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The premier resource for hospital professionals from Relias Media, the trusted source for healthcare information and continuing education.

Drug Overdose Deaths Top 100,000 for First Time

By Jill Drachenberg, Editor, Relias Media

For the first time, American drug overdose deaths topped 100,000 in 12 months, according to provisional data from the Centers for Disease Control and Prevention (CDC).

From April 2020 to April 2021, 100,306 overdose deaths were reported — a 28.5% increase from the previous year. Most of the deaths — 75,673 — were caused by opioids, an increase from 56,064 the year before.

This was largely fueled by fentanyl, which accounted for nearly two-thirds of the overdose deaths — a whopping 49% increase over the fentanyl deaths the year before. Methamphetamine- and cocaine-related overdoses increased by 48%.

The overdose deaths were fueled by the rise of fentanyl and by the COVID-19 pandemic. Isolation from support systems during the pandemic can lead to greater usage of illicit drugs or could lead to relapse. Access to substance use disorder (SUD) treatment remained an issue during the pandemic. Although all states quickly passed laws requiring benefit coverage for telehealth services, only 22 states waived the pre-existing patient-provider relationship for SUD treatment, meaning patients must have visited the telehealth provider in person. The 2016 Comprehensive Addiction and Recovery Act expanded buprenorphine prescribing waivers to physician assistants and nurse practitioners; however, burdensome state regulations prevented many from taking advantage, according to an analysis of state and federal SUD treatment policies.

“This cross-sectional study found that federal and state governments have taken important steps to ensure OUD [opioid use disorder] treatment availability during the COVID-19 pandemic, but few states are comprehensive in their approach,” the authors noted. “With considerable policy changes potentially affecting access to treatment and treatment retention for patients with OUD during the pandemic, evaluations must account for the variation in state approaches in related policy areas because the interactions between policies may limit the potential effectiveness of any single policy approach."

Experts also are urging more harm reduction policies, such as fentanyl test strips, that could potentially save substance users from unintentionally ingesting fentanyl. Currently, such test strips are considered illegal drug paraphernalia. The American Medical Association (AMA) is advocating for civil and criminal immunity for use of drug contamination testing and clean needles.

“Over the past decade, mitigation efforts like syringe service programs have effectively promoted safe use and recovery for people who inject drugs,” AMA Immediate Past Board Chair Russell W.H. Kridel, MD, said in a statement. “This policy builds on those successful efforts and seeks to break down barriers to better address the ongoing tragedy of the drug-related overdose crisis.”