Heroin, drugs CDC/ Louis Alexander

Fentanyl Death Rates Shoot Upwards Especially Among Black Men

MedicalResearch.com Interview with:

Maria-Rita D'Orsogna Ph.D.Professor, Mathematics California State University, Northridge Adjunct Associate Professor Department of Computational Medicine at UCLA

Dr. D’Orsogna

Maria-Rita D’Orsogna Ph.D.
Professor, Mathematics
California State University, Northridge
Adjunct Associate Professor
Department of Computational Medicine at UCLA

MedicalResearch.com: What is the background for this study?

Response: Drug overdose deaths have been increasing in the USA for the past two decades. A ‘third wave’ of overdose fatalities started in 2013, with a shift from prescription opioids towards synthetic ones, in particular illicit fentanyl.

To examine trends in drug overdose deaths by gender, race and geography in the United States during the period 2013-2020, we used an epidemiological database provided by the Centers for Disease Control and Prevention, extracting rates by race and gender in all 50 states plus the District of Columbia. We considered the impact of four main drug categories psychostimulants with addiction potential such as methamphetamines; heroin; prescription opioids and synthetic opioids such as fentanyl and its derivatives.

MedicalResearch.com: What are the main findings?

Response:  We found significant increases in overdose deaths from all categories except heroin in 2020, with data surpassing predictions derived from 2013-2019 trends. Rates among black individuals of both genders exceeded those for white individuals for fentanyl and psychostimulants starting in 2018; the gap continued to widen in the years since. The largest 2020 death rate is for black males in the District of Columbia due to fentanyl with a rate almost 10 times higher than that for white males.

MedicalResearch.com: Would you comment on the introduction of xylazine (or ‘tranq’) into the fentanyl supply?

Response:  Xylazine is a non-opioid drug used as a sedative and muscle relaxant in horses and cattle. As a substance of abuse, it is also known by the street name ‘tranq’ and has made its way into the drug supply by being mixed with opioids — heroin, cocaine, and especially fentanyl. Consumers find that it tends to extend the duration of the ‘high’ from fentanyl, although sometimes they are unaware of its presence in the drugs they are using. The effects are devastating as it causes difficult to heal skin wounds all over the body. Because xylazine is not part of the existing records of the database we analyzed, we hope to be able to provide a more detailed analysis in future work. The introduction of tranq and other new drugs shows that dealers are always reinventing their ‘products’ and that mitigating drug abuse will require constant innovation in the methods used to test illicit drug samples, in the messaging to drug users and first responders, and in prevention campaigns.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: Although it is difficult to identify all drivers of increased drug overdoses, we believe that pandemic-related anxieties, and a greater availability of cheaper drugs contributed to the exceptional rise in fatal overdoses in 2020. Given the high levels of heterogeneity in overdose patterns across different demographic groups, prevention and mitigation campaigns should be tailored to specific at-risk groups. Our youth should be especially encouraged to refrain from drug experimentation: today’s drug mixes are much more potent, addictive, and lethal than even a generation ago.


  1. R. D’Orsogna, L. Böttcher, T. Chou, Fentanyl-driven acceleration of racial, gender and geographical disparities in drug overdose deaths in the United States, PLOS Global Public Health (2023)
  2. Böttcher, T. Chou, M. R. D’Orsogna, Modeling and forecasting age-specific overdose mortality in the United States, European Physical Journal Special Topics (forthcoming)

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