More Americans died of drug overdoses in 2021 than in any previous year, a grim milestone in an epidemic that has now claimed 1 million lives in the 21st century, according to federal data released Wednesday.
More than 100,000 Americans died of drug overdoses in 2021, up 15% from the previous year, according to an estimate released by the National Center for Health Statistics. The tally of 107,622 reflects challenges exacerbated by the coronavirus pandemic: lost access to treatment, social isolation and a more potent drug supply.
Drug overdoses, which long ago surged above the country's peak deaths from AIDS, car crashes and guns, killed about one-quarter as many Americans last year as covid-19.
More than 80,000 people died using opioids, including prescription pain pills and fentanyl, a deadly drug 100 times as powerful as morphine and increasingly present in other drugs. Deaths from methamphetamine and cocaine also rose.
Since the start of the 21st century, an overdose epidemic led by prescription pain pills and followed by waves of heroin, fentanyl and meth has killed more than 1 million people, or roughly the population of San Jose, according to the provisional data.
And there is no clear end in sight, according to experts.
"2022 will probably be as horrible as 2021 was, quite possibly worse," said Keith Humphreys, an addiction and drug policy researcher at Stanford University.
Nora Volkow, director of the National Institute on Drug Abuse, said the country is emerging from the pandemic with a "significant increase" in depression, anxiety, loneliness and suicidal thinking, "and that's not going to disappear."
"I think the next few years will be challenging," she said.
PANDEMIC EFFECT
Officials warn that they are responding to more and more overdoses as the pandemic has persisted. Pennsylvania Attorney General Josh Shapiro's office has seized 1.8 million doses of fentanyl in the first three months of 2022, more of the potent synthetic opioid than in all of 2021.
Overdose deaths nationwide jumped to previously unseen levels in the first half of the pandemic, rising 30% from 2019 to 2020. The pandemic strained finances, mental health, housing and more for many, all the while overshadowing the drug crisis. There is concern that a predicted spike in coronavirus cases this fall could again curtail access to treatment and medication.
Covid-19 has taken as many lives in two years as the opioid epidemic has over a two-decade span. The victims of the drug epidemic, however, are overwhelmingly young. Between 2015 and 2019, young Americans lost an estimated 1.2 million years of life from drug overdoses, according to a study published in JAMA Pediatrics in January.
Rural areas have been especially devastated by the overdose crisis during the pandemic, as residents struggle to reach remote, limited treatment options. Alaska experienced the biggest increase in overdose deaths in 2021, roughly 75%, according to the federal data. The National Center for Health Statistics is part of the Centers for Disease Control and Prevention.
In Arkansas, there was a 20% increase in the number of drug overdose deaths from December 2020 to 2021. The total number of overdose deaths in the state was 618, according to preliminary data from the CDC.
From February to August 2019, Arkansas saw a dip in the number of drug overdose deaths. But since March 2020, the number of people who have died from overdoses has steadily gone up according to CDC data. Arkansas drug and health officials could not be reached for comment.
In California, where more than an estimated 10,000 people died from overdoses in 2021, psychostimulants such as methamphetamine made up about half of the overdose deaths and led to 15% more deaths than the prior year, according to a Washington Post analysis of the data. Opioid overdoses, including fentanyl, jumped more than 27% in the state.
Between 2018 and 2020, drug users in San Francisco shifted from injecting tar heroin to smoking fentanyl after noticing improved health and reduced stigma, according to research co-authored by Alex Kral, an epidemiologist at RTI International who has studied California's drug supply.
Experts have increasingly warned of a wave of meth. In 2021, nearly 33,000 people died from psychostimulants, less than half the deaths caused by opioids. The combination of an opiate with a stimulant -- commonly called a "speedball" -- has become increasingly popular, said Daniel Ciccarone, a professor at the University of California at San Francisco who studies drugs.
While the more potent drug supply will continue to drive deaths, Ciccarone predicted that the increasing rate of overdoses will flatten out or possibly decline within the next year due to a confluence of events: the pandemic easing, the government ramping up its response and drug companies paying billions to help abate the crisis. Still, the number of people using drugs is also on the rise, Ciccarone added.
"There's something to be said about demand," he said. "Why is America so hungry for drugs? Why does that seem to be increasing generation over generation? Does it have something to do with our economic inequalities and other disparities?"
Information for this story was contributed by Meryl Kornfield of The Washington Post, The New York Times and Neal Earley of the Arkansas Democrat-Gazette.