Friday is the International Day of Overdose Sensitization, a time to raise awareness and combat stigma associated with drug overdose and addiction. But the day is particularly relevant in these times as America deals with its most deadly drug overdose crisis in its history in the opioid epidemic.
According to preliminary data from the Centers for Disease Control and Prevention, 2017 was the worst year for drug overdose deaths in US history. This year more than 72,000 people died of overdose – or nearly 200 people a day. That's more overdose deaths in a single year than ever, and at least two-thirds of those deaths were associated with opioids.
In other words, more Americans died of overdoses in 201
If you look at the death toll until the beginning of the opioid epidemic in the late 1990s, more than 700,000 Americans have died of overdose during that period. During this epidemic, more people have died of drug overdoses than in major US cities such as Denver and Washington, DC
The opioid epidemic began in the 1990s when pharmaceutical marketing and lobbying led physicians to prescribe far more opioid analgesics first wave of overdose deaths as more people, including patients and people who had stolen or bought painkillers from patients who abused drugs and become addicted.
A second wave of overdoses began in the 2000s when heroin flooded the illicit market as drug traffickers exploited a new population of opioid users who either lost access to painkillers or simply sought a better, cheaper high. And now the US is in the middle of a third wave, because Fentanyle, a class of synthetic opioids, is taking over the illicit drug market and providing an even more potent, cheaper – and deadlier – alternative to heroin.
With every new wave, the crisis has become deadlier.
That's not because policymakers are helpless. On the contrary, experts argue that there are really solutions to the crisis. It is only a matter of dedicating resources to these solutions.
There are solutions to the opioid epidemic
Experts say that there is no silver bullet that could solve the opioid epidemic overnight, but there are many steps that the country could take to address the crisis – and hopefully, too prevent future.
First, America could expand access to addiction treatment. According to a 2016 surgeon's report, only 10 percent of Americans with a drug disorder receive special treatment. The report attributed the low rate to severe supply shortages and some areas of the country lack affordable treatment options – which can also lead to waiting weeks or even months for the services offered. Adequate response would increase access to medications such as methadone and buprenorphine, which is the gold standard for the treatment of opioid dependence apply as they lower the mortality rate for opioid addicts by half or more and treatment holds better than other patients approaches. In 1995, when France relaxed restrictions on physicians who prescribed buprenorphine in response to its own opioid crisis, the number of people in treatment rose and the number of cases of overdose fell by 79 percent over the next four years.
Ideally, there should be an extension to treatment. Also health services beyond these medications – because buprenorphine and methadone are very good for opioid addiction, but do not work for everyone and can not treat alcohol, cocaine or meth dependence. A better addiction treatment system would provide comprehensive services to address a medical condition that can vary greatly from person to person.
Beyond the treatment, prescribers could also reduce the prescription of opioid analgesics – to reduce access to the onset of addiction for so many – while ensuring that patients who really need painkillers still get access , Minimization approaches, such as replacement of needles and greater distribution of the opioid overdose antidote naloxone, would also help.
A recent study by Stanford researchers suggested that a mix of all these options could save tens of thousands of lives in the next decade.
In fact, several of the states that had seen overdose deaths in 2017 were taking these types of steps.
Vermont's overdose mortality rate dropped nearly 7 percent last year with the continued expansion of a hub-and-spoke system that integrates addiction treatment into the rest