Blog & News
Drug overdose deaths grew by almost 30 percent in 2020
July 15, 2021:Fentanyl- and methamphetamine-type drugs surged roughly 50 percent in 2020
Drug overdose deaths surged in the United States during the first year of the COVID-19 pandemic, increasing nearly 30 percent in just 12 months. Provisional data recently published by the U.S. Centers for Disease Control and Prevention (CDC) show that more than 92,000 people died of drug overdoses in 2020—surpassing records yet again.1
The growth was widespread throughout the country, with only two states (New Hampshire and South Dakota) spared from the jump in drug overdose deaths. Conversely, some states saw their death rates increase more than 50 percent, including Kentucky, South Carolina, Vermont, and West Virginia.
Much of the growth in drug overdose deaths was driven by synthetic opioids such as fentanyl, which increased more than 50 percent from 2019 to 2020 (see Figure 1). Fentanyl has become a key product for international drug traffickers, often finding its way as an adulterant in other drugs like heroin and cocaine, and even as an ingredient in counterfeits of common opioid prescription pills such as Oxycontin. The emergence of fentanyl in the U.S. illicit drug trade is a newer phenomenon beginning in the past decade, and it has recently spread from eastern states to increasingly affect states in the western half of the country as well.
Figure 1. Changes in drug overdose deaths in the U.S., 2019 to 2020
A family of drugs called “psychostimulants”—mostly methamphetamine—also drove a large increase in deaths in 2020, up nearly 50 percent since 2019. Deaths involving methamphetamine and other psychostimulants have grown dramatically in the past few years. The increased death toll involving psychostimulants is likely caused by two factors: First, the methamphetamine trafficked in the U.S. today is generally much more potent than methamphetamine sold in the past, raising the potential risk of overdoses caused by methamphetamine. Second, methamphetamine today is often contaminated with, or used alongside, synthetic opioids, raising the risk of an overdose involving the use of multiple drugs simultaneously.
Of the main drugs involved in overdoses2, only heroin was associated with a decline in deaths during 2020—falling by less than 10 percent since 2019. Meanwhile, overdose deaths involving prescription opioids increased more than 20 percent, reversing a trend of relatively stable or even declining death rates over several years. Cocaine overdose deaths similarly increased by more than 20 percent in 2020.
1 National Center for Health Statistics (NCHS). (2021, July 14). Vital Statistics Rapid Release: Provisional Drug Overdose Death Counts [Data set]. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
2 The drug overdose death categories presented in the CDC data include: heroin, natural opioid analgesics (e.g., morphine and codeine) and semisynthetic opioids (e.g., oxycodone and hydrocodone), synthetic opioids such as methadone and synthetic opioids other than methadone (e.g., fentanyl and tramadol), cocaine, and psychostimulants.
Blog & News
New Study Shows Heightened Mental Health Burdens for Young Adults, Adults with Lower Incomes or Lower Education Levels, and Adults who Experienced Income Loss during the COVID Pandemic
July 1, 2021:As rates of COVID vaccination increase around the world and the nation, attention is beginning to turn toward addressing more of the non-physical impacts and effects of the virus, such as the mental health burdens borne by large segments of the population.1
In a new issue brief released this week, SHADAC researchers used the U.S. Census Bureau’s Household Pulse Survey to study the relationship between the COVID-19 pandemic and mental health burdens for the United States’ adult population. Based on data gathered in April/May through December of 2020, the brief’s authors found that reported rates of combined and individual symptoms of anxiety and depression in the first part of the year were more than triple when compared with data from a similar time period in a related survey, the Center for Disease Control and Prevention’s (CDC) National Health Interview Survey (NHIS). The HPS found a rate of 35.9 percent of adults reporting anxiety or depression symptoms in April/May 2020, versus 11.0 percent from the NHIS in January-June 2019.2 And rates only continued to grow significantly throughout the remainder of 2020, reaching a peak of 41.9 percent in December.
In particular, the analysis found that the highest rates of these mental health burdens were borne by younger adults, adults with less than a high school education, adults with lower incomes, and adults who experienced or anticipated job-related income loss. In each case, reported rates of anxiety or depression symptoms were significantly higher than those for the total population (41.9 percent).
In December 2020…
…younger people consistently reported the highest rates of anxiety or depression, with more than half (56.4 percent) of 18-29 year-olds reporting symptoms of anxiety or depression, a significantly higher rate than this same group reported in April/May 2020.
…roughly one-half (51.2%) of adults with less than a high school education reported anxiety or depression symptoms.
…more than half (58.2 percent) of adults with household incomes of less than $25,000 reported anxiety or depressions symptoms, a statistically significant increase over their April/May 2020 rate.
