America’s two-decade drug crisis hit another new low in 2020. New estimates from the CDC indicate that roughly 93,000 people died from drug overdoses last year, a 30 percent increase over 2019. As drug-policy expert Keith Humphreys noted, drugs are likely now killing more people per day than Covid-19 does.

Some commentators will be quick to blame the surge in deaths on the pandemic and ensuing lockdowns, the psychological effects of which may have driven more people to use drugs or the same people to use more heavily. CDC simulation data from earlier this year do show that drug deaths likely spiked above pre-2020 levels during lockdowns.

This is probably not the whole story, though. Lockdowns had counterintuitive effects on other causes of death—causing suicides to decline, for example—which suggests that their effect on drug overdoses may not be so simple. Furthermore, global shutdowns of trade should have reduced the supply of drugs, which today flow primarily from China and Mexico; seizures of non-marijuana drugs fell below pre-2020 levels in March and April of last year. And my analysis of the CDC’s data indicates that the largest increase in overdoses relative to 2020 came in May and June, after many states had lifted their stay-at-home orders.

More fundamentally, even if 2020 were not a particularly bad year for the factors that determine drug demand—depression, despair, and disconnection—we could still have expected an increase in overdose deaths, as we have seen in 18 of the last 20 years.

That’s because of a fundamental shift in the supply of drugs—a shift that continued last year. The two leading causes of overdose death are now, per the CDC data, synthetic opioids (primarily fentanyl and its analogs) and methamphetamine, involved in 57,000 and 24,000 deaths, respectively. Both drugs are differentiated from more traditional narcotics—heroin, cocaine, and prescription opioids—because they are synthesized in a lab from easily obtained precursor chemicals. This allows their producers, predominantly Mexican drug cartels, cheaply to produce incredibly potent drugs, which are smuggled across the southwestern border and come to adulterate most of the ostensibly non-synthetic illicit drug supply.

This technological transition—from harvesting coca and poppy to synthesizing ultra-potent versions of their active ingredients in the lab—is the major driver of the multi-decade increase in drug-overdose deaths to levels never before seen in U.S. history. Covid-19 likely accelerated this grim process, but even post-pandemic, we should expect drug deaths to continue rising for the foreseeable future.

Photo by Dania Maxwell / Los Angeles Times via Getty Images


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