Fentanyl surpasses heroin in cause of U.S. drug overdose deaths

By Dr. Ananya Mandal, MDDec 13 2018

According to a new report from health officials, Fentanyl – a synthetic opioid drug, is surpassing heroin as cause of drug overdose deaths in the United States. The report was released 12th of December 2018 in the CDC’s National Vital Statistics Report.

Prescription opioids. Image Credit: Darwin Brandis / Shutterstock

Epidemiologists and researchers at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics led by Dr. Holly Hedegaard write that cocaine and heroin still remain the street drug of choice for abuse. However fentanyl alone or mixed with other narcotics is taking over in terms of cause of deaths due to drug overdose. The researchers noted that between 2013 and 2016 there has been a 113 percent rise in fentanyl induced overdose deaths in the country.

Dr. Hedegaard in a statement said, “The drugs most frequently involved in overdose deaths change quickly from one year to the next.” She added that many of these deaths are due to fentanyl or its combination with other drugs. Fentanyl is being combined with cocaine as well as heroin she said.

Fentanyl is 80 to 100 times more potent than heroin and cocaine says the U.S. Drug Enforcement Agency (DEA). It is used for pain relief in patients with terminal cancer pain and as an adjunct to anesthetic agents. The DEA explains that when fentanyl is added to heroin, it potency is increased and drug users are being sold a combination of heroin and fentanyl as “highly potent heroin”. This means that many users are unaware that they are using a combination rather than heroin alone. This increased potency could also be a reason for deaths due to overdose, the DEA states.

The CDC report states that the common causes of deaths due to overdose include fentanyl, heroin, hydrocodone (Vicodin), methadone, morphine, oxycodone, alprazolam, diazepam, cocaine and methamphetamine. Oxycodone was a top killer among drug users in 2011. Between 2012 and 2015 the leading killer was heroin and since then Fentanyl has been at the top position. Cocaine remains the second or third most common drug of abuse during this period between 2011 and 2017. Overdose deaths during the period of 2011 and 2016 due to heroin or methamphetamine has tripled write the researchers. Deaths due to fentanyl overdose were less than 1 per 100,000 in 2013 and has risen to around 6 per 100,000 in 2016. During this period deaths due to methadone overdose has dropped the authors of the report add.

The team of researchers note that deaths due to suicides are mostly with prescription or over-the-counter drugs (commonly OxyContin, Benadryl, Vicodin and Xanax) but deaths due to drug overdoses is seen commonly with illegal drugs. The team notes that death certificates do not always clearly mention the exact drugs that led to overdosage and death.

Experts have stated that there are other forms of fentanyl which are doing the rounds. These include carfentanil or butyrfentanyl etc. These are more potent than fentanyl. CDC statistics report that around 50000 Americans die each year from drug overdoses.