Beneath COVID-19, Tennessee suffered the worst year for drug deaths ever

As the coronavirus pandemic dominated government priorities and the public consciousness, Tennessee quietly recorded more than 3,000 fatal drug overdoses in 2020 – the deadliest year ever.

Fatal overdoses, most of which involved fentanyl or similar synthetic opioids, rose more than 44% in 2020, according to new data released by the Centers for Disease Control and Prevention. Deaths spiked nationwide but grew more in Tennessee than in 43 other states.

Only two states, South Dakota and New Hampshire, reported a decline in drug deaths.

For those engrossed by the ebb and flow of the coronavirus, surging drug deaths are a stark reminder of another public health crisis that existed long before the pandemic and probably will persist after it fades. The opioid crisis has not killed as many as quickly as the virus, but the nation’s struggle with drug addiction can’t be ended by a jab or two in the arm either.

Tennessee reported 3,091 confirmed fatal drug overdoses in 2020, and another 37 remain unconfirmed while under investigation, according to the CDC’s latest overdose data, made public last week. The 2020 death total is more than double the fatal overdoses counted five years prior in 2015. The death toll rose every year since then.

Nashville on pace for more drug deaths in 2021

Nashville, the most populated region of Tennessee, was hit the hardest by the surging drug crisis.

The city reported 621 overdose deaths in 2020 – up 33% since the previous year. About 65% of those victims were Nashville residents. The remainder included commuters, tourists and those who were rushed into the city for medical attention, according to the Metro Public Health Department.

The city also saw record levels of just about every other measurement of the drug crisis, said Josh Love, a Metro Health epidemiologist. The city recorded spikes in non-fatal overdoses, drug-related emergency room visits, Narcan used by cops and firefighters as well as syringes collected off the streets.

Fatal overdoses were largely attributable to fentanyl, a synthetic opioid that can be deadly in doses no larger than a few grains of sand. Fentanyl, once barely known outside of hospitals, became the deadliest drug in America a few years ago when drug traffickers began lacing the substance into heroin or cocaine. Now it appears many with opioid addiction seek fentanyl out specifically for its potency, Love and Henderson said.

Fentanyl is also found in fake prescription pills sold on the streets and dark web, a black market that has grown since Tennessee cracked down on the reckless prescription of opioid painkillers.

“It’s a complete coin toss if you are using drugs these days,” Love said. “The drug dealers, or whoever is making these pills, they aren’t chemists. They aren’t measuring out how much fentanyl they are putting in, and analogues have different potencies depending on what you get. It’s just deadly.”

Henderson said the 2020 death toll probably was elevated by the pandemic, as job losses, hospital bills and the untimely deaths of loved ones are “stressors” that can push people deeper into addiction. And some people lost access to drug treatment when the nation shut down to slow the virus.

But even after the virus waned and virus regulations were lifted, the tide of drug deaths continued to rise. Nashville is on pace to suffer more than 700 drug deaths in 2021.

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