Overdoses are On the Rise, And It’s Not Just Opioids Anymore

Except for 2018, every year’s death toll from drug overdoses has been higher than the last. This trend has continued since the turn of the century. Now, the overdose crisis is being pushed forward by more than just opioid drugs.

There has been a recent surge in cocaine overdoses and meth overdoses. Many of these overdoses have been fatal. People are now dying from stimulant drugs that are not known for causing deaths, at least not in the high numbers of fatalities that are occurring today.

Overdose Deaths on the Rise, Across Multiple Sectors of Drug Use

Fatal overdoses are undoubtedly the worst tragedy connected to drug addiction. According to the Centers for Disease Control and Prevention, over 81,000 people died from drug overdoses from May 2019 to May 2020, the highest death toll from drugs during any 12 months ever recorded. The CDC reported that synthetic opioids (mainly illicit fentanyl) were the primary driver in the surge in deaths.

In just one year, fentanyl-related deaths went up 38%, with some geographic areas being hit much harder. For example, ten western states reported over a 98% increase in synthetic opioid-involved deaths.

Fentanyl has played a key role in the recent surges in overdose deaths, but it hasn’t been the only drug to cause thousands of people to die. At least not by itself. Overdoses involving cocaine also increased by 26%, with increasing evidence suggesting drug traffickers and cartels are adding illicit fentanyl to cocaine and meth batches to increase potency and make the drugs more addictive.

The same phenomenon has been occurring with psychostimulants, primarily methamphetamine. According to the CDC, overdose deaths involving psychostimulants recently increased by 34%. There is also a geographic factor in cocaine and meth deaths. From 2018 to 2019, the largest increase in overdose deaths involving psychostimulants like meth (often laced with fentanyl) occurred in the Northeast. Before 2018, the East Coast had the highest rate of psychostimulant deaths.

Cocaine and Meth

Throughout most of the 21s-century’s crippling addiction crisis, opioids played a prominent role in causing the most addiction, devastation, and death. Now that’s changing, particularly as more addicts are using multiple drugs at once. When they use multiple drugs, they die from multiple drugs.

“An alarming increase in deaths involving the stimulant drugs methamphetamine and cocaine are a stark illustration that we no longer face just an opioid crisis. We face a complex and ever-evolving addiction and overdose crisis characterized by shifting use and availability of different substances and use of multiple drugs (and drug classes) together.”

To that point, NIDA Director Dr. Nora Volkow writes, “An alarming increase in deaths involving the stimulant drugs methamphetamine and cocaine are a stark illustration that we no longer face just an opioid crisis. We face a complex and ever-evolving addiction and overdose crisis characterized by shifting use and availability of different substances and use of multiple drugs (and drug classes) together. Overdose deaths involving methamphetamine started rising steeply in 2009, and provisional numbers from the CDC show they had increased 10-fold by 2019 to over 16,500. A similar number of people die every year from overdoses involving cocaine (16,196), which has increased nearly as precipitously over the same period.” America no longer has just an opioid crisis but a crisis with multiple drug types.

The National Institute on Drug Abuse and the Centers for Disease Control and Prevention are not the only public health groups observing a surge in cocaine and meth deaths or the link to fentanyl that’s propelled the death rate forward.

A research paper in the journal Addiction also discovered the same connection and the fact that cocaine and meth overdoses have been on the rise, particularly from fentanyl being mixed with cocaine and meth. Quoting the authors, “While increases in cocaine‐involved deaths in the United States from 2006 seem to be driven by opioids, particularly synthetic opioids, increases in non‐fatal and fatal overdoses involving psychostimulants are occurring with and without opioids.” Drug addiction is becoming more complex and more dangerous as addicts take multiple drugs at once.

Fatal Drug Overdoses – Summarizing A Public Health Crisis

Even separating fentanyl, cocaine, and meth from the picture, overdose deaths for all other types of drugs are also on the rise. There is a crisis of drug overdose deaths in this country, a National Public Health Emergency that must be addressed. According to the Centers for Disease Control and Prevention, almost 841,000 people have died from drug overdoses since 1999, with each year’s death toll being higher than the last. In 2019, 70,630 people died from drug overdoses (a 4% increase from 2018). And while the numbers are still being finalized for 2020, CDC experts predict that deaths will have been even higher in 2020 than they were in 2019.

Opioids continue to be the main driver behind overdose deaths. Despite surges in cocaine and meth deaths, opioids still account for almost 73% of all fatal overdoses in the United States. That amounts to 49,680 opioid-related overdose deaths in 2019.

Addiction Treatment – The Way Out of an Addiction to Stimulants

An addiction to drugs is a life or death matter, no matter what type of drug an addict uses. As stimulant drug deaths rise from cocaine and meth addiction, public health experts must broaden their approach towards helping addicts. The National Public Health Emergency decree in 2017 that was meant to be directed solely at opioids now must be broadened to include other drugs. The last several years have been a grim reminder that no addict is ever safe using any drug type.

Now more than ever, addiction treatment is a must for those who use drugs and alcohol. Dr. Volkow’s recommendations and warnings seem particularly relevant here. She writes, “Efforts to address stimulant use (cocaine and meth) should be integrated with the initiatives already underway to address opioid addiction and opioid mortality. The complex reality of polysubstance use is already a research area that NIDA funds, but much more work is needed. The recognition that we face a drug addiction and overdose crisis, not just an opioid crisis, should guide research, prevention, and treatment efforts going forward.” Truly, if we as Americans are going to tackle the addiction epidemic effectively, we’ll have to broaden our focus to help all persons who are addicted to all types of drugs, including those who are using more than one type of drug.

The Sources (cited in the order of appearance in the article):

• https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html
• https://www.drugabuse.gov/about-nida/noras-blog/2020/11/rising-stimulant-deaths-show-we-face-more-than-just-opioid-crisis
• https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14878
• https://www.cdc.gov/drugoverdose/data/statedeaths.html
• https://www.drugabuse.gov/about-nida/noras-blog/2020/11/rising-stimulant-deaths-show-we-face-more-than-just-opioid-crisis

Reviewed by Matt Hawk, BS, CADC-II, ICADC