Fentanyl Has Outpaced Heroin as Drug Implicated Most Often in Fatal Overdoses

Fentanyl, a synthetic opioid 80 to 100 times stronger than morphine, is now the drug most often involved in fatal overdoses across the United States, according to a new report published by the Centers for Disease Control and Prevention. The document implicates the powerful drug in nearly 29 percent of all overdose deaths—more than 18,000 of the year’s 63,000 fatalities—in 2016.

Nadia Kounang of CNN writes that this figure represents a startling jump from 2011, when fentanyl was involved in just 4 percent, or about 1,600 instances, of fatal overdoses. That same year, oxycodone—a semi-synthetic opioid prescribed as a legal painkiller but often abused due to its addictive qualities—was the deadliest drug, popping up in 13 percent of all U.S. overdose deaths.

Between 2012 and 2015, heroin surpassed oxycodone, but as The Huffington Post’s Erin Schumaker points out, fatal overdoses involving fentanyl rose about 113 percent per year from 2013 to 2016. Heroin use also increased during this time, with heroin-related deaths skyrocketing from 4,571 in 2011 to 15,961 in 2016.

More than two-thirds of fentanyl-related deaths involved at least one other drug—a trend likely linked to the fact that drug dealers often lace heroin and cocaine with fentanyl in order to increase potency at a low cost, reports NPR’s Laurel Wamsley. And, according to CNN’s Kounang, the report further shows that in 2016, two out of five cocaine-related overdose deaths also involved fentanyl, while nearly one-third of fentanyl-related fatalities also involved heroin. More than 20 percent of methamphetamine overdose deaths also mentioned heroin.

The scale and seriousness of the national drug crisis is evident in these numbers, but opioids aren’t the only substances contributing to the epidemic, reports Katie Zezima for The Washington Post. Cocaine and methamphetamine, stimulants once believed to be lessening in popularity, are not fading. Between 2011 and 2016, overdose deaths from cocaine increased by around 18 percent each year.

Earlier this month, the CDC published three separate reports detailing a worrying downward spiral in Americans’ average life expectancy. The Washington Post's Lenny Bernstein reports that the steady decline—a three-year drop that represents the longest sustained decline in expected lifespan since the tumultuous period of 1915 to 1918—to “escalating drug and suicide crises.”

In 2017, drug overdoses claimed 70,237 lives, while suicides claimed more than 47,000. Both of these figures rose between 2016 and 2017. Interestingly, Schumaker of The Huffington Post explains that these figures are reflected in the latest CDC report, which found certain drugs more likely to be implicated in either unintentional overdoses or death by suicide. In 2016, fentanyl, heroin and cocaine were most frequently cited in overdoses, while prescription and over-the-counter medicines such as oxycodone and hydrocodone were most frequently recorded in suicides.

Combined, the quartet of December reports present a stark portrait of the drug and suicide crises’ increasingly deadly toll. Still, the newest report’s lead author, Holly Hedegaard of the National Center for Health Statistics, tells Schumaker that the findings could help experts and policymakers better understand the patterns underlying both public health emergencies.

Hedegaard concludes, “For folks who work in prevention, having information helps them think about what prevention tactics to use or approaches that might be effective.”

Meilan Solly | | READ MORE

Meilan Solly is Smithsonian magazine's senior associate digital editor, history.