Fentanyl overdoses in New York City soared 3,000 percent between 2014 and 2017, new CDC figures reveal.
Despite attempts to curb opioid prescription, addiction and deaths, fentanyl – a synthetic drug up to 100 times stronger than heroin – has crept into the market.
It killed at least 18,335 Americans nationally in 2016, the latest year for which we have national data – which marks a 113 percent increase from 2013.
But rates are soaring fastest in urban areas, and experts warn cities like New York are petri dishes for what is set to come nationwide.
The new stats, released today, reveal that the rate of overall drug deaths in New York City almost doubled, rocketing 81 percent, between 2014 and 2017 – driven by a 3,000-percent increase in fentanyl deaths.
New CDC data (pictured) show fentanyl overdose deaths rose 3,000% in 2014-17 in NYC
‘The trends seen in NYC reflect the broader impact of fentanyl on rates of overdose deaths across the country,’ writes Denise Paone, director of research and surveillance of drug use and prevention at the New York City Department of Health.
‘Addressing the fentanyl-driven overdose epidemic requires the coordinated efforts of public health authorities and medical examiners to systematically identify and list fentanyl in fatal overdose cases, to the extent possible.’
Cocaine and heroin are still by far the most popular street drugs among users. A recent study, interviewing drug users, found there is little demand and no common street slang for fentanyl.
But fentanyl is increasingly ubiquitous (it’s cut into everything from heroin to street-sold Percocet), impossible to detect, mysterious (most dealers aren’t sure the strength of their product), and incredibly potent (just two milligrams is enough to kill an adult male).
Experts believe illegal drug traffickers have slipped fentanyl (which is easier to make than heroin) into the market to capitalize on America’s booming addiction crisis.
And we’re seeing the effects.
Between 2000 and 2014, 10,673 people died of an opioid overdose in New York City.
Just two percent of those deaths (246) were caused by fentanyl.
After that, it started to change. Drug-related deaths started to become more common – and fentanyl was to blame for a larger proportion.
In 2016, 44 percent of drug overdose deaths (624 of 1,425) were caused by or involved fentanyl.
In 2017, fentanyl was responsible for 57 percent (842 of 1,487).
Taking an overview of that increase: the rate of total overdose deaths in New York City almost doubled, rising 81 percent between 2014 and 2017.
But it’s clear that that was driven by fentanyl-related overdose deaths, which rocketed 3,000 percent in that time period.
Fentanyl’s rise: This graph from the new CDC report, published in December, shows age-adjusted rates for drug overdose deaths involving opioids between 2011 and 2016
TOP 10 DRUGS INVOLVED IN OVERDOSE DEATHS (2016)
DRUG (IN ORDER)
A similar situation is happening nationwide.
Late last year, the CDC published data on the 10 deadliest drugs, showing fentanyl is the deadliest drug in America, and its potency is driving up drug deaths across the US.
‘The drugs most frequently involved in overdose deaths change quickly from one year to the next,’ Dr Holly Hedegaard, a medical epidemiologist at the US Centers for Disease Control and Prevention’s National Center for Health Statistics, said.
Most overdose deaths involve multiple drugs, Hedegaard said.
‘A lot of the deaths that mention fentanyl also mention heroin, and a lot of the deaths that mention cocaine also mention fentanyl,’ she said.
Those who do seek out fentanyl specifically tend to be longer-term heroin or opioid users, who had built up a tolerance to the effects, according to a report published in early December by the University of California, San Francisco.
Fentanyl’s effects are shorter but stronger. They cut through the body’s resistance to give them a feeling of euphoria.
However, the UCSF report found that most people who consume fentanyl do not actively seek it out. There is no fanfare about the drug, as there is for others like cocaine and heroin.
Often, it’s cut into other drugs – drugs which can be taken in larger quantities without it being lethal.
But even a pinch of fentanyl can push them over their high and into a coma.
OPIOIDS IN AMERICA: BY THE NUMBERS
Opioid prescriptions are going down across the US, but overdoses are not.
Last year, the rate of opioid overdose deaths hit a record high, with around 200 Americans dying every day, according to new figures, published by the DEA earlier this month.
US Health and Human Services Secretary Alex Azar insists the tide has turned.
However, doctors warn the boom in prescriptions flooded the market with unused pills, some of which may have made it onto the black market.
An in-depth analysis of 2016 US drug overdose data shows that America’s overdose epidemic is spreading geographically and increasing across demographic groups.
Drug overdoses killed 63,632 Americans in 2016 and increased to 70,237 in 2017.
Nearly two-thirds of these deaths involved a prescription or illicit opioid. Overdose deaths increased in all categories of drugs examined for men and women, people ages 15 and older, all races and ethnicities, and across all levels of urbanization.
Source: Centers for Disease Control and Prevention
The reason fentanyl infected the US market was unusual.
Analyzing the shift, the UCSF team said it seemed to be part of a much bigger, longer-term strategy from global trafficking groups as the demand for opioids shot up dramatically in the US.
Prescription rates have skyrocketed in the US over the last three decades, demand for any kind of opioid soared. Many patients would be prescribed highly-addictive opioids, but then wouldn’t be able to afford more. So they would turn to heroin.
It was a dramatic shift in a very short space of time.
But heroin is timely and complicated to make. It is beholden to the poppy-growing season, and can be susceptible to pests.
Fentanyl, meanwhile, is entirely lab-made. It can be produced year-round at a much cheaper rate – and it’s 40 times stronger.
‘The full motives of wholesale suppliers still remain hidden, but there are significant incentives for them to shift over partially or completely to fentanyl, even though it often causes users to overdose,’ the researchers said, adding: ‘It may just be a matter of time before fentanyl takes over more of the illicit US and worldwide drug market, as has already happened in Estonia [home to a devastating overdose crisis].’
Questions surrounding fentanyl are not new, but reached new heights in December, when the CDC published new data showing another rise in overdose deaths in 2017, primarily driven by the synthetic drug.
The new data add more pressure.
According to the Drug Enforcement Agency, most of the supply is routinely traced back to wholesalers in China.
In December, President Donald Trump addressed that, promising (again) that China would curtail its supply, though offering few details on how that would happen.
But the fact remains that fentanyl is now ubiquitous in the US drug market (just late last year two 19-year-old boys died after taking a Percocet that they didn’t know was laced with fentanyl), and its not clear how to weed it out.
‘Fentanyl is rarely sold as fentanyl,’ said Sarah Mars, PhD, a researcher in the Department of Family and Community Medicine at UCSF and the first author of the paper.
‘The dealers selling fentanyl directly to the users often don’t know what’s in it. Not only is this particularly dangerous, but it also means penalizing low level dealers isn’t going to make any difference in the fentanyl poisoning epidemic.’
In early December the CDC published data (pictured) showing fentanyl, the synthetic opioid 100 times stronger than morphine, was the driving culprit for the spike in overdose deaths. Alone, it accounted for a 45 percent increase in deaths between 2016 and 2017