The United States is in the throes of a drug overdose epidemic.

Approximately 81,230 drug overdose deaths occurred in the United States in the 12-months ending in May 2020. This represents a worsening of the drug overdose epidemic in the United States and is the largest number of drug overdoses for a 12-month period ever recorded.

The number of overdose deaths increased 18.2% from the 12-months ending in June 2019 to the 12-months ending in May 2020.

Drug overdose deaths during this time increased more than 20% in 25 states and the District of Columbia, 10% to 19% in 11 states and New York City, and 0% to 9% in 10 states.

The increases in drug overdose deaths appear to have accelerated during the COVID-19 pandemic.

Synthetic opioids are the primary driver of the increases in overdose deaths.

Overdose deaths involving cocaine also increased by 26.5% from the 12-months ending in June 2019 to the 12-months ending in May 2020.

Other data have shown that recent increases in overdose deaths involving cocaine are primarily related to overdose deaths that involved both cocaine and synthetic opioids (primarily illicitly manufactured fentanyl)

These deaths are likely linked to co-use of cocaine among people injecting opioids such as illicitly manufactured fentanyl or heroin.

In contrast, overdose deaths involving psychostimulants, such as methamphetamine, have been increasing with and without synthetic opioid co-use and at a rate faster than overdose deaths involving cocaine.

Provisional 12-month counts of overdose deaths involving psychostimulants in the United States increased by 34.8% from the 12-months ending in June 2019 compared to the 12-months ending in May 2020.

The number of deaths involving psychostimulants now exceeds the number of cocaine-involved deaths.

These increases are consistent with the increased availability of methamphetamine in the illicit drug supply and increases in methamphetamine-related treatment admissions.

Source: Centers for Disease Control and Prevention (CDC) – Increase in Fatal Drug Overdoses Across the United States Driven by Synthetic Opioids Before and During the COVID-19 Pandemic.  December 17, 2020.  Accessed on May 10, 2021 from HAN Archive – 00438 | Health Alert Network (HAN) (

Alcohol and drug misuse and severe substance use disorders, commonly called addiction, are one of America’s most pressing public health concerns.

Nearly 21 million Americans – more than the number of people who have all cancers combined – suffer from substance use disorders.

“Alcohol and drug addiction take an enormous toll on individuals, families, and communities,” said U.S. Surgeon General Dr. Vivek Murthy. “Most Americans know someone who has been touched by an alcohol or a drug use disorder. Yet 90 percent of people with a substance use disorder are not getting treatment.”

One in seven people in the U.S. is expected to develop a substance use disorder at some point in their lives. Yet only 1 in 10 receives treatment. Substance use disorders typically develop over time following repeated episodes of misuse that result in changes to the brain circuitry.

Substance misuse – which includes use of a substance in any way that can cause harm to oneself or others – is an underappreciated but critical public health challenge that can lead to substance use disorders, such as addiction.

In 2015, nearly 48 million Americans used an illicit drug or misused a prescription medication, approximately 67 million reported binge drinking in the past month, and nearly 28 million self-reported driving under the influence in the past year.

Substance use disorder treatment in the United States remains largely separate from the rest of health care and serves only a fraction of those in need of treatment.

Source: National Institute on Alcohol Abuse and Alcoholism – Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, Thursday, November 17, 2016.  Accessed 5.2.2021 from

The United States has the ignominious distinction of leading the world in opioid prescribing, and in opioid-related overdose deaths. The Centers for Disease Control (CDC) estimates that over 40,000 people died of an opioid-related overdose, with fentanyl-related deaths exceeding those of heroin or prescription opioids. Opioid overdoses are now the leading cause of unintentional deaths in the US and of declining lifespan expectancies.

Madras BK. The President’s Commission on Combating Drug Addiction and the Opioid Crisis: Origins and Recommendations. Clin Pharmacol Ther. 2018 Jun;103(6):943-945. doi: 10.1002/cpt.1050. Epub 2018 Mar 23. PMID: 29570781. Accessed 5.2.2020 from