Using data on drug overdose deaths from the National Vital Statistics System's multiple cause-of-death mortality files, the CDC examined age-adjusted overdose death rates for 2015 and 2016 for all opioids, opioid subcategories (i.e., prescription opioids, heroin and synthetic opioids), cocaine, and psychostimulants with abuse potential by demographics, urbanization levels, and in 31 states and Washington, D.C.
Compared with previous years, opioid-involved overdose deaths increased in all categories of drugs examined for both men and women, in individuals ages 15 and older, among virtually all races and ethnicities, and across all levels of urbanization. Overall drug overdose death rates increased by 21.5 percent -- from 16.3 to 19.8 per 100,000 -- from 2015 to 2016; for opioid-involved overdose deaths, the rate increase was 27.9 percent for the same period.
The CDC said its analysis confirmed that the sharp uptick in overdose deaths were driven by age-adjusted deaths from synthetic opioids other than methadone, such as illicitly manufactured fentanyl (IMF), which doubled from 2015 to 2016. During the same timeframe, deaths involving cocaine increased more than 52 percent.
The analysis clearly demonstrated that the U.S. opioid epidemic continues to spread both geographically and demographically. The largest increase in opioid overdose deaths was seen in men ages 25-44.
"No area of the United States is exempt from this epidemic -- we all know a friend, family member or loved one devastated by opioids," said CDC Principal Deputy Director Anne Schuchat, M.D., in a news release. "All branches of the federal government are working together to reduce the availability of illicit drugs, prevent deaths from overdoses, treat people with substance-use disorders and prevent people from starting using drugs in the first place."
Additional overdose death rate trends included
The CDC added that because IMF is mixed into counterfeit opioid and benzodiazepine pills, heroin and cocaine, it likely contributed to increases in overdoses involving these other substances.
Geographically, death rates from overdoses involving synthetic opioids increased in 21 states, with 10 states doubling their rates from 2015 to 2016. New Hampshire, West Virginia and Massachusetts saw the highest death rates from synthetic opioids.
As for heroin-related death rates, 14 states had significant increases, with Washington D.C., West Virginia and Ohio having the highest rates.
For prescription opioids, eight states saw significant increases in overdose death rates, with West Virginia, Maryland, Maine and Utah recording the highest rates.
Cocaine-related overdose death rates spiked in 16 states, with Washington D.C., Rhode Island and Ohio having the highest rates.
Finally, 14 states had significant increases in death rates involving psychostimulants; the highest death rates occurred mostly in the Midwest and Western regions.
The CDC pointed to its Overdose Prevention in States effort, which includes funding for state-level public health efforts in 45 states and Washington, D.C., to implement key prescription and illicit opioid surveillance and prevention activities, as key to the agency's continuing battle against the opioid epidemic.
"The CDC equips states with resources to prevent opioid misuse and overdose by tracking and monitoring the epidemic, helping scale up effective programs and equipping health care providers with tools and guidance needed to make informed clinical decisions," said the news release.
Additionally, the CDC said it's working with the DEA's High Intensity Drug Trafficking Areas program on the Heroin Response Strategy to increase uptake of community interventions that address the impact of illicit opioids.
"Effective, synchronized programs to prevent drug overdoses will require coordination of law enforcement, first responders, mental health/substance-abuse providers, public health agencies and community partners," said MMWR study lead author Puja Seth, Ph.D., in the release.
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