Opioid Overdose Deaths Surged During the Pandemic

A new cross-sectional study found that unintentional deaths in the U.S. due to opioid overdose increased by 289% between 2011 and 2021, especially among men, younger adults, and adolescents.

Over the past 20 years, opioid use disorder involving all opioids, including fentanyl, have fueled a growing public health crisis. According to the NIH, in the United States, deaths due to opioid overdose increased from 21,089 in 2010 to 80,411 in 2021, primarily due to fentanyl.

Because of these concerning trends, researchers from Toronto, Ontario, Canada, sought to determine the societal burden and identify mortality patterns of unintentional opioid-related deaths in the U.S. before and during the COVID-19 pandemic.

Their research, published on July 7 in JAMA Network Open, looked at all unintentional opioid-related deaths by year and age group from 2011 to 2021. In addition, the researchers estimated the overall total years of life lost (YLL) due to unintentional opioid overdose and estimated YLL by age group and sex for each year.

Using data retrieved from the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death database, the team identified 422,605 unintentional deaths due to opioid toxicity between 2011 and 2021.

They found that overall, unintentional deaths due to opioid overdose increased 289% over the 10-year study period, from 19,395 in 2011 to 75,477 in 2021.

In addition, by 2021, opioid toxicity was responsible for 10.2% of all deaths among 15 to 19-year-olds, 21.7% of deaths among those aged 20 to 29 years, and 21.0% of deaths among those 30 to 39 years of age.

When the research team examined the data further, they estimated that years of life lost due to opioid overdose rose 276% over the study period, from 777,597 YLL in 2011 to nearly three million YLL in 2021.

Although YLL due to opioid overdose leveled off between 2017 and 2019, it increased by nearly 63% between 2019 and 2021, concurrent with the COVID-19 pandemic. The researchers found this rising trend was similar across all age groups and sexes. However, years of life lost due to opioid toxicity nearly tripled among 15-19-year-olds.

Moreover, the researchers suggest that the YLL from unintentional opioid overdose in 2020 was similar to years of life lost from COVID-19 in that same year.

In addition, when the research team looked at other causes of death from the 2019 Global Burden of Disease study, they estimated that opioid overdose-related YLL among people aged 15 to 74 years far exceeded years of life lost from diabetes, road injuries, and stroke in this age group.

The study authors say that deaths due to opioid toxicity in the U.S. worsened substantially during the COVID-19 pandemic, and opioid overdose was responsible for one in 22 deaths in the U.S. in 2021. They note that these results shine more light on the current and ongoing opioid crisis and underscore the urgent need to support those who are at risk of opioid overdose.

The authors also suggest that investigators should look closely at 2022 mortality data when it becomes available to determine the pandemic’s potential ongoing influence on opioid overdose trends.

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