The war on drugs needs to shift away from prescriptions written in your doctor’s office to street drugs bought in our communities.

In 2010, the prescription opiate, oxycodone, was the primary drug implicated in overdose deaths in the U.S. But now, based on data from a new report from the CDC, heroin is the leading cause of overdose deaths.

Drug syringe and cooked heroin on desk (Courtesy Shutterstock)

The report also describes a dangerous rise in overdose deaths linked to fentanyl, a synthetic opiate 50-100 times more potent than morphine. Data from the study indicates that the number of deaths related to fentanyl doubled from 2013 to 2014.

Fentanyl is manufactured in a lab, and is much cheaper to produce than heroin. In fact, those who produce heroin in the U.S. and abroad often choose to cut their production costs by adding fentanyl, since it lowers their overall costs. Illegal shipments from China are increasingly responsible for the surge in fentanyl entering the U.S. market.

The problem is that those who overdose on fentanyl require significantly more of the reversal agent known as naloxone, or Narcan, in order to reverse its deadly effect of sedation and respiratory depression. Physicians who practice in emergency departments are well aware of the prevalence of fentanyl complicating heroin overdoses, especially in those patients who may require 5-10 times the normal dose of Narcan to reverse the synthetic opiate.

The new study employed a new method to search for specific drugs implicated the overdose deaths, including words such as “drug” and “overdose” as search terms.

The results are striking: Overdose deaths from heroin jumped from 3,000 in 2010 to 10,000 in 2014. Meanwhile, deaths from oxycodone remained steady at 5,000, unchanged from 2010.

This rise in deaths from heroin also reflects a shift away from prescription opiates, as access to the drug becomes more difficult as well as costly. The shift to heroin and fentanyl also reveals the changing face and demographics of addicts, with an uptick in suburban working professionals unable to obtain oxycodone or hydrocodone in medical offices or on the streets.

In 2014, the five most commonly cited drugs implicated in overdose deaths in descending order of frequency were as follows: heroin, cocaine, oxycodone (OxyContin), alprazolam (Xanax) and fentanyl. The largest jump in the list was from fentanyl, leaping from 8th place to 5th place.

This study arrives amid updated numbers from the CDC indicating that overdose deaths are still increasing in the U.S., which began in 1999. The revelation that deaths from overdoses rival deaths as a result of motor vehicle crashes remains an eye-opener.

Data from the CDC continues to show an increase in overdose deaths in 2015–up 11% from 2014, as 5,400 more people died. One of the explanations for this increase were deaths related to synthetic opioids such as fentanyl, which increased nearly 72% from 2010-2015.  Meanwhile, deaths from heroin increased 20% during the same time period.

And amid such alarming data, Congress just passed the 21st Century Cures Act, which was recently signed by President Obama, setting aside $1 billion for treating substance abuse over the next 2 years. Greater investment in programs that provide a reasonable chance to treat opiate addiction using medications such as Suboxone (buprenorphine and naloxone) would be a major step in the right direction. Buprenorphine belongs to a class of medications known as partial agonists which may help reduce and alleviate symptoms of opiate withdrawal.