Mortality with Meep: Huge Increase in Death by Drug Overdose in 2020

There were also huge increases in drug overdose deaths in 2016 and 2002

In 2020, there were over 93K deaths due to drug overdoses — a 30% increase over 2019.

This is super-bad, and worse than what I have seen for increases in other causes of death. I knew it was going to be bad, but I didn’t realize it was going to be this bad.

News coverage: not spending enough on drug crisis?

Politico: Pandemic fueled deadliest year for drug overdoses, CDC data shows

Drug overdose deaths surged to a record high last year, according to new federal data that lays bare the deadly impact of the coronavirus pandemic’s disruption to drug abuse treatment and prevention efforts.

There were 93,331 reported deaths from overdoses in 2020, up from 70,980 the year before, marking the largest annual increase in at least 50 years, said officials at the Centers for Disease Control and Prevention on Thursday. The preliminary numbers, which will be finalized later this year, underscore the challenge the Biden administration faces in confronting a resurgent drug crisis that’s been both fueled and overshadowed by the worst pandemic in a century.

Resurgent drug crisis? Well, it may be true. One can have drug overdose deaths steadily increasing at an insane pace while drug use in general drops off, and then drug use revs up again. But as we’ll see when I dig into the data, drug overdose death trends have been horrid since 2015.

This isn’t “resurgent” in 2020. It accelerated in 2020.

In case you were not aware: one of the big drivers has been the production of super-cheap and fairly lethal fentanyl. Fentanyl gives a stronger kick to the illegal drugs people are buying, but make it much more of a crapshoot as to whether they’ll survive the hit. The amount of fentanyl it takes to kill is small – it takes only 2 mg of fentanyl to kill, where it takes 200 mg of morphine to kill. It’s tough to intercept enough of the supply given how such small amounts can have huge effects.

I will get into the stats at the end of this post, but the trend was already bad before 2020. It got much worse. That has shocked me. I knew it was bad. I didn’t know it was this bad.

News coverage: federal bailouts led to more drug use

From AP: US overdose deaths hit record 93,000 in pandemic last year

There’s no current evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths most likely were people who had already been struggling with addiction. Some have told her research team that suspensions of evictions and extended unemployment benefits left them with more money than usual. And they said “when I have money, I stock up on my (drug) supply,” she said.

See, federal bailouts kill people!

There is a way we can test many of these hypotheses, by the way. Eviction moratoriums are still ongoing in some states. Also, some states have extended unemployment benefits (and some haven’t). Then there are some tax credit thing that are supposed to be going to some parents tomorrow. I will not be looking into these drivers too deeply myself, mainly because I know other people will be looking for the causal chain.

I’m just trying to show you what the trends are, without plying on my own theories of drivers.

That said, that bailout/stimulus money was used on people’s favorite way to relieve mental/emotional/physical pain does seem reasonable. After all, booze and tobacco sales went up in 2020 as well. Alcohol sales increased 34% and tobacco increased 13%. Seems to me everybody was spending more on their drugs of choice… just some drugs can kill immediately.

(and don’t get me started on the people who have decided to use the money to play with all sorts of financial derivatives. Some habits can be super-expensive to maintain.)

Drug overdose death trends have been horrible since 2015

This is not a new trend, but it got a lot worse in 2020.

Here, let me show you, direct from the CDC’s drug overdose deaths dashboard.

(you didn’t know they had one, did you? … Neither did I, til today.)

Now, let me explain the graph you’re looking at. It’s not monthly drug overdose deaths (that would be horrific). It’s the 12-month moving window of total drug overdose deaths.

But it only goes back to 2015, and with this monthly rolling window, you can’t see how shocking this graph really is. It does seem like a steep climb, but hey, we had a lot of increases in deaths last year, right?

Huge drug overdose death increase in 2020, worse than 2016

I will just hit you with the graph:

Those are the annual death counts. You can see the huge step up from 2019 to 2020, but there was also a sizable step up from 2015 to 2016.

Percentage changes have not been this bad before, but they’ve been really bad

Here are the year-over-year percentage changes:

Did you know there was such a large increase in drug overdose deaths in 2002 and 2016?

Heck the over-10% increase in 2015 was a bad sign as well. It just really took off in 2016.

I am doing just a really high-level review of the trend in this post, not getting into the geographic footprint where it’s hitting (and there’s an obvious fentanyl distribution network underlying most of the recent increases. I can’t tell you about the 2002 & 2006 large increases right now.) I’m not getting into the age ranges involved, or the rate changes… just raw death counts.

Because everybody understands counting dead bodies.

But even with the slight drop back in 2018, these drug overdose death rates are too damn high, y’all. (Rates are for a future post)

Splitting out drug overdoses by intent: almost all accidental

My final new graph for this post:

I didn’t tell you that these drug overdose deaths included suicides and homicides.

Now, looking at my graph above and the labels, you may be thinking “Where are the drug overdose homicides?” They’re there, in yellow. You may barely see them. That’s because it’s fewer than 200 per year on a graph that goes up to 100K.

My betting is the final death certificates are going to have similar proportions of accidental drug overdoses to the other intents.

DATA SOURCES:
CDC WONDER saved search for drug overdose deaths: https://wonder.cdc.gov/controller/saved/D76/D185F421
Recent rapid data release: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

Continuing the investigation into non-COVID death increases in 2020

Whatever the cause (governmental largesse, lack of support in drug treatment programs, friends not checking in on their druggie friends, China churning out extra fentanyl or fentanyl precursors because drop in other revenue streams), this leap up in drug overdose deaths is truly shocking, and we’ve had some really shocking drug overdose death statistics since 2015.

I will revisit this later, but there are multiple death trends for me to come back to, as noted in this post: Mortality with Meep: U.S. Life Expectancy Fell 2.4% in 2020, and Death Rates Increased 16.1%.

In this graph, I showed multiple causes of death that had leaped up in 2020:

Accidental drug overdoses are included in “unintentional injuries”, and we already know car crash deaths were up as well.

I have a feeling one huge category in “unintentional injuries” — falls — was down. Because that’s mainly old people, and they went nowhere in 2020. Except, potentially, to the grave.

I plan on stepping through some major causes: heart disease, cancer, diabetes, Alzheimer's disease, homicide, suicide, and unintentional injuries through a variety of slices: age ranges, sex, race, geography, more detailed cause split-outs, and long-term trends.

There were a lot of moving parts with death trends in 2020, and like with drug overdoses, some of these trends far pre-dated the pandemic.