International Overdose Awareness Day and other such observances offer an opportunity to reflect on the human toll that overdoses take throughout the world. As the opioid epidemic spread and grew in severity across the United States, fatal overdoses have increased almost every year since 1999. In recent years, fatal overdoses involving stimulants have increased as well. Between 1999 and 2019, there were 840,565 fatal overdoses in the US, with 70,630 in 2019 alone.¹ These figures underscore the magnitude of the cost that fatal overdoses have placed on families, communities, prevention professionals, and other stakeholders for the past two decades.

Then the COVID-19 pandemic began. Provisional findings for the US indicate more than 93,000 fatal overdoses in 2020 – up 30% from 2019.² Several recent Central East Prevention Technology Transfer Center webinars have highlighted research and preliminary surveys suggesting that pandemics can dramatically increase risk factors for substance use and its consequences. Prevention professionals must understand the effects of the pandemic to better serve their communities, including possibly modifying interventions and approaches.

Prevention professionals must also understand the changing nature of fatal overdoses. In 2015, 89% of all fatal overdoses involved opioids, but by 2019, that rate had fallen to 71%. Opioids remain the most significant overdose threat facing most communities, but stimulant overdoses are also rising. Unfortunately, one of the most successful opioid overdose prevention interventions—naloxone education and distribution—does nothing to prevent other overdoses. Moreover, other strategies may require modifications. For example, the signs of a stimulant overdose can differ from those of an opioid overdose, which may require modifications to overdose identification and emergency response strategies.³

Prevention training and technical assistance on these and other topics are available through the Central East Prevention Technology Transfer Center. Of particular interest may be recent webinars on Identifying and Responding to Emerging Drug Trends Part 1 and Part 2, as well as our four-part series on overdose prevention from 2019.

1. Centers for Disease Control and Prevention, National Center for Health Statistics (2020). Multiple Cause of Death 1999-2019 on CDC WONDER Online Database. Available from https://wonder.cdc.gov/
2. Centers for Disease Control and Prevention, National Center for Health Statistics (2021). Provisional Drug Overdose Death Counts. Available from https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
3. Bohnert, A. et al (2018). Overdose and Adverse Drug Event Experiences among Adult Patients in the Emergency Department. Addictive Behaviors 86, 66-72.