According to the CDC’s latest statistics, about 200 Americans are now dying each day from drug overdoses—the first time the numbers have breached that benchmark. About 136 of the 200, or 68 percent, are dying of opioid overdoses.
The agency’s provisional data show that 72,855 people likely died of drug overdose during the 12-month period ending November 30, 2017—a rise of 13.2 percent over the previous 12-month period, ending November 30, 2016. The agency reports that 49,466 of those deaths involved at least one opioid.
The most commonly detected drugs in fatal overdose victims during this period were synthetic opioids—mainly illicit fentanyl and its chemical variations—which were found in 40 percent of all overdose victims and in 59 percent of all opioid-related deaths.
Fentanyl is 30 to 50 times more powerful than heroin, and some of its variations, or analogs, are stronger still. Fentanyl is often now laced into heroin or other drugs, without the user’s knowledge. Even those who seek out fentanyl may not be able to survive its unexpected strength, especially if they are relapsing after period of abstinence, and have lost their tolerance to opioids.
At least another 15,279 deaths during this period—21 percent of all drug deaths and 31 percent of all opioid fatalities—involved common prescription drugs, like hydrocodone and oxycodone. Though some people think the prescription opioid problem is subsiding, this figure still represents a 3 percent increase year-over-year. (The CDC’s categories are not mutually exclusive, and many overdose victims have multiple drugs in their system.)
The most recent finalized overdose death numbers from the Centers for Disease Control and Prevention are for calendar year 2016. They showed 63,632 deaths, of which 42,249 involved an opioid. The finalized figures for 2017 won’t be ready until December.
Last August, however, the CDC began releasing, after a six-month lag, monthly updates of provisional overdose death data relating to rolling 12-month periods. This data is incomplete and, therefore, “subject to change.” The “predicted” numbers described in this article are a mix of both hard data—69,948 reported deaths for the 12 months ending November 30, for instance—plus statistical adjustments reflecting past experience with the data still outstanding or under investigation.
The state with the most severe hike in overdose death rates, according to these numbers, was Nebraska, which experienced a 35.7 percent increase. But that jump may reflect, at least in part, that Nebraska had the country’s lowest overdose death rate to start with—just 6.4 per 100,000 people in 2016, compared to a national average of 19.8. (The worst statewide rate that year was West Virginia’s, at 52 per 100,000.) A spokesperson at the Nebraska Department of Health and Human Services did not respond to calls and an email seeking comment.
More troubling is the case of New Jersey, which endured the country’s second worst overdose fatality hike—a 33 percent year-over-year increase for the period ending November 30. (For the 12-month spans ending September 31 and October 31, New Jersey owned the nation’s worst increases, at 50 percent and 42 percent, respectively.)
New Jersey’s numbers are striking because few American political figures have been as associated with the fight against drugs as New Jersey’s then-governor, Chris Christie, who last year chaired the President’s Commission on Combating Drug Addiction and the Opioid Crisis. (Christie was succeeded as governor by Phil Murphy on January 16.) While campaigning for the presidency in November 2015, Christie revealed—in speeches whose videos later went viral—how he had been personally touched by the epidemic. He recounted how an admired law school classmate fatally overdosed on Percocet (oxycodone plus acetaminophen) and vodka. His administration later spent $42.6 million on television commercials, in which Christie himself appeared, urging residents to seek help for addiction.
Christie did not respond to inquiries left with his spokesperson.
Four experts interviewed by Opioid Watch identify the rising influx of fentanyl into the New Jersey as the key factor in the increase, rather than any glaring failure on Christie’s or New Jersey’s part.
Lewis Nelson, chair of the medical toxicology division at the Rutgers New Jersey Medical School, observes in an interview that fentanyl can be flown, shipped, or mailed into the state in many ways, including the Port of Newark and the Newark, New York, and Philadelphia airports.
“We’re so close to the source,” he says, “the purity is greater, so the concentration is higher”—i.e., more dangerous. “The further you go down the chain of distribution, the more it gets diluted.”
Frank Greenagel, Jr., who headed a New Jersey task force on heroin and opiate use in 2014, also focused on fentanyl, but with a slight twist. He says the recent numbers may reflect that fentanyl was actually a little slower to reach New Jersey than in some other northeastern states—and now it’s finally catching up with a vengeance. “Now the wave is cresting,” says Greenagel, an adjunct professor at the Rutgers School of Social Work.
New Jersey has severe pockets of poverty that have had heroin problems for years, especially in Camden, Newark, and Paterson, and where fentanyl is now elevating death rates.
“I do think that deep down he did care,” Nelson said of former Gov. Christie. “But the problem he cared about was prescription opioid-related death, which is a middle-class problem. The population really dying at a much higher rate is the illicit users.”
The neighboring states of Delaware and Pennsylvania experienced the third and fourth worst overdose fatality hikes in the country: 29.4 percent and 27 percent, respectively, with Pennsylvania being tied with Indiana.
Eight states showed reductions in overdose death, though most of them—like Wyoming, which had the largest drop, at 26.3 percent—had relatively low statewide death rates to start with. The only hard-hit, northeastern state to show a reduction was Rhode Island, with a 4 percent drop. (We’ve written about some reasons why.) The other states with decreasing death rates were Utah, Minnesota, North Dakota, Idaho, Kansas, and Mississippi.
The CDC’s data for the latest 12-month period are summarized below.
|Drug Present||# of ODs||% opioid ODs||% drug ODs|
|Synthetic opioid (e.g., illicit fentanyl)||29,293||59%||40%|
|Heroin (an opioid)||16,240||33%||22%|
|Natural or Semi-Synthetic opioid (e.g. oxycodone, hydrocodone, etc.)||15,279||31%||21%|
|Psychostimulant (e.g., meth)||10,643||——————–||15%|
|Methadone (an opioid)||3,299||7%||5%|