December 18, 2020 – New York, NY – In response to new CDC provisional overdose counts (nearly 80,000) for the 12 months leading up to May 2020, which show an alarming increase in deaths and accounting for the beginning of the COVID-19 pandemic, Sheila Vakharia, PhD, Deputy Director of the Department of Research and Academic Engagement at the Drug Policy Alliance, released the following statement & analysis:

“What these numbers shows us is that the COVID-19 pandemic is clearly exacerbating the already devastating overdose crisis. These numbers include the first three months of the pandemic, when increasing jurisdictions were in lockdown, showing thousands more deaths per month than the same time period last year. These numbers are an early glimpse of what we can expect to see for the remainder of 2020 and perhaps in 2021 as well.

It is clear that more can and must be done, and so we are urging the incoming Biden administration to prioritize a health-centered approach over past punitive approaches that have failed our communities. Instead of increasing access to care, our policies have often served to criminalize, incarcerate, and neglect our most vulnerable. This data shows us that the solution is clear – we must divest from these failed interventions of the past and instead increase access to the services we know are effective, like harm reduction and medications for substance use disorder.”

Further Analysis

The overdose crisis continues to claim lives at an alarming rate and overdose rates increased in nearly every state. It is clear that the COVID-19 pandemic exacerbated risk conditions for people who use drugs and more must be done to address these overlapping health crises.

Fentanyl has driven overdose deaths in the United States since 2015 and played an even larger role in the overdose crisis over the past year, including the early months of the COVID-19 pandemic. These deaths continued to increase even while more states and the federal government continued the failed strategy of passing even tougher policies to further criminalize fentanyl rather than funding harm reduction and better treatment It is clear that  we must focus on a public health approach instead by increasing access to harm reduction, drug checking supplies, overdose prevention centers, and medications for substance use disorder. The majority of the 38 states and jurisdictions that track fentanyl-involved overdose deaths saw dramatic increases. Most notably, 17 states in the southern, midwestern, and western regions of the United States had increases of over 50% in the rates of fentanyl-involved overdose deaths suggesting that fentanyl availability is spreading farther across the country.

As we have seen in recent years, stimulant-involved overdose deaths continue to be on the rise and more people lost their lives due to cocaine- or methamphetamine-involved overdoses than heroin- or prescription opioid-involved overdoses in the first months of the COVID-19 pandemic. This only reiterates the need for a more comprehensive and robust overdose prevention approach that acknowledges the role of polysubstance use in our overdose crisis, beyond opioids alone. 

Recommendations 

The solutions are clear. Although many states deemed harm reduction services to be “essential” during the early months of the COVID-19 pandemic, far too many states still do not have any legal harm reduction or syringe services available in their states. Federal, state and local funding should help support these life-saving efforts, since many of the existing programs continue to struggle with budget shortfalls which limit their ability to serve their communities.

As fentanyl enters new drug markets, people who use drugs should have more ready access to drug checking equipment like fentanyl test strips so that users are informed about their drug supply however these strips are still criminalized in many jurisdictions.

While COVID-19 has spurred loosened regulations for access to methadone and buprenorphine for opioid use disorder, access to these medications remains far too limited and policies should be even further loosened to remove prescribing and dispensing barriers for both. Since no FDA-approved medications for stimulant use disorders exist, doctors should consider off-label prescribing of regulated stimulants to prevent people who use stimulants from using adulterated stimulants which can increase overdose risk.