(Source: Drug Overdose Deaths in the United States)

According to a report from the Centers for Disease Control and Prevention (CDC) released in December 2020, 10 western states have seen drug overdoses deaths increase in 2020. 

The increases are particularly troubling for rural counties in those states, some of which have the highest rates of opioid overdose deaths in the country. 

The CDC’s report found that drug overdose deaths related to synthetic opioids like fentanyl have seen their levels increase by more than 98%. 

When comparing the drug overdose rates for the 12-month period ending in June 2019, to the 12-month period ending May 2020, 37 of 38 jurisdictions studied showed increases in synthetic opioid overdose deaths, the CDC reported.

“Eighteen of these jurisdictions reported increases greater than 50%, 11 reported increases of 25 %to 49%,” the report said. “State and local health department reports indicate that the increase in synthetic opioid-involved overdoses is primarily linked to illicitly manufactured fentanyl. Historically, deaths involving illicitly manufactured fentanyl have been concentrated in the 28 states east of the Mississippi River…In contrast, the largest increases in synthetic opioid deaths from the 12-months ending in June 2019 to the 12-months ending in May 2020 occurred in 10 western states (98.0% increase).”

Arkansas, Arizona, California, Colorado, Hawaii, New Mexico, Nevada, Oregon, Utah and Washington, are not known for fentanyl deaths. 

Still in rural New Mexico, opioid deaths are high.

In 2019, a detailed interactive database by the U.S. Department of Agriculture and the National Opinion Research Center at the University of Chicago, one of the largest independent social research organizations in the United States, showed that in rural Rio Arriba County, the opioid overdose mortality rate was 120.6 deaths per 100,000 people. That’s more than six times the national opioid overdose mortality rate of 18.3 deaths per 100,000 people and more than four times the state’s opioid overdose mortality rate of 26 deaths per 100,000. 

Rio Arribba County, population 39,307, sits on the central northern border of the state, butting up against Colorado. Between 2009 and 2013, the county saw 77 opioid overdose related deaths. Between 2014 and 2018, that number had nearly doubled to 135. 

DEA records released in July of 2019 showed that the county was flooded with opioid prescriptions between 2006 and 2012. During that seven year period pharmacies dispensed more than 13 million opioid pills – the equivalent of 46 pills per person within a five-mile radius of the county center, Espanola. Many in the town attributed the high number of prescriptions to residents in neighboring rural counties coming to Rio Arriba County and its big box pharmacies to get their prescriptions. 

However, researchers said those using opioids recreationally don’t normally use prescription pills. People addicted to opioids in western states frequently use a type of heroin that doesn’t mix well with fentanyl, Chelsea Shover, an epidemiologist at Stanford University said, eliminating fentanyl as a killer in those states. 

But Shover and other researchers found what they called a “fentanyl breakthrough” in the West. 

Starting in 2018, deaths due to fentanyl started to increase in Western states. Data from Arizona, California, Colorado, Texas, and Washington showed that deaths due to fentanyl increased 371% between 2017 and 2019. Preliminary data showed that fentanyl deaths had increased 63% over 2019’s deaths. 

The problem, Shover told NPR, was that fentanyl was contaminating other drugs, or fentanyl was disguised to look like other drugs. 

“You think you’re using heroin or you think you’re using Ecstasy or Xanax or what looks like an Oxycontin pill, but it’s actually fentanyl,” Shover said.

The CDC said the increases in drug overdose deaths also coincide with states’ responses to the Covid-19 pandemic.  

In Oregon, officials concluded that state saw 580 drug overdose deaths during that period. Oregon Health Authority (OHA)  officials said that in the second quarter of 2020, drug overdose deaths increased 63%. 

“Food insecurity and disruptions in access to safe housing and mental health services have compounded stress from job losses, school and social isolation, and other problems brought on by the pandemic,” Tom Jeanne, deputy state health officer and deputy state epidemiologist from OHA Public Health Division, said in a statement

“The Covid crisis also interrupted ways people with substance use disorder can get help, such as mental health services, 12-step programs and ambulatory visits.”

In Washington state,  Caleb Banta-Green, a principal research scientist at the Alcohol & Drug Abuse Institute at the University of Washington, told KUOW, the increase in drug overdose deaths is concerning. 

“We’ve seen a striking increase in drug overdoses in the first half of 2020, and even continuing on further into the year. Specifically, what we’ve seen is that in an average quarter for the last several years there have been about 300 overdose deaths in Washington state,” he said. 

“In the second quarter of 2020, we saw 400. That was up significantly from another significant increase we saw in the quarter before. So, we’ve seen a really striking increase in all drug overdose deaths. It’s really clearly getting driven by these deaths that are involved in Fentanyl.”

Banta-Green said the combination of the increased availability and the pandemic creates a deadly situation. 

Stress and isolation caused by the pandemic are contributing to increased drug use, he said. That, in turn, increases chances of a deadly overdose with nobody present to render first aid.

The CDC recommends that states increase the availability of Naloxone, an opioid overdose reversal agent, as well as increasing treatment and prevention programs. 

As a response, several members of Congress have introduced legislation to increase funding for substance use disorder prevention and treatment by $5 billion in the next Covid-19 relief bill. A coalition of nearly 80 lawmakers sent Congressional leadership a letter on Feb. 4, urging them to provide the money in Substance Abuse Prevention and Treatment block grants.

Led by Rep. David Trone (D-Maryland), the coalition said the grants would be used by states and territories to assess what is going on in their communities and then plan and implement prevention and treatment strategies. 

“We will never have a vaccine to address mental health or addiction, which is why we need consistent, long-term funding to support those across our country that are impacted by these diseases,” Trone said.

The money would be in addition to the $4.25 million for substance use disorder and mental health disorders provided approved by Congress in the omnibus spending bill that was signed into law in December of 2020.