The HPS also collected data on anxiety and depression symptoms from adults who had either experienced or anticipated a job-related income loss during the 2020 year. Just over one-half of individuals (53.2 percent) who had experienced an employment income loss reported symptoms of anxiety or depression, which was significantly higher than the roughly one-third (31.5 percent) rate among people who hadn’t experienced such a loss. An even greater number of people who anticipated an employment income loss (58.0 percent) reported anxiety or depression symptoms, which was again significantly higher than the approximately one-third (35.0 percent) rate among people who didn’t anticipate such a loss.
The pandemic's toll on mental health, especially for younger adults, has become increasingly worrisome in recent months.3 Mental health burdens, such as suicide deaths, were already an area of concern prior to COVID, with rates trending upward in the years before 2020.4
It is important for policymakers, as they consider directing resources toward addressing the impacts of COVID-19 on their individual populations, to understand which groups (i.e., younger adults, adults with lower incomes and education levels, and adults who experienced income losses) might benefit most from outreach to connect them with or increase their access to mental health care services.
Explore Additional COVID-related SHADAC Work Using the HPS
SHADAC previously wrote a blog post that provided an overview of the Household Pulse Survey (HPS) methodology as well as survey and questionnaire updates.
SHADAC has also used HPS data to track vaccination rates for a range of demographic groups, producing our own state-level estimates of vaccination rates for a biweekly blog series.
Additionally, SHADAC produced a blog studying vaccine hesitancy rates among adults during the first part of 2021.
1 Tully, T. (Updated 2021, June 11). Covid-19: U.S. Vaccine Production and Supply Increase After Snowstorms Caused Delays. The New York Times. https://www.nytimes.com/live/2021/02/23/world/covid-19-coronavirus
Soucheray, S. (2021, May 28). COVID-19 vaccinations increase in US, but unevenly. Center for Infectious Disease Research and Policy (CIDRAP). https://www.cidrap.umn.edu/news-perspective/2021/05/covid-19-vaccinations-increase-us-unevenly
Abbot, A. (February 2021). COVID’s mental-health toll: how scientists are tracking a surge in depression. Nature. https://www.nature.com/articles/d41586-021-00175-z
2 The pandemic-era rates from the CDC study and the HPS are not perfectly comparable to the pre-pandemic rates from the NHIS because they come from different surveys with different methodologies. However, since they ask essentially the same questions on anxiety and depression, the rates should presumably be similar, so the substantially higher estimates in the pandemic-era surveys provide reason for concern.
3 Fernandez, M.E. (2021, March 8). AHA News: COVID-19 Mental Health Crisis Is Hitting Young Adults. U.S. News & World Report. https://www.usnews.com/news/health-news/articles/2021-03-08/aha-news-covid-19-mental-health-crisis-is-hitting-young-adults
4 Planalp, C., Hest, R., & Au-Yeung, C. (June 2020). Suicide Rates on the Rise: National Trends and Demographics in Suicide Deaths from 2000 to 2018. State Health Access Data Assistance Center (SHADAC). https://www.shadac.org/sites/default/files/publications/2020_NATIONAL-Suicide-brief.pdf
Hill, R.M., Rufino, K., Kurian, S., Saxena, J., Saxena, K., & Williams, L. (March 2021). Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19. Pediatrics, 147(3), e2020029280; DOI: https://doi.org/10.1542/peds.2020-029280
Publication
COVID-19 Pandemic Coincided with Elevated and Increasing Anxiety and Depression Symptoms
SHADAC Director Dr. Lynn Blewett and SHADAC Researchers Colin Planalp and Robert Hest used data from the U.S. Census Bureau’s Household Pulse Survey (HPS) to study rates of anxiety and depression in the U.S. adult population for the months of April to December 2020.
The brief looks at both combined and individual rates of reported anxiety and depression symptoms for the total adult population as well as by specific breakdowns, including age, gender, race/ethnicity, income and education levels, and employment status.
Designed to provide near-real-time estimates of the economic, financial, and health impacts of the pandemic, the HPS asks questions covering topics such as health insurance coverage, medical treatment, employment status, and job loss, food security, and transportation access, among others. The HPS questions used in the analysis of this brief were adapted by the Census Bureau from a four-item screening tool commonly used by health care providers to identify symptoms of anxiety and depression.
Though the United States is beginning to emerge from the darkest days of the pandemic, it is important to remember that this crisis affected not only physical health, but mental health as well, and these burdens must be continued to be monitored and addressed at the local, state, and national levels. This brief provides an overview of mental health impacts on different portions of the populations, and highlights which groups may benefit from particular outreach to connect them with needed mental health care.
Explore Additional COVID-related SHADAC Work Using the HPS
SHADAC previously wrote a blog post that provided an overview of the Household Pulse Survey (HPS) methodology as well as survey and questionnaire updates.
SHADAC has also used HPS data to track vaccination rates for a range of demographic groups, producing our own state-level estimates of vaccination rates for a biweekly blog series.
Additionally, SHADAC produced a blog studying vaccine hesitancy rates among adults during the first part of 2021.