Statement for the Record: An Epidemic Within a Pandemic: Understanding Substance Use and Misuse in America

The COVID-19 pandemic has diverted the nation’s attention away from an overdose epidemic that was raging long before the appearance of the deadly virus and has accelerated during the viral pandemic.

April 14, 2021 • Testimony

Subcommittee on Health
Committee on Energy and Commerce
United States House of Representatives

Dear Chairwoman Eshoo, Ranking Member Guthrie, and Members of the Subcommittee on Health:

My name is Jeffrey A. Singer. I am a Senior Fellow in Health Policy Studies at the Cato Institute. I am also a medical doctor specializing in general surgery and have been practicing that specialty in Phoenix, Arizona for over 35 years. I would like to thank the Subcommittee on Health for convening a hearing on Wednesday, April 14, 2021 on “An Epidemic Within a Pandemic: Understanding Substance Use and Misuse in America.” I appreciate this opportunity to provide my perspective, as a health care practitioner and policy analyst, to assist this committee with its assessment of the current state of substance use and misuse in the United States.

The COVID-19 pandemic has diverted the nation’s attention away from an overdose epidemic that was raging long before the appearance of the deadly virus and has accelerated during the viral pandemic. The Centers for Disease Control and Prevention reported last December that, after a brief pause in 2018, the overdose rate increased during 2019 by more than 5 percent to a total of 70,630. Overdose deaths due to opioids of any kind increased from roughly 47,000 to over 50,000, representing an increase of more than 6 percent. But illicit fentanyl and its analogs comprised more than 36,000 of all opioid overdose deaths, an increase of nearly 16 percent over one year, while heroin was responsible for approximately 14,000 (a roughly 7 percent decrease) and prescription opioids were found in just under 12,000 overdose deaths, representing a decrease of more than 7 percent. Methadone was found in a little more than 2,700 overdoses, a decrease of more than 10 percent. Perhaps even more alarming was that deaths due to psychostimulants such as methamphetamine and cocaine increased to historically high levels of more than 16,000, representing a nearly 24 percent jump in just one year.

Now a study from the Commonwealth Fund suggests that overdose deaths may have increased by more than 27 percent in 2020, the year of the pandemic, to roughly 90,000 with opioids comprising 75 percent of overdose deaths and fentanyl and its analogs involved in 80 percent of opioid overdoses.

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