Short Answers to Hard Questions About the Opioid Crisis

How bad is it?

It’s the deadliest drug crisis in American history.

Drug overdoses are the leading cause of death for Americans under 50, and deaths are rising faster than ever, primarily because of opioids.

 

Overdoses killed more people last year than guns or car accidents, and are doing so at a pace faster than the H.I.V. epidemic at its peak.

In 2015, roughly 2 percent of deaths — one in 50 — in the United States were drug-related.

 

Overdoses are merely the most visible and easily counted symptom of the problem. Over two million Americans are estimated to have a problem with opioids. According to the latest survey data, over 97 million people took prescription painkillers in 2015; of these, 12 million did so without being directed by a doctor.

 

So is this crisis about prescription painkillers or heroin?

Both.

The crisis has its roots in the overprescription of opioid painkillers, but since 2011 overdose deaths from prescription opioids have leveled off. Deaths from heroin and fentanyl, on the other hand, are rising fast. In several states where the drug crisis is particularly severe, including Rhode Island, Pennsylvania and Massachusetts, fentanyl is now involved in over half of all overdose fatalities.

 

While heroin and fentanyl are the primary killers now, experts agree that the epidemic will not stop without halting the flow of prescription opioids that got people hooked in the first place.

 

Show me one way the epidemic has changed.

Distribution of drug deaths by age [See graph in NY Times: https://www.nytimes.com/interactive/2017/08/03/upshot/opioid-drug-overdose-epidemic.html?mcubz=1

The latest iteration of the opioid epidemic has been especially deadly among adults in their 20s and early 30s.

 

First wave of drug overdose deaths,primarily from prescription opioids. Second wave, primarily heroin and fentanyl.

 

In 2000, the most common age for drug deaths, including those not involving opioids, was around 40. This was the generation that first grew addicted to prescription opioids in large numbers — white people especially so. Now there’s evidence that the opioid epidemic is dividing into two waves, with a new group of younger drug users growing addicted to, and dying from, heroin or fentanyl rather than prescription pills.

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