the COVID-19 Pandemic.” December 17, 2020. Retrieved from https://emergency.cdc.gov/han/2020/han00438.asp