The U.S. has reached a grim milestone: overdose deaths topped 93,000 last year amid the COVID-19 pandemic — far outpacing the rates of previous years,  reports The New York Times.

According to preliminary estimates released Wednesday by the Centers for Disease Control and Prevention, last year’s 93,000 deaths translate to 250 deaths per day, or 11 per hour. Deaths in 2020 jumped by 29 percent from 2019, when 72,000 people died of drug overdoses. Nearly every state saw higher death rates, particularly those in the South and West.

2020 saw the most drug overdose deaths in a year, as well as the most overdose deaths from opioids, stimulants like methamphetamine and the synthetic opioid fentanyl. The reasons for this surge in overdose deaths are complicated. The pandemic limited treatment options for drug users, experts say, but this overdose crisis had been building prior to COVID-19.

In many cities, fentanyl had been outpacing heroin for years — and the drug’s incredible potency put overdose deaths on a fast-track. A combination of fewer treatment resources and more dangerous drugs led to lethal results, according to José Benitez, the executive director of Prevention Point Philadelphia. Benitez told the Times that people continued to mix heroin and other drugs with fentanyl during the pandemic, but due to restrictions appointments at his organization dropped by 20 percent.

The South and West, where overdose deaths most prominently rose, have also seen rising rates of fentanyl use. While the drug had not previously been widespread in these regions, researchers have noticed an uptick in the sale of fentanyl as counterfeit pills or an injectable drug.

“What’s really driving the surge in overdoses is this increasingly poisoned drug supply,” said Shannon Monnat, a Syracuse University sociology professor who researches geographic patterns in overdoses. “Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated.”

Racial disparities, too, define overdose deaths. Deaths in 2020 grew faster in Black and Hispanic populations than in white ones, though the opioid epidemic is often imagined as primarily afflicting rural America. Researchers and community members attribute these rates to a multitude of factors, including underfunded social services in Black and Hispanic neighborhoods, the consequences of which the pandemic compounded.

“The pandemic has been far more disruptive in communities of color than in white communities — the death rates, the infection rates, the unemployment rates, the food insecurity rates,” said Joshua Sharfstein, a vice dean for public health practice at Johns Hopkins University. “So many consequences of the pandemic have hit communities of color harder. So it’s not out of line for overdoses to do the same.”

The pandemic has also presented new opportunities for drug treatment. Temporary changes allowed people enrolled in methadone treatment to take doses home with them rather than visit a clinic every day. Telemedicine has also allowed people to more conveniently seek medical care. The government permitted the purchasing of needles and syringes for exchange programs with federal funds from the stimulus bill.

But the skyrocketing death rates represent governmental failures, researchers say.

Members of Congress and the public have blamed the U.S. Food and Drug Administration for approving new synthetic opioids, and makers of some of the drugs — notably Oxycontin maker Purdue Pharma — have been prosecuted for their role in marketing them. Some doctors have also overprescribed opioids in several high-profile cases, directly contributing to deaths.

“There are definitely actions that the clinical community can take to reduce the risk of people becoming addicted to opioids,” Sharfstein told CNN.

“The FDA oversight of medical and clinical practice is an area the agency acknowledges it needs to improve. The question of whether a particular drug should have been approved or not is fair to ask. But now the emphasis should be on the oversight of prescribing.”

Eva Herscowitz is a TCR Justice Reporting intern.

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