Which Drug Causes the Most Deaths Each Year?

Every year, tens of thousands of Americans die from drug overdoses. Perhaps the most well-known source of these deaths is the opioid heroin. However, another, more powerful opioid substance — fentanyl — now causes more fatalities than any other drug in the U.S.

What Is Fentanyl?

Fentanyl first became available in the 1960s and under the brand name Sublimaze, it originally was used as a form of IV anesthetic. Today, U.S. doctors write millions of prescriptions each year for a variety of fentanyl-based products including lozenges, sublingual (under-the-tongue) tablets and sprays, transdermal patches, nasal sprays and injectables.

The uses for these fentanyl-laced products include:

• Anesthesia
• Treatment of chronic pain
• Treatment of a severe form of cancer-related pain known as breakthrough pain

Fentanyl[i] belongs to a group of substances known as synthetic opioids. All substances in this category are designed in a laboratory and produce the same general effects in the human body as other opioids. However, they don’t contain any material from the opium poppy, the plant that serves as the source material for natural and semisynthetic opioids such as morphine and heroin.

Potency of Fentanyl and Fentanyl Analogs

There is another important distinction between synthetic opioids and other opioids. Pharmaceutical researchers working in a laboratory setting can produce drugs with far greater potency than drugs produced from natural substances. Fentanyl and its chemical analogs, such as butyryl fentanyl, acetyl fentanyl and carfentanil, perfectly illustrate the boost in potency made possible by the creation of fully synthetic opioids.

Reports from the National Institute on Drug Abuse and the Drug Enforcement Administration identify fentanyl as 80 to 100 times more powerful than morphine[ii], the source of heroin. While not as widely available as fentanyl, carfentanil is an astounding 10,000 times stronger than morphine. Butyryl fentanyl and acetyl fentanyl are 30 times and 15 times stronger than morphine, respectively.

Increased Potency Means Increased Overdose Risks

All opioid substances produce three main effects in the human body: a slowdown of normal activity in the central nervous system (brain and spinal cord), pain relief and the onset of a powerful form of pleasure commonly known as euphoria. The source of overdose risks for opioid users results from these substances’ impact on the function of the central nervous system. Specifically, people who consume large amounts of opioids can experience a severe drop in normal lung function. Unless identified and treated, this decline in function can lead to complete loss of breathing and death.

Since fentanyl and its analogues are so powerful, it takes only a relatively small amount to trigger an overdose. The increased risk is perhaps most dramatic for people with no previous history of opioid use or abuse. However, risks also spike significantly for people accustomed to the effects of heroin or prescription opioids such as oxycodone or hydrocodone.

How Many People Die?

Every year, the federal Centers for Disease Control and Prevention (CDC) record and report the number of Americans who die from fatal drug overdoses. As of late 2017, the most recent CDC information covers the year 2016. In 2016, 20,145 people died after using fentanyl or fentanyl analogues[iii]. The drug responsible for the second highest death total was heroin with 15,446 fatalities.

Other top killers included:

• 14,427 fatalities – natural opioids and semisynthetic opioids other than heroin
• 10,619 fatalities – cocaine
• 7,663 fatalities – methamphetamine
• 3,314 fatalities – methadone

Specific Problems Related to Fentanyl

Fentanyl abuse is a topic of special concern for several reasons. First, compared to most other opioids, the drug reaches the brain quite rapidly and begins to produce its effects in a shorter amount of time. In addition to increasing the odds of user addiction, this fact increases the odds of user overdose.

The misuse of fentanyl has also risen sharply in just a few years. In 2013, only 3,105 Americans fatally overdosed on the drug and its analogs. Therefore, the figures for 2016 (20,145 deaths) represent more than a sixfold increase in such deaths.

There is another issue that makes fentanyl a target of worry for public health officials and addiction treatment specialists. Some people who abuse the drug have access to legally produced medications manufactured under controlled laboratory conditions. However, the National Institute on Drug Abuse reports that the recent increase in fatal overdoses is largely linked to the consumption of fentanyl produced in illicitly run labs that undergo no official scrutiny for quality control.

In addition to manufacturing a drug that might fail to pass accepted standards for purity, these labs can — and do — combine fentanyl with other substances capable of increasing the odds of an overdose. What’s more, fentanyl manufacturers sometimes purposefully produce the drug in forms that mimic the appearance of other types of substances, including benzodiazepine tranquilizers and various types of opioid medications. Among other things, this means that someone with no intention of using fentanyl can still consume the drug and fall subject to unanticipated overdose risks.

In addition, rising tolerance among fentanyl abusers has led to the production of increasingly potent illicit versions of the drug. This means that even someone who knowingly abuses fentanyl can overdose unexpectedly when taking a quantity of the substance that seemed safe to consume in the past.

Getting Help for Fentanyl Addiction

While fentanyl is a particularly powerful opioid drug, the same treatment techniques used for people addicted to other opioid substances also work for people with fentanyl-related problems. At Transformations Treatment Center, we specialize in the treatment of opioid abuse and addiction, as well as problems related to the use of other substances. Our caring staff of addiction treatment professionals are here to help you recover emotionally, spiritually and physically.