The Epidemic of Overdose

Since the year 2000, over 300,000 Americans have died as a result of a drug overdose. In 2015 alone, over 50,000 deaths were attributed to overdose, and nearly two thirds of those were the result of prescription or illicit opiates. The CDC’s latest national analyses indicate that the increase in opioid overdose death rates is driven in large part by illicit opioids, like heroin and illicitly manufactured fentanyl, a synthetic opioid. While opium has been around for centuries, the problem we face today seems to stem from the aggressive marketing of opiates as safe pain-killers in the 1990’s. The pharmaceutical industry specifically targeted prescribers, noting that OxyContin was an ideal drug for pain management, as seen in this blatantly misinformed advertisement made by Purdue. According to a journal article from the American Journal of Public Health “From 1996 to 2001, Purdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended these all-expenses-paid symposia, where they were recruited and trained for Purdue's national speaker bureau. It is well documented that this type of pharmaceutical company symposium influences physicians’ prescribing, even though the physicians who attend such symposia believe that such enticements do not alter their prescribing patterns.”

What was once an isolated problem, in parts of New Mexico and the Appalachian region covering parts of Kentucky and West Virginia, is now reaching epidemic levels across the country. In an exposé by the Guardian, Nadja Popovich writes: “In central Appalachia, as in many parts of the country, the prescription painkiller epidemic also fuelled the influx of a cheap, alternative opioid: heroin. As painkiller-related deaths began to fall in the early 2010s following federal and state crackdowns on prescription opioids, heroin-related deaths began to rise. In all, West Virginia's overdose death rate rose nearly eightfold between 1999 and 2014, from four deaths per 100,000 residents to more than 35 – double the national average. During the same period, Kentucky experienced a fivefold increase in its own rate of overdose deaths.”

This map from the CDC shows the drastic change from 1999 to 2014. (SOURCE)

More recently, the drug Fentanyl, a synthetic that is 50 times as potent as Heroin, is causing devastation across the NorthEast. The drug, often prescribed to cancer patients can be abused by addicts who suck on patches that were intended to be worn on the dermis.

While this problem is arguably as devastating as any other drug crises in recent memory, it is being defined by society in an entirely different way, in large part due to the population affected.  As Katherine Seelye notes in an article in the New York Times: “When the nation’s long-running war against drugs was defined by the crack epidemic and based in poor, predominantly black urban areas, the public response was defined by zero tolerance and stiff prison sentences. But today’s heroin crisis is different. While heroin use has climbed among all demographic groups, it has skyrocketed among whites; nearly 90 percent of those who tried heroin for the first time in the last decade were white.”  This data visualization tool from the CDC shows the ways in which different demographics have been impacted. Many of the families of young overdose victims are middle class and well connected, and they are using their influence to change the dialogue about drugs in America.

While politicians are often slow to adapt, a CDC press release notes that “the Obama Administration has undertaken a series of initiatives to address the opioid crisis. On December 13, 2016, the President signed the 21st Century Cures Act, which implements his Budget proposal to provide $1 billion in new funding to combat the opioid crisis. In addition, HHS has made addressing the opioid overdose epidemic a high priority, implementing an evidence-based initiative in 2015, focused on three priority areas: informing opioid prescribing practices, increasing the use of naloxone, and expanding Medication-Assisted Treatment.  HHS continues to coordinate with agencies across the Department to ensure effective implementation of the initiative’s programs and policies, improve prescribing practices, reduce overdose deaths, and support the millions of Americans in recovery.”

For more information about the opioid problem, see links below.

Sources for this post include: