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News From the Centers for Disease Control and Prevention
February 9, 2021

Accelerated Overdose Deaths Linked With COVID-19

JAMA. 2021;325(6):523. doi:10.1001/jama.2021.0074

More than 81 000 people died of drug overdoses in the US between June 2019 and May 2020, a record-breaking number that CDC officials suggested is related to the coronavirus disease 2019 (COVID-19) pandemic.

US Drug Enforcement Agency

Synthetic opioid use—primarily illicit fentanyl—appeared to explain why overdose deaths reached a new peak. Compared with the 12-month period ending in June 2019, synthetic opioid overdose deaths increased by 38% during the subsequent 12 months, the CDC reported.

“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” then-CDC Director Robert Redfield, MD, said in a statement.

Historically, deaths involving illicit fentanyl have been concentrated in states east of the Mississippi River, but during the 12 months ending in May 2020, fentanyl-related overdose deaths increased by 98% in 10 Western states, according to a CDC health advisory. Overdose deaths involving cocaine increased by 27%; many were the result of mixing synthetic opioids with cocaine. Methamphetamine overdoses increased by 35% between June 2019 and May 2020.

In its advisory, the CDC recommended that clinicians alert patients to the risks of highly potent synthetic opioids and that they prescribe naloxone for high-risk individuals such as those with a history of a substance use disorder or a previous overdose. Clinicians should also ensure that patients know it could take multiple doses of naloxone to reverse an overdose involving fentanyl or other synthetic opioids.

The agency also recommended coprescribing naloxone for patients who take high-dose prescription opioids or for patients receiving prescription opioids along with benzodiazepines, which may increase the risk of overdose.