Cornyn right that annual drug overdose deaths top 100,000

Days after the U.S. reached 900,000 total COVID-19 deaths, U.S. Sen. John Cornyn, R-Texas, highlighted another morbid statistic.

He tweeted on Feb. 14, "We recently found out our nation hit a grim milestone: 100,000 Americans died of an overdose in a single year."

He also linked this statistic to President Joe Biden's border policy and wrote, "Pres. Biden’s open borders policies are letting drugs like Fentanyl pour into our communities. This cannot go on - we must secure the border."

Is it true that 100,000 Americans died of overdose "in a single year"? PolitiFact Texas took a look.

Cornyn's office pointed to a Centers for Disease Control and Prevention Nov. 17 news release and a Feb. 13 article by The New York Times citing that November release. 

The National Center for Health Statistics estimated there were more than 100,300 drug overdose deaths nationally in a 12-month period ending April 2021. That matches what Cornyn said. Compared to the same period the year prior, drug overdose deaths had increased 28.5%.

Data released Feb. 16 indicate an estimated 104,288 Americans died from drug overdoses from September 2020 to September 2021, according to CDC media relations.

Marcia Ory, Texas A&M University School of Public Health professor and co-chair of Texas A&M's Opioid Task Force, believes that number may be an undercount. Ory said she sees that to be the case in Texas' rural counties.

"Texas has very few medical examiners in all of our 254 counties, so we already know that it's often a justice of the peace or someone who's not medically trained," Ory said. "Because of that the symptoms of an overdose death might be interpreted as cardiac failure, respiratory problems."

According to 2019 posts by the Texas Medical Association, only 15 of Texas' 254 counties have populations large enough to have a medical examiner's office.

Cornyn's tweet included a video of his remarks in the Feb. 14 Senate session, where he described how opioid overdose deaths are driving drug overdose deaths and how the drug overdose death rate changed from 2018 to 2020.

Scott Walters— professor at the University of North Texas Health Science Center at Fort Worth and a leader in a National Institutes of Health-backed initiative to stem the opioid crisis — said Cornyn's characterization of overdose deaths decreasing in 2018, increasing in 2019, and skyrocketing in 2020 was right.

"Cornyn's right that in 2018 we had seen a slow decrease, slow slide, of drug overdose deaths. That's absolutely true. But coinciding with the start of the pandemic, we saw a sharp increase in the number of overdose deaths," Walters said.

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When it comes to drug overdose deaths, the driver of the increase is opioid use. The CDC press release indicated deaths from opioids increased by 35% from the one-year period ending in April 2020 to the one ending in April 2021. 

Cornyn specifically emphasized fentanyl use. Fentanyl is a synthetic opioid that, even in small amounts, can be lethal. The Department of Justice describes fentanyl "practically and effectively 50 and 100 times more potent than heroin or prescription opioids" on its public awareness webpage on opioids.

Cornyn wrote in his tweet, "Pres. Biden’s open borders policies are letting drugs like Fentanyl pour into our communities. This cannot go on - we must secure the border." Cornyn said he believed Customs and Border Protection agents' focus on an influx of migrants has detracted from drug interdiction efforts.

It's important to note, however, that the one-year period cited by Cornyn's office started during Donald Trump's presidency and ended roughly three months after Biden took office.

U.S. Customs and Border Protection in South Texas saw a 1,066% increase in fentanyl seized in fiscal year 2021, according to a January press release from the agency. Mexico and China were the primary source for fentanyl trafficked into the U.S. in 2019, according to a 2020 report by the U.S. Drug Enforcement Administration.

"Starting with the beginning of the pandemic and the lockdown, what happened was that the normal — the so-called normal — supply routes for heroin were all pinched. It was just plain more difficult to get heroin anymore," Walters said.

So people started to shift during the pandemic, Walters said.

"You saw a shift from heroin and prescription pill-based products to more synthetic products. Synthetic opioids like fentanyl," Walters said. "That's responsible for the increase."

Jane Maxwell, a University of Texas professor who monitors drug use patterns in Texas, said there is not a lot of data available on users, despite fentanyl's link to many recent drug overdose deaths.

While Cornyn pointed to Biden's border policy as part of the problem, Walters said he isn't sure "open borders" is the problem. Walters noted people have been moving substances across the border for years, and fentanyl is smaller and easier to conceal.

Walters said he believes drug awareness campaigns need to be rethought. Well-established public health education tactics, like for public education on the dangers of smoking, assume people have a long time to use drugs before something terrible happens. That long period of time allows more opportunities to cut down or quit.

"With fentanyl, lethal doses are much smaller. It's a lot more like a poison in circulation. And we ought to be thinking more about a poison control solution rather than a stereotypical drug use campaign," Walters said.

Cornyn tweeted on Feb. 14, "We recently found out our nation hit a grim milestone: 100,000 Americans died of an overdose in a single year."

While Cornyn did not specify which year in the tweet, the most recent data from the Centers for Disease Control and Prevention support this.

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