While the opioid epidemic has had significant impacts across the labor market, its effects have been particularly pronounced in specific occupations and industries. A CDC analysis of mortality data from 21 states concluded that unintentional and undetermined overdose deaths accounted for a disproportionate share of all deaths in the following six occupational groups: construction, extraction (e.g., mining), food preparation and serving, health care practitioners, health care support, and personal care and service. These fatalities are particularly concentrated in construction and extraction: an analysis by the Massachusetts Department of Public Health found that individuals employed in construction and extraction accounted for over 24% of all overdose deaths in the state’s working population.
Drug-overdose deaths in 2021 topped 100,000 for the first time in a calendar year, federal data showed, a record high fueled by the spread of illicit forms of fentanyl throughout the country.
More than 107,000 people in the U.S. died from drug overdoses last year, preliminary Centers for Disease Control and Prevention data released Wednesday showed, roughly a 15% increase from 2020. The proliferation of the potent synthetic opioid fentanyl has been compounded by the destabilizing effects of the Covid-19 pandemic on users and people in recovery, according to health authorities and treatment providers.
The U.S. has recorded more than one million overdose deaths since 2000, and more than half of those came in the past seven years.
The agency has counted about 103,600 overdoses for 2021 but believes the number is several thousand higher due to suspected overdoses that haven’t yet been confirmed by local death investigators, Dr. Anderson said.
This data visualization presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation (see Technical notes) resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts (see Technical notes).
These are measures taken by people desperately fighting, largely on their own, against a drug-overdose death toll that historically has killed more Americans than the coronavirus pandemic. Since 1996, the year OxyContin launched and the United States’ health-care system fell prey to the lie that opioid painkillers were safe for virtually everything from headaches to wisdom-tooth surgery, more than 1 million Americans have died of overdoses; the coronavirus pandemic has claimed about 850,000. During the first year of the pandemic, the Centers for Disease Control and Prevention reported a record 100,000 annual overdose deaths.
But with an even more lethal overdose crisis — and that’s not counting all the addiction-related deaths from hepatitis, endocarditis and suicide — the nation’s leadership appears capable of only minor tweaks.
Some blue-leaning states and cities now offer evidence-backed practices such as supplying drug users with clean needles and fentanyl test strips, and even offering medically supervised spaces to inject illicit drugs — all of which foster important connections to professional care and wraparound services. But in much of the world’s richest nation, where a few million Americans suffer with opioid use disorder, these measures remain anathema.
The pandemic-prompted loosening of federal regulations for the telehealth prescribing of buprenorphine, the lifesaving addiction medication, has been a bright spot, particularly for rural people who have long struggled with transportation issues. But that policy change remains temporary and the treatment gap (with an estimated 10 to 12 percent of addicted people receiving treatment in an average year) has barely budged.
Epidemiologists predict that by 2029, U.S. overdose deaths will have doubled to nearly 2 million. Until we stop arresting and abandoning people who use drugs and start meeting them where they are with treatment and compassion, rare will be the family that remains untouched.
From 2010 to 2019, the drug-related death rate among never-married prime-age white men increased some 125 percent: from 52 deaths per 100,000 to 117 (including 2020 would show an even steeper rise, but the pandemic affected Census data collection). If single and divorced prime-age white men had seen opioid deaths rise by only the same rate as those deaths rose among their married counterparts, the U.S. would have seen 38,800 fewer deaths from drug-related causes over the past decade just among this demographic group.
A marriage certificate is no prophylactic against the scourge of drug overdoses, of course. Marital status is correlated with income, race, and age; while death certificates don’t report income, we know that married decedents are more likely to be white, older, and better-educated. Controlling for those factors still shows single men to be at greater risk of dying from drug-related causes than married ones.
LAST YEAR was a woeful time for people suffering from a drug addiction. Government shutdowns brought job losses and social isolation—conditions that make a transportive high all the more enticing. Those who had previously used drugs with others did so alone; if they overdosed, no one was around to call for help or administer naloxone, a medication that reverses opioid overdoses.
Fatal overdoses were marching upwards before the pandemic. But they leapt in the first part of last year as states locked down, according to provisional data from the Centres for Disease Control and Prevention. Deaths from synthetic opioids—the biggest killer—were up by 52% year-on-year in the 12 months to August, the last month for which data are available. Those drugs killed nearly 52,000 Americans during the period; cocaine and heroin killed about 16,000 and 14,000, respectively (see chart). Once fatalities are fully tallied for 2020, in a few months’ time, it is likely to be the deadliest year yet in America’s opioid epidemic.
The dataset summarized in this article is a combination of several of U.S. federal data resources for the years 2006-2013, containing county-level variables for opioid pill volumes, demographics (e.g. age, race, ethnicity, income), insurance coverage, healthcare demand (e.g. inpatient and outpatient service utilization), healthcare infrastructure (e.g. number of hospital beds or hospices), and the supply of various types of healthcare providers (e.g. medical doctors, specialists, dentists, or nurse practitioners). We also include indicators for states which permitted opioid prescribing by nurse practitioners. This dataset was originally created to assist researchers in identifying which factors predict per capita opioid pill volume (PCPV) in a county, whether early state Medicaid expansions increased PCPV, and PCPV’s association with opioid-related mortality. Missing data were imputed using regression analysis and hot deck imputation. Non-imputed values are also reported.
Taken together, our data provide a new level of precision that may be leveraged by scholars, policymakers, or data journalists who are interested in studying the opioid epidemic. Researchers may use this dataset to identify patterns in opioid distribution over time and characteristics of counties or states which were disproportionately impacted by the epidemic. These data may also be joined with other sources to facilitate studies on the relationships between opioid pill volume and a wide variety of health, economic, and social outcomes.
Author(s): Kevin N. Griffith, Yevgeniy Feyman, Samantha G. Auty, Erika L. Crable, Timothy W. Levengood