According to a 2018 Pew survey, over 85% of Americans view drug addiction as a serious problem in their community regardless of whether they live in an urban, suburban, or rural setting, and for good reason.
During the past decade, close to half a million Americans died from a drug overdose. By the end of 2019 drug overdoses had become the leading cause of death, superseding gun violence and car accidents. In this country, the rate of overdose deaths rose by 76% from 2010 to 2017.
The American Society of Addiction Medicine President Paul Earley summed up the reality by saying, “No one predicted the ferocity of the opioid epidemic.” In short, the death toll due to opioid overdoses during the last 10 years has resulted in a national public health emergency.
As the horrifying statistics began to rise, the unprecedented epidemic shifted from prescription painkillers such as OxyContin to illegal drugs including heroin and synthetic fentanyl.
Statistics show that at the start of the 2010s opioid painkillers such as OxyContin, Percocet and Vicodin were the medications most associated with drug overdose deaths.
As a result, several measures were implemented in order to address the problem. For example, individual states went after so-called “pill mills,” sites in which doctors readily prescribed painkillers, oftentimes for cash, and the FDA sanctioned a form of oxycodone that was resistant to misuse via crushing and snorting.
In 2016 federal guidelines were implemented making opioids a last choice option for long-term pain treatment and at the time the former director of the CDC, Thomas Frieden, stated, “We know of no other drug prescribed so frequently that kills so many patients.”
Around this same time period, the signs of another disturbing trend began to appear– an increase in the number of young white males receiving treatment for heroin addiction. Public health officials interpreted the rise like a red flag for an epidemic rise in the number of fatal heroin overdoses in the first half of the decade.
In 2014, the CDC reported a rise in the percentage of heroin-related deaths in nearly 30 states. They also noted an eye-opening twist in the twin epidemics: there was a decided split between younger people dying from heroin and older people dying from painkillers.
By 2015 America was now experiencing two intersecting overdose epidemics, with heroin and prescription painkillers linked to the deaths of over 13,000 individuals annually.
According to the drug policy expert Andrew Kolodny, the heroin supply in the U.S. had become more dangerous as Mexican drug cartels began a trend of transporting the drug to rural America. The cartels also targeted smaller cities like Minneapolis, Cincinnati, and Nashville, areas where heroin had been relatively rare.
Attributing the dual epidemics to a switch to heroin after doctors clamped down on prescription painkillers is too simplistic of an explanation according to experts. One 2014 study reported that 75% of new users of illicit drugs had previously used painkillers. However, many of these individuals were thought to have been using someone else’s prescription versus their own.
Unfortunately, the dire story of American addiction doesn’t end there. Another opioid—fentanyl—came on the scene wrecking its own brand of havoc.
Fentanyl can be up to 50 times more potent than heroin.
According to Kolodny, “Fentanyl was a game-changer.” At the beginning of 2015, the Drug Enforcement Administration issued a warning that the misuse of the drug was extremely dangerous and widespread. For example, in 2014 Ohio recorded over 500 deaths linked to fentanyl, a 500% increase from 2013.
To underscore how drastic the fentanyl epidemic in Ohio was, in early 2017 the Canton, Ohio coroner ran out of storage space for corpses. Police data from the state reveals that official seizures of heroin containing fentanyl or carfentanil rose from under 4% to over 48% in the span of three years (2014-2017).
The astonishing potency of fentanyl was incredibly dangerous and made even more so because the potential difference between a safe and a fatal dose was one milligram or less. As Earley said, “Drug dealers are not chemists, there’s no quality control in illegal drugs.”
In 2017 U.S. deaths due to overdose took 70,000 lives and President Donald Trump announced that the opioid crisis was a national public health emergency.
At this time it was clear that fentanyl and its analogs were the leading cause of drug overdose deaths in the country, responsible for nearly 30,000 deaths, almost the number of both the opioid and heroin fatalities combined.
Fentanyl fatalities deaths were concentrated in the Northeast and Midwest states as well as Appalachia. In these areas, brown powder heroin was mixed with illegal fentanyl from China and distributed by drug cartels.
As public awareness of opioid dangers has increased, so have resources to combat the problem. At the end of 2019 drug overdose deaths began to plateau. But that promising sign coincides with yet another dark drug trend, one that is predicted to spread into the next decade.
What is the new drug scourge set to afflict another wave of users? Public health statistics reveal a sudden increase in deaths linked to stimulant drugs, particularly cocaine and meth.
Why the sudden rise in stimulant related deaths? According to epidemiologists, there is a predictable swing of the pendulum when it comes to the widespread use of depressants and stimulants.
In other words, the sudden shift in drug use may be as simple as a backlash reaction to opioids resulting in a return to stimulants as a drug of choice.
There has been no shortage of efforts aimed at squashing the opioid crisis, with President Trump donating the majority of his most recent quarterly salary ($100,000) to the fight against the opioid misuse.
But, all appearance, there is a new drug problem on the block, one that authorities would do well to heed going into 2020 lest it turns into another devastating and deadly U.S. epidemic.
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