Understanding the Opioid Crisis in the United States

Readers of this blog are certainly aware that the United States is in the midst of what has been widely described as an “opioid crisis” or an “opioid epidemic.” I remember the first time that I was made aware of the severity of the epidemic being covered in mainstream media, I was in a physician’s office and had picked up an issue of Time Magazine from June 2015 that described opioid misuse as creating “the worst addiction crisis ever seen in America.” While alcohol and tobacco would deservedly like to have a say about what substance has created the greatest societal health problems, the number of individuals in the U.S. who have died from an opioid overdose is staggering. As a researcher whose primary area of work is prescription drug misuse, though, I have been aware of the dangers of opioid misuse for nearly a decade.

In this post, and over the course of several subsequent blog posts, I plan to do a deep dive into the opioid crisis. Topics will range from looking into the history of the opioid epidemic, the spike in fentanyl use and abuse, personal stories of those affected by the opioid crisis, and how and where we as a society should go from here—both in terms of policy and for individuals who are currently dependent on opioids.

First, though, let’s start with some slightly good news. As covered in this recent New York Times article (and this more technical CDC webpage), the current estimates for overall drug overdose deaths in 2018 indicate that they finally decreased from the year before. The CDC webpage has a wonderful interactive figure that shows the number of estimated drug overdose deaths in the past 12 months, updated monthly. That figure suggests that the 12-month running total of overdoses actually peaked in November of 2017, at 72,287 estimated deaths. The running total to December 2018 was 68,557 estimated deaths or a decrease of 5.2 percent. While this is a notable decrease in deaths related to opioids, there is still a significant amount of work to do as a society.

The total number of opioid overdose deaths is estimated to be about 47,590 to-date since December 2018. Opioids caused 70 percent of all drug overdose deaths in 2018, but that is also a nearly 3 percent decrease from December 2017, further slightly good news. In 2017, the number of drug-related deaths was greater than those caused by suicide, accidental poisoning, car accidents, all kidney diseases, flu, and pneumonia, or many types of cancer (see here for a deep dive). Opioids alone caused more deaths than suicide, homicide or assault, car accidents, and many cancers.

The bad news is, unfortunately, more obvious: over 47 thousand people died from an opioid overdose in the year to December 2018. That is 47,590! While any decrease is typically welcome news, the work that lies ahead to truly reduce opioid deaths is nearly overwhelming. One other statistic from The New York Times that I want to call out was that methamphetamine-related deaths jumped significantly in 2018. (This will most likely be a topic for another post or series).

As the subtitle of this post implies, this conversation on the opioid epidemic will cover (at least) the next six blog posts, and depending on feedback in the comments, I would be open to the idea of hitting some other topics of interest related to opioids and the opioid crisis. I hope you’ll come along on this series, and please do let me know if specific topics I haven’t mentioned are of interest. We won’t be able to address every suggestion, but hopefully we can get to some.