In 2017, the U.S. Department of Health and Human Services (HHS) declared a public health emergency regarding the opioid epidemic in the U.S. While recent data shows that death rates have been dropping in recent years, data has also shown that opioid abuse related deaths still seem to be much more common in some states than others.
According to HHS, the opioid epidemic in the U.S. began in the 1990s when pharmaceutical companies began to reassure health professionals that patients would not become addicted to their products. Consequently, since 1999, overdose deaths involving opioids have been on the rise: About 215,000 people died of opioid overdose from 1999 to 2017. Scientists consider this to be the first wave of the opioid epidemic.
The second wave of the epidemic in the U.S. began in 2010, when there was a spike in overdose deaths involving heroin. Heroin related deaths increased five-fold from 2010 to 2017, and while rates have been relatively stable since 2016, about five in every 100,000 Americans died of heroin overdose in 2017 alone.
Lastly, the third wave of the epidemic began in 2013, when epidemiologists began to see an increase in deaths from synthetic opioids.
Synthetic opioids are drugs that are designed to mimic naturally occurring pain relieving drugs, such as morphine and codeine. Specifically, deaths involving fentanyl (IMF), which is produced to be 50 times as strong as heroin and 1000 times as strong as morphine, seemed to be the most frequent.
The two main types of fentanyl include pharmaceutical fentanyl, which is often prescribed as a pain reliever for patients with cancer and other terminal illnesses, and non-pharmaceutical fentanyl, which has proven to be the more toxic of the two. Non-pharmaceutical fentanyl is produced illegally and can often be seen mixed in with heroine, cocaine or counterfeit pills.
While the Center for Disease Control (CDC) has been striving to build prevention efforts and raise awareness of the epidemic, it is still estimated that 115 Americans die each day of opioid overdose.
In 2016, it was reported that 64,000 Americans died of drug overdose, and 42,000 of those deaths were opioid related. Researchers believe that opioid misuse was responsible for shaving 0.36 years off the average American lifespan in 2016.
In addition, some researchers believe that the rise in opioid related deaths has contributed to outbreaks of other infectious diseases that are linked to intravenous drug use.
According to data from the National Institute on Drug Abuse, the rate of opioid related deaths is generally higher on the East Coast than the West Coast: The states with the highest rates in 2016 being West Virginia, New Hampshire, Ohio, Maryland and Massachusetts.
Mathew Kiang, a researcher at Stanford University’s Center for Population Health Sciences, believes that this regional difference may simply be due to differences in drugs on the east coast.
“One thing I do want to highlight is that, despite the large differences in deaths across states, there’s no evidence to suggest that there’s differences in use,” Kiang said, according to CNN.
“What we think is happening is that the heroin just continues to get more and more potent in the eastern United States, whereas heroin [in] the western United States has traditionally been this brown tar heroin. It’s much harder to lace with fentanyl or other synthetic opioids.”
Kiang stated that it is most likely that the number of opioid related deaths is being under reported because confirming the use of synthetic opioids requires testing from a medical practitioner. Furthermore, he strongly believes that the opioid epidemic is a clear signal that medical treatment needs to be made more accessible in this country.
“We need to make treatment at least as accessible, available and affordable as heroin,” Kiang said. “It shouldn’t be harder to get help than it is to get heroin.”