Recently, the U.S. government released the first complete tally of nationwide drug deaths in 2016, showing that about 64,000 people died of overdoses last year. That’s an increase of more than 22 percent over the 52,404 deaths recorded in 2015.
The most troublesome statistic is the growth in deaths caused by synthetic opioids – mainly fentanyl and its analogues.
Deaths involving synthetic opioids, mainly fentanyls, grew to more than 20,000, up from 3,000 in 2013 — a 540 percent increase. Drug deaths caused by fentanyl more than doubled from 2015 to 2016, to 20,100. Heroin caused 15,400 deaths last year, followed by 14,400 deaths attributed to prescription opioids.
The new report is the first national data to quantify the growth in fatal overdoses by drug and by state.
Of the 21 states that reported the high-quality data for 2016, the largest increases in drug overdose deaths were in Delaware (up 71 percent, to 309), Maryland (up 67 percent, to 2,171), and Florida (up 55 percent, to 5,167), the New York Times reported.
According to the National Center for Health Statistics, fentanyl and fentanyl analogues were the biggest cause of overdoses in 2016, at 20,100; followed by heroin, 15,400 heroin deaths and 14,400 deaths from prescription opioids.
One reason fentanyl is so dangerous is that an amount as little as two milligrams (about the size of two grains of salt) can cause an overdose. Fentanyl is 50 to 100 times more toxic than morphine and 100 times more potent than heroin, according to the National Institute on Drug Abuse. After being ingested, it can reach the brain within minutes and cause respiratory failure.
Dealers often combine fentanyl with other drugs; it has been found mixed with heroin, cocaine and oxycodone. Since fentanyl has no smell or taste, users can’t detect its presence.
Doctors prescribe fentanyl for cancer patients with tolerance to other narcotics. It comes in skin patches, lozenges, nasal spray and tablets. As a schedule II prescription drug, it is typically used to treat patients with severe pain or to manage pain after surgery.
It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. In its prescription form, fentanyl is known by such names as Actiq, Duragesic, and Sublimaze.
Some pharmaceutical fentanyl is illegally diverted to the black market. But most illicit fentanyl – and “copycat” drugs – is manufactured in clandestine labs, many of those in China. The U.S. Drug Enforcement Administration has linked many fentanyl seizures to Mexican drug-trafficking groups.
The non-pharmaceutical fentanyl is sold in several forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. People can swallow, snort, or inject fentanyl, or they can put blotter paper in their mouths so that fentanyl is absorbed through the mucous membrane.
Robert Perez, an acting commissioner with the U.S. Customs and Border Protection (CBP) agency, said recently he expects the numbers of seizures in the mail and from delivery services like FedEx and UPS will be much higher than they were in 2016. He said CBP seized more than 400 pounds of fentanyl in fiscal year 2016 — up from eight pounds in 2014.
But it remains difficult to detect and intercept, and the amount of fentanyl coming into the U.S. continues to grow.