Political | Process

“We’ve never seen anything like this,” said Robert Anderson, chief of the mortality-statistics branch at the CDC’s National Center for Health Statistics, regarding fentanyl’s impact on the numbers.

The agency has counted about 103,600 overdoses for 2021 but believes the number is several thousand higher due to suspected overdoses that haven’t yet been confirmed by local death investigators, Dr. Anderson said.

Fentanyl, a drug up to 50 times the strength of heroin, has ratcheted up risks for drug users. There is a legal form, sometimes prescribed for managing cancer pain, but the main problems are illicit forms made in clandestine labs in Mexico, according to U.S. law-enforcement authorities. These cartel-made drugs then pour through the U.S. border, often hidden in vehicles traveling through border checkpoints.

The drug is attractive to cartels because it is synthetic, made from easily sourced chemicals rather than relying on crops, like the poppies used to make heroin. U.S. deaths linked to heroin have been declining as fentanyl’s profile rises.

But deaths linked to synthetic opioids, a category largely made up by fentanyl, climbed 23% last year to about 71,200 while representing about two-thirds of all drug deaths, the preliminary CDC numbers show.

The agency also noted rising fatalities linked to two stimulants methamphetamines and cocaine which researchers say people are often intentionally using alongside fentanyl.

Deadly overdoses in a category that includes mostly meth rose 34% to nearly 33,000 while cocaine-linked deaths increased 23% to about 24,500. These deaths often overlap with the opioid count in the CDC data.

Encounters with fentanyl can also be accidental as dealers combine it with stimulants, said Nora Volkow, director at the National Institute on Drug Abuse. Thirty-year-old Alexander Gilman died last August with a mix of cocaine and fentanyl in his system just 16 months after his stepsister, Holly, died from a fentanyl overdose, his mother, Denise Avery, said.