Fentanyl surpasses heroin as cause of overdose deaths while cocaine deaths surge

Deaths from cocaine sharply increased from 2011 to 2016 across the United States, adding another dimension to a crisis of fatal overdoses that has primarily been driven by opioids, according to new data from the National Center for Health Statistics.

Overdose deaths from cocaine increased by about 18 percent each year during the five-year period. The data also showed a staggering rise in the number of deaths from fentanyl, with deaths from the powerful synthetic opioid increasing about 113 percent each year from 2013 to 2016.

The report, released Wednesday, provides a deeper look at drug overdoses than annual overdose data, attempting to identify the drugs that most commonly lead to overdose. For opioids, oxycodone, a prescription painkiller, contributed to the most opioid overdoses in 2011. Heroin took over as the top overdose drug from 2012 to 2015, and fentanyl caused the most overdose deaths in 2016.

But cocaine, a stimulant that had been waning in popularity, made a comeback. The drug was the second- or third-most-common cause of overdose deaths every year, and the number of overdose deaths from cocaine nearly doubled from 2014 to 2016.

Overall, fatal overdoses have reached record levels in the United States; more than 70,000 people died of drug overdoses in 2017, according to the Centers for Disease Control and Prevention.

The data also show that methamphetamine, a stimulant, also is becoming more popular. Use of meth declined after authorities cracked down on illegal labs where the drug was manufactured and as the government made it more difficult to purchase large quantities of pseudoephedrine, an over-the-counter decongestant that can be used to make meth.

But Mexican cartels started manufacturing the drug, pushing its availability on the black market. The number of overdose deaths involving meth increased from 1,887 in 2011 to 6,762 in 2016.

Researchers found that most overdose deaths involved users who had ingested more than one drug. People who overdosed from benzodiazepines, which are used to treat anxiety, had other drugs in their system 96 percent of the time. The combination of benzodiazepines and opioids can shut down the respiratory system. Seventy-four percent of cocaine users had one or more additional drugs in their system when they died, as did half of meth users.

One of the factors in multidrug overdoses has been the inclusion of fentanyl in the mix; It is becoming increasingly common for drug dealers to cut fentanyl into other drugs, a relatively inexpensive way to dramatically increase the potency of other opioids. And some of the nation’s cocaine supply also includes fentanyl. Fentanyl is so potent that just a few grains can kill a person, especially if the user does not regularly use opioids.

Nearly 70 percent of fatal fentanyl overdoses involved one or more drug, as did 71 percent of fatal heroin overdoses, according to the report.