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The Guardian - US
The Guardian - US
World
Melody Schreiber

‘Completely devastating’: US passes 1m overdose deaths since records began

People hold signs for loved ones lost to opioid overdoses during a protest at Purdue Pharma headquarters in Stamford, Connecticut, in August 2018.
People hold signs for loved ones lost to opioid overdoses during a protest at Purdue Pharma headquarters in Stamford, Connecticut, in August 2018. Photograph: Jessica Hill/AP

Trevor Foster, 26, loved the Cowboys, the Yankees, fishing, animals and above all his daughter.

Jarod Galloway, 21, wanted people to be the best version of themselves, and his niece was his favorite human.

Taylor Miller, 27, was a nursing student and a staunch supporter of anyone in recovery.

Michael Stabile, 15, was ending his freshman year with great grades and a promotion at the restaurant where he worked.

Jared Tyler Olvera, 20, always befriended the new kids at school.

Jordan Humphrey, 21, loved sneakers, cars and his family, who loved him “as big as the sky”.

All were among US overdose deaths in 2021, a record year for such fatalities with an estimated 107,622, the US Centers for Disease Control and Prevention (CDC) said on Wednesday.

It was an increase of 15% from the previous year, which was also a record.

The US has now passed 1m overdose deaths since the CDC began collecting data about two decades ago.

The surge in deaths in 2021 was fueled primarily by fentanyl, a highly dangerous synthetic opioid that accounted for about 70% of fatalities.

Black American men and boys have the highest fatality rates from drug overdoses, followed closely by American Indian and Alaska Native men and boys – a significant increase among these demographics in recent years.

Overdose deaths among teens have doubled in the past three years, even though drug use is decreasing overall among teens. Teens are more likely to buy pills they think are Adderall, Xanax or Percocet, seeking help in studying for exams, calming anxiety, helping sleep, or treating pain, said Dr Nora D Volkow, director of the National Institute on Drug Abuse (Nida) at the National Institutes of Health.

“They’ve been doing this for decades. What is now different is these prescription drugs that are illicitly manufactured containing fentanyl have increased fiftyfold,” Volkow said.

The almost fiftyfold increase in illicit pills containing fentanyl happened between 2018 and 2021, she said – a “huge proliferation”.

One-time and casual users, including children, are dying.

“They were poisoned by taking a pill that contains something that they did not know was there,” Volkow said.

Cameron March, 23, was a Sacramento Kings basketball fan, one of 10 children in a bustling blended family.

Cameron March.
Cameron March. Photograph: Lisa Ezell

From a friend, he bought two pills he thought were Percocet. He had struggled with anxiety and depression since middle school and he had bought pills before. This time, the pills, pressed to look like real prescription medication, contained twice the lethal dose of fentanyl.

On 11 August 2021, March never woke up.

“He didn’t really know how it’s everywhere,” said his mother, Lisa Ezell. “He just didn’t know.

“It’s completely devastating. That one missing person is just so glaringly obvious – his presence is so greatly missed.”

Cameron’s older siblings are stricken with grief and his younger siblings can’t comprehend why someone would “put poison in a pill and give it to him”, his mother said.

Volkow said: “We as a nation have to say, ‘What is it that we can do to avoid that [increase in deaths] happening again?’ What is it that we’re doing wrong?”

Drug overdoses are particularly tragic because they are entirely preventable, Volkow said. Opioid overdoses can be reversed with naloxone.

Schools and parents, Volkow said, need to reach out to kids to educate them on the dangers of fentanyl, and medical providers can screen for drug use in teenagers or the presence of an underlying mental disorder, like anxiety or depression.

Offering social support can also make a huge difference.

“Isolation, feeling that actually nobody cares for you, is one of the factors that increases risk – that you don’t have alternatives in your life, that you’re not doing well at school, that you feel very, very depressed and nobody seems to care,” Volkow said.

“This is a disease of distress. So what are the support systems that we need to provide to people to contain this very dangerous use of drugs?”

Harm reduction is also an important part of stemming the tide of deaths, Volkow said. That includes the widespread distribution of naloxone, which is extremely easy to use in the inhalable form known as Narcan.

“It’s a no-brainer,” Volkow said.

Offering substance use treatment options, distributing test strips to detect the presence of fentanyl, offering needle exchanges and safe injection sites, and ensuring a safe, uncontaminated supply of substances for those who continue using are also important steps for addressing the epidemic of overdose deaths.

Many of those who die from overdoses are young, Volkow said.

“They are in the most productive years of their life. Many of them have families and children, and all of them are left behind.”

Overdose can strike anyone, even the first time they take a contaminated pill.

“It’s not a drug addict problem,” Lisa Ezell said. “It could be a one-time thing at a party, or your kid has a toothache or a back problem and they get a pill from a friend.”

She wants officials to hold people accountable, and to do everything they can to spread the word about the epidemic sweeping the US.

“There’s so many people dying and nothing’s being done,” she said.

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