Pills lay scattered on a counter; a person’s arms partially blurred in the background also rests on the counter

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Recent statistics indicate that the COVID-19 pandemic is driving drug overdose trends—and deaths. As the pandemic dominates as the top national health and economic concern, clinical labs, federal agencies, and medical groups continue to monitor the opioid crisis, taking steps to tamp down on designer drug use and watch prescription trends.

Even before coronavirus, U.S. drug overdose deaths reached a record high of 70,980 in 2019, an increase of 4.6% from 2018, according to Politico. Fentanyl and other synthetic opioids caused 36,500 of the overdose deaths. A more region-specific study underscores the depths of a national problem. Investigating 7 years of deaths in San Francisco, investigators found that more than 1 in 6 deaths attributed to out-of-hospital cardiac arrest were actually due to overdose. The findings are significant in that San Francisco’s age-adjusted overdose mortality rate nearly mirrors the national rate.

White House and health officials said they expected the COVID-19 pandemic to result in the overdose death rate climbing higher this year.

Major news organizations have since linked the events of COVID-19 to increased illicit drug use and mortality. Politico reported on a White House drug policy office analysis showing that drug overdose deaths had risen 11.4% in the first four months of this year compared to the same period last year. According to Politico, Kentucky saw a 25% increase in overdose deaths between January and March, while emergency medical system calls and emergency department visits related to overdoses also rose between March and June. West Virginia reported a 50% increase in emergency calls in May. The Washington Post similarly reported that suspected overdoses have steadily increased, from an 18% jump in March 2020 compared to March 2019 to a 42% increase in May 2020 compared to last May.

“Once the tsunami of Covid-19 finally recedes, we’re going to be left with the social conditions that enabled the opioid crisis to emerge in the first place, and those are not going to go away,” Mike Brumage, MD, former director of the West Virginia Office of Drug Control Policy, said in a news report. In his state, deaths related to drug overdoses have eclipsed deaths from SARS-CoV-2. Yet another news report from Milwaukee found that street drugs with more dangerous substances such as fentanyl are proliferating at a time when clinics are closing down, limiting access to social services.

In its analysis of 500,000 urine drug tests, Millenium Health in July reported national increases in non-prescribed fentanyl (31.96%), methamphetamine (19.96%), cocaine (10.06%), and heroin (12.53%) since COVID-19 was declared a national emergency in March. “Public health officials across the country are reporting spikes in drug overdose deaths during the COVID-19 pandemic, with over 30 states reporting increases in opioid-involved overdose deaths, primarily related to illicit fentanyl,” wrote the authors of the report.

National Institutes of Health Director Francis Collins and Nora Volkow, director of the National Institute on Drug Abuse, recently discussed the intertwined challenges of substance abuse and the COVID-19 pandemic.

The U.S. Food and Drug Administration (FDA) recently required a naloxone reference on all opioid labels. Manufacturers of opioid painkillers must now include information about this overdose reversal agent on package labels, according to new FDA requirements. FDA is also going to require labels for three other drugs that help treat opioid use disorder: methadone, buprenorphine, and naltrexone. “Today’s action can help further raise awareness about this potentially life-saving treatment for individuals that may be at greater risk of an overdose and those in the community most likely to observe an overdose,” FDA Commissioner Stephen Hahn said in a statement.

Even as fatal opioid overdoses hit record highs, with the pandemic threatening to make matters worse, the latest report from the American Medical Association’s Opioid Task Force found that opioid prescriptions actually decreased in 2019 (by 37%), the sixth consecutive year of decline. Other trends also point to higher scrutiny of these prescriptions: There was a 64% increase since 2018 in physicians’ use of state drug monitoring programs. And, more doctors are prescribing naloxone: More than 1 million prescriptions of the drug were dispensed last year, which is more than double the number in 2018.

A Clinical Chemistry Q&A recently extolled the team-based approaches on the part of clinical labs, mass spectrometrists, public health, and law enforcement to fight the opioid epidemic. Using high-resolution mass spectrometry has been a key tool in staying ahead of designer drug evolution and development, the article stated.