U.S. drug deaths hit a new peak last year, but the rate of fatal overdoses in Pennsylvania soared twice as fast as the nation's, and New Jersey outpaced the national average as well.
Experts say the underlying causes of the epidemic are too many prescription opioid pain pills, and too little money for addiction treatment. When they no longer can afford costly prescription medicines, some users turn to far more dangerous heroin to avoid withdrawal symptoms.
Heroin death rates in Pennsylvania and New Jersey are higher than the national average as well.
The drug lately has become even more dangerous because of the introduction of the opioid fentanyl. Doctors have prescribed it for extreme pain for years, but illicit forms produced by overseas drug cartels have been appearing at different times in different places around the country, often with deadly outcomes. Fentanyl is a suspect in an unprecedented string of 35 deaths over five days in Philadelphia last week.
The CDC said the category of deaths that is dominated by fentanyl shot up 72 percent last year. Locally, it rose 100 percent in Pennsylvania and 125 percent in New Jersey.
"I don't think we've ever seen anything like this. Certainly not in modern times," said Robert Anderson, who oversees death statistics at the CDC.
The overdose statistics came the same week as the announcement that Americans' U.S. life expectancy has fallen for the first time in decades. Though an uptick in heart disease deaths led the list of causes, some experts also say overdose deaths play a role.
In addition, one-third of Americans who used prescription opioid painkillers for at least two months say they became addicted to them, according to a Washington Post-Kaiser Family Foundation survey.
That has implications for the heroin epidemic, because heroin is a cheap opioid that people may turn to when they no longer can get enough prescription medication to prevent withdrawal symptoms. Yet most survey respondents said their doctors never advised them on how to stop taking prescription painkillers.
Some even said they weren't warned of the addiction risk of the medicines, which until fairly recently were used only for the kind of severe pain that some cancer patients suffer. Now, however, medicines such as OxyContin are prescribed for more common maladies such as chronic back pain.
Pennsylvania's overdose fatality rate, 26.3 per 100,000 residents last year, according to the CDC, was sixth in the nation, compared with eighth in 2014. New Jersey, which had hovered below the national average for several years, rose in 2015 to match the nation's rate of 16.3 per 100,000 residents.
Pennsylvania is known for the purity of its heroin, and the rate of deaths involving the drug, 5.6 per 100,000 residents, is 37 percent higher than the national average.
But heroin is involved in an even greater proportion of deaths in New Jersey, according to federal statistics: 5.8 per 100,000 residents, 41 percent higher than the national rate of 4.1 per 100,000.
Roseanne Scotti, New Jersey state director of the Drug Policy Alliance, a nonprofit advocacy group, said she was expecting numbers like these.
"A lot of the drugs that are out there are simply stronger and more fast-acting," she said this week. "It used to be we would tell people there is a period of one to three hours when they overdose before they pass away. There is a shorter window now."
That heightens the importance of overdose-reversal medication. "We have made naloxone available to first responders, and that is good," Scotti said, "but it is not available [enough] to what are truly the first responders: the people who are using drugs with each other."