Drug overdose deaths, many from fentanyl, surge again in Knox and Anderson counties

Liz Kellar, Knoxville News Sentinel
·3 min read

Overdose deaths in 2021 surged at alarming rates for the second straight year in Knox and Anderson counties, according to the Drug-Related Death Report released Wednesday by the Knox County Regional Forensic Center.

The upward trend isn't slowing down in 2022, according to preliminary data.

Last year, overdose deaths in Knox County increased 29% to 533 after a 41% increase in 2020, according to the report authored by Knox County Chief Medical Examiner Dr. Darinka Mileusnic-Polchan.

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Anderson County drug overdose deaths — a total of 85 in 2021 — increased 67% after an increase of 81% in 2020.

Overdose deaths had begun to decline in 2019 before the spike, Mileusnic-Polchan wrote.

“The overdose epidemic in Knox County, like across the nation, continues to grow in magnitude and new stronger drugs are making it worse,” said Chris Thomas, director of the Knox County Regional Forensic Center.

Who are the victims?

In Knox and Anderson counties, more than 40% of drug overdose deaths were men ages 35-44. Overall, more than 60% of the victims were male.

Individuals 55-64 saw the sharpest increase — 138% — over two years, according to the report.

In the city of Knoxville, the ratio of Black-to-white overdose deaths remained at about 1:9, reflecting community demographics, the report noted.

Mileusnic-Polchan said the combination of stronger drugs and direct modes of administration like vein injection make naloxone, which reverses opioid overdose, frequently ineffective.

“It is disheartening to see that many of the deceased individuals had gone through different drug rehabilitation programs and facilities more than once, only to go back to their previous ways shortly after the last session,” Mileusnic-Polchan added.

She said it might be time to "reevaluate many of the programs and measures," highlighting medication-assisted treatment, increasing the availability of naloxone, and needle exchange programs.

A CDC report from January that examined Knox County data suggested expanding availability of naloxone.

"Naloxone still serves as an effective drug to reverse opioid overdose," the "Notes From the Field" CDC report stated. "However, additional doses of naloxone might be required when stronger opioids like fentanyl, para-fluorofentanyl, metonitazene, or other benzimidazoles are involved or combined."

Which drugs led to the most overdoses?

Polypharmacy, when more than one drug is responsible for death, was involved in 76% of overdose deaths in Knox County and Anderson County.

Fentanyl, fentanyl analogues and some of the synthetic opioids were the most frequently identified drugs in drug-related deaths in 2021, the report stated.

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“Last year, we elaborated on the new novel synthetic drugs,” said Mileusnic-Polchan. “There are more of them on the market this year and they are deadlier than ever — alone or in combination with other drugs. Snorting and/or intravenous drug abuse continue to be the predominant modes of intake in drug intoxication deaths.”

The five most common drugs identified in drug-related deaths in 2021 were synthetic opioids, methamphetamine, diphenhydramine, alcohol/ethanol and cocaine.

  • Methamphetamine was the most observed stimulant, either alone or in combination with opioids

  • Prescription opioid-related deaths continue to decrease

  • Anxiety, anti-depressant and anti-psychotic medications were found in 30% of drug deaths in Knox County and 38% of drug deaths in Anderson County.

This article originally appeared on Knoxville News Sentinel: Drug overdoses in Knox County, Anderson County caused by fentanyl