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WASHINGTON — Synthetic opioids, particularly illicit fentanyl, contributed to more overdose deaths in the United States in 2016 than prescription opioids, according to a new analysis.

Synthetic opioids, a category distinct from heroin and prescription drugs like Vicodin or OxyContin, were listed as contributing to 19,413 deaths in 2016, 2,000 more than were connected to prescription opioids, according to an analysis published Tuesday in JAMA Psychiatry.


The numbers represent the first time this decade that synthetic opioids were found to have contributed to more overdose deaths than prescription versions. The data also shows a dramatic shift from 2010 to 2016, during which the portion of all opioid-related deaths involving synthetic opioids rose from 14 to 46 percent.

Nearly 80 percent of those who died from a synthetic opioid-related overdose in 2016 also had another drug or alcohol in their system. Of the roughly 15,000 heroin-related deaths reported in 2016, 37 percent also involved synthetic opioids.

The study corresponds to an increased focus within the public health community on fentanyl, the powerful synthetic opioid sometimes used as an anesthetic in hospitals and to treat chronic pain. Increasingly, however, drug dealers sell opioids laced with fentanyl — often cheaper than other forms of illicit opioids — to purchasers either unaware that they are getting the synthetic drug or unable to predict its increased potency.


Some first responders have reported that it’s increasingly difficult to revive people who have overdosed on opioids. They often need to administer the overdose-reversal drug naloxone multiple times before it takes effect.

The study also emphasized awareness of fentanyl and knowledge of how to administer naloxone, in line with a recent advisory from Surgeon General Jerome Adams, who has urged the friends and family of individuals at risk for overdose to carry the drug even if they have no medical or emergency-response training.

“Widespread public health messaging is needed, and clinicians, first responders, and lay persons likely to respond to an overdose should be trained on synthetic opioid risks and equipped with multiple doses of naloxone,” the authors wrote.

The Trump administration and health officials at all levels have made naloxone access a key element of their response to the opioid epidemic. Some manufacturers have donated units to health departments and advocacy groups, and Congress has allocated millions to purchase naloxone.

At the same time, President Trump’s staff has made lowering the rate of opioid prescriptions a focus of his drug policy. The administration has also invited a memorial to overdose victims called “Prescribed to Death” to display its exhibit for a week on the White House lawn, and alluded at various points to taking legal action against some prescription drug manufacturers.  

The study noted that between 15 and 25 percent of drug overdose deaths listed by coroners and other health officials don’t include a specific cause of death, limiting the analysis and meaning the data likely understated the true number of deaths due to synthetic and prescription opioids.