Drug overdose deaths have doubled over the past six years, soaring in recent months amid the Covid-19 pandemic and a continued rise in the use of fentanyl. New data published Wednesday by the Centers for Disease Control and Prevention (CDC) reported that overdose deaths hit a record high last year.
The CDC’s Provisional Drug Overdose Death Counts shows drug overdose deaths at 104,288 in the 12-month period that ended in September 2021, marking an increase of nearly 16 percent and roughly 14,000 more deaths than the previous year.
The high number of overdose deaths is indicative of a growing problem in the U.S. – First, the supply of opioids has surged. Second, Americans have insufficient access to treatment and other programs that can ease the worst damage of drugs.
According to the New York Times, experts have a concise, if crude way to summarize this: “If it’s easier to get high than to get treatment, people who are addicted will get high. The U.S. has effectively made it easy to get high and hard to get help.”
Interestingly, no other advanced nation is dealing with as bad a drug crisis as the U.S. In 2015, there was an estimated 48,126 overdose-related deaths, while in the year that preceded March 2020, estimated overdose deaths stood at 75,702, and as the pandemic turned Americans’ daily lives upside-down, those numbers spiked.
“If and when Covid restrictions ease, you won’t see a reversal in the same way you saw the acceleration because these drug distribution networks and addiction become embedded in the community,” Katherine Keyes, an associate professor at the Columbia University’s Mailman School of Public Health, said to CNN in an interview. “And it’s not like they turn off overnight.”
An in-depth look at the problem
To find answers to the opioid crisis and how to reduce drug overdose deaths in the U.S., we have to look back to the 1990s, when drug companies started promoting opioid painkillers as a solution to a problem that remains today: a need for better pain treatment.
The manufacturer of OxyContin, a controlled-release preparation of oxycodone, Purdue Pharma, claimed in their 1992 patent application that the duration of action of OxyContin is 12 hours in “90 percent of patients.” problem was – It has never performed any clinical studies in which OxyContin was given at more frequent intervals.
However, in 2016 an investigation by the Los Angeles Times found that “the drug weans off hours early in many people,” inducing symptoms of opiate withdrawal and intense cravings for OxyContin.
To make a long story short – doctors bought into the hype, and they started prescribing larger 12-hour doses of the opioid. Some even operated “pill mills,” trading prescriptions for cash.
A growing number of people started misusing the drugs, crushing or dissolving the pills to inhale or inject them. Many shared, stole and sold opioids more widely.
It wasn’t until 2010 that Purdue introduced a new formulation of the drug that made it harder to misuse, and the CDC didn’t publish guidelines calling for tighter prescribing practices for OxyContin until two decades after the drug hit the market.
During this whole period, the opioid crisis deepened, with many people turning to heroin for a bigger high than they could get with the opioid, while others were cut off from painkillers and looking for any kind of replacement to get high.
Traffickers met that demand by flooding the U.S. with heroin. Then, in the 2010s, they started to transition to fentanyl, mixing it into heroin and other drugs or selling it on its own.
Fentanyl was first created by Paul Janssen in 1960 and approved for medical use in the United States in 1968. In 2015, 1,600 kilograms (3,500 lb) were used in healthcare globally.
As of 2017, fentanyl was the most widely used synthetic opioid in medicine; and by 2019, it was the 278th most commonly prescribed medication in the United States, with more than 1 million prescriptions.
Fentanyl is around 100 times stronger than morphine and about 50 times stronger than heroin. Some fentanyl analogues such as carfentanil are up to 10,000 times stronger than morphine.
And Fentanyl has proved to be a very lucrative “cash cow” for drug cartels and illicit drug makers. Unlike heroin, which depends on a field of poppies, fentanyl can be easily made in a garage or basement laboratory, following a recipe that is easily acquired.
No one has a good answer for how to halt the spread of fentanyl. Synthetic drugs, in general, remain a major, unsolved question not just in the current opioid epidemic but in dealing with future drug crises as well, Keith Humphreys, a Stanford University drug policy expert, said.
Other drug crises are looming. In recent years, cocaine and meth deaths have also increased. Humphreys said that historically, stimulant epidemics follow opioid crises.
Solutions will be very costly
Sadly, treatment for drug addiction remains unavailable for many people in the United States. Many families spend thousands of dollars trying to get loved ones into care. Health insurers often refuse to pay for treatment; legal requirements for insurance coverage are poorly enforced.
And when treatment is available, it is often of poor quality or it amounts to a scam – where nothing is done. Some providers are ill-equipped and overwhelmed. Some seemed to offer no evidence-based care at all.
Beyond treatment, the U.S. lags behind other countries in approaches like needle exchanges that focus on keeping people alive, ideally until they’re ready to stop using drugs. The country also could do more to prevent drug use and address root causes of addiction, a recent report from Stanford University and The Lancet found.
And, yes, solutions can be costly. A plan that President Joe Biden released on the campaign trail, which experts praised, would total $125 billion over 10 years. That’s far more than Congress seems to want to commit to the crisis.
But inaction carries a price, too. Overdose deaths cost the economy $1 trillion a year in health expenses, reduced productivity, and other losses, a new government report concluded — equivalent to nearly half of America’s economic growth last year.
