100,000 people died from drug overdoses in the US in one year, a record

During a one-year period from April 2020 to April 2021, more than 100,000 people died from a drug overdose in the US, according to provisional data from the National Vital Statistics System, a government network for sharing public-health data. The number is a record for the US and means about 274 people died each day.

In December 2020, the US Centers for Disease Control and Prevention sounded the alarm on an increase in overdose deaths -- more than 93,000 in 2020. Factors compounding the existing overdose epidemic may include the financial and emotional burdens of the coronavirus pandemic, along with COVID-era problems in getting health care and mental health services. 

Fatal overdoses continue to be driven by opioids, particularly the extremely potent fentanyl. Overdose deaths involving fentanyl or other synthetic opioids increased 12-fold from 2013 to 2019, the CDC reported. 

Fentanyl, which is legal if it's prescribed to treat severe pain, is up to 50 times more potent than heroin and 100 times stronger than morphine, the CDC says. Nonprescription fentanyl is illegal, which means it doesn't undergo any testing or safety regulations. Heroin, cocaine and other drugs are often laced with fentanyl, so people who overdose on fentanyl may not even know they consumed it or may have underestimated how much fentanyl was in the other drug. 

The US Drug Enforcement Agency says that without laboratory testing, there's no way to know the amount of fentanyl in a pill or drug. Test strips people can use to check whether a drug contains fentanyl can be found at some public health clinics, including syringe services programs. But they don't reveal the amount of fentanyl in the drug; they only show its presence.

Harm-reduction tools such as the fentanyl test strips are gaining momentum among public health organizations, including the CDC, as part of an arsenal against drug overdoses. One of the most important harm-reduction tools for people who use drugs is naloxone, a lifesaving drug that can stop the effects of an opioid overdose in someone who's taken fentanyl, heroin or other opioids, including prescription substances.

Naloxone, which comes in the form of a nasal spray (under the brand name Narcan) or an injectable, can be purchased without prescription and given to a person experiencing overdose. A person overdosing can't administer it themselves. More than one dose of naloxone may be required for stronger opioids, like fentanyl, according to the CDC. 

The CDC says that if you or someone you know is taking opioids, legally or illegally, you should carry naloxone and keep it at home (80% of drug overdoses take place at home, the agency says). It's "no different," the CDC says, than someone carrying an EpiPen, a tool used to inject epinephrine into someone having a severe allergic reaction. Many people who use opioids, however, hide that use from family and friends. If no one's aware you're using opioids, it makes it harder to access resources and emergency support in case of an overdose.

As an additional barrier during the country's worst year for drug overdoses, naloxone has become harder for harm-reduction groups to acquire. Pharmaceutical company Pfizer had sold affordable naloxone to these groups, but the company experienced a manufacturing issue that created a scarcity of affordable naloxone. Thus, the harm-reduction groups have been forced to buy the drug from other suppliers at much higher prices. Pfizer says it expects to be back on track by the end of the year.