Deaths involving both heroin and synthetic opioids rose sharply in the United States after 2013—driven in part by substantial increases in the supply of heroin and illicitly manufactured fentanyl (IMF), according to CDC's Morbidity and Mortality Weekly Report released Friday.
For the report, CDC researchers analyzed trends in undetermined and unintentional deaths involving heroin or synthetic opioids, except methadone, from 2006 to 2015 in the Midwest, Northeast, South, and West U.S. Census regions. The researchers also examined drug reports from the Drug Enforcement Administration's National Forensic Laboratory Information System for drug products that tested positive for heroin or fentanyl.
According to the report, death rates involving heroin increased across the United States from 2006 to 2015, and the rise appeared to be driven in part by increases in the supply of heroin in the country, as well as the introduction of the synthetic opioid IMF into the heroin market.
Overall, the number of opioid-related overdose deaths in the United States quadrupled from 8,050 in 1999 to 33,091 in 2015, when such deaths accounted for 63 percent of drug-related overdose deaths in the country, the researchers found. According to the researchers, overdose deaths tied specifically to heroin quadrupled from 3,036 in 2010 to 12,989 in 2015.
According to the report, all regions of the United States experienced increases in heroin drug reports. The researchers found that the Northeast and Midwest experienced a steady rise in heroin drug reports from 2006 to 2015, while such reports began increasing in the South and West in 2010.
The researchers said U.S. deaths involving heroin and synthetic opioids increased sharply after 2013, with the largest increases occurring in regions where individuals primarily use white powder heroin. According to the report, the rise in deaths involving synthetic opioids without heroin indicated an emergence of synthetic products that did not contain heroin, such as mixed products containing IMF and other drugs.
The researchers wrote that "sustained, targeted, and multisectoral responses to the opioid overdose epidemic are needed, including timely surveillance, safer opioid prescribing, education on opioid overdose and naloxone, linkage and access to treatment, leveraging of community-based services, and collaboration between public health and public safety agencies" (AHA News, 9/5; CDC Morbidity and Mortality Weekly Report, 9/1; Lopez, Vox, 9/5).
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