Fentanyl is the deadliest drug in America, CDC confirms

By Nadia Kounang, CNN

Fentanyl is now the most commonly used drug involved in drug overdoses, according to a new government report. The latest numbers from the US Centers for Disease Control and Prevention's National Center for Health Statistics say that the rate of drug overdoses involving the synthetic opioid skyrocketed by about 113% each year from 2013 through 2016. The number of total drug overdoses jumped 54% each year between 2011 and 2016. In 2016, there were 63,632 drug overdose deaths.

According to Wednesday's report, which analyzed death certificates for drug overdose deaths between 2011 and 2016, fentanyl was involved in nearly 29% of all overdose deaths in 2016. In 2011, fentanyl was involved in just 4% of all drug fatalities. At the time, oxycodone was the most commonly involved drug, representing 13% of all fatal drug overdoses.

Most common drugs found in overdose deaths in 2016

Rank	Referent drug1	Number of deaths2	Percent of deaths3
1	Fentanyl	18,335	28.8%
2	Heroin	15,961	25.1%
3	Cocaine	11,316	17.8%
4	Methamphetamine	6,762	10.6%
5	Alprazolam	6,209	9.8%
6	Oxycodone	6,199	9.7%
7	Morphine	5,014	7.9%
8	Methadone	3,493	5.5%
9	Hydrocodone	3,199	5.0%
10	Diazepam	2,022	3.2%

¹ Ranks were not tested for statistical significance.
² Number of drug overdose deaths involving the referent drug.
³ Percentage of drug overdose deaths involving the referent drug.
Note: Drug overdose deaths are identified using International  Classification of Diseases, Tenth Revision underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), and Y10–Y14 (undetermined). Only deaths with at least one specific drug identified are included in the analysis. The results for 110 deaths with an intent of homicide (X85) are not shown due to small numbers. Deaths may involve other drugs in addition to the referent drug (i.e., the one listed). Deaths involving more than one drug (e.g., a death involving both heroin and cocaine) are counted in both totals.

Source: CDC

From 2012 to 2015, heroin became the most frequently involved drug in overdose deaths. In 2011, the number of fatal heroin overdoses was 4,571, or 11% of all drug fatalities. In 2016, that number more than tripled to 15,961 deaths, representing a quarter of all drug overdoses that year.

The authors of the new study also found that most overdoses involved more than one drug. In 2016, 2 in 5 cocaine-related overdose deaths also involved fentanyl. Nearly one-third of fentanyl-related overdoses also involved heroin. More than 20% of meth-related fatal overdoses also involved heroin.

In 2016, over 18,000 overdose deaths involved fentanyl, and 16,000 fatalities were due to heroin.

While America wages war on opioids, meth makes its comeback

Although many experts have pointed to the over prescribing of prescription painkillers as the root of the US opioid crisis, they say it has evolved, first into a heroin crisis and now into a fentanyl epidemic.

In the 2011-16 period examined, the number of drug overdoses involving methadone has dropped. But Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing, cautioned against interpreting these findings as an end to the prescription drug problem. Kolodny, who was not involved in the study, pointed to states such as Oklahoma, where overdose deaths from prescription opioids still outnumber heroin and fentanyl deaths.

"Fentanyl is so deadly, in the geographic regions where it's been flooding in, deaths soared like we've never seen before," he said.

Much of the emphasis of the drug overdose crisis has been on opioids, but there has also been an increase in the rates and numbers of cocaine- and methamphetamine-related deaths.

In the same six-year time frame, cocaine was consistently the second or third most commonly used drug, and the rate of overdose deaths involving methamphetamines tripled. Cocaine-related fatalities nearly doubled from 2014 to 2016, jumping from 5,892 to 11,316 overdose deaths.

The authors of the study used text analysis to evaluate death certificates for specific drug mentions. They found that the top 10 drugs in the six-year period remained the same and belonged to three classes of drugs:

·   Opioids such as fentanyl, heroin, hydrocodone, methadone, morphine and oxycodone

·         Benzodiazepines such as alprazolam and diazepam

·Stimulants such as cocaine and methamphetamines

The study found that illicit drugs like fentanyl and heroin were the leading causes of unintentional overdoses, and prescription drugs were more likely to be involved in suicidal overdoses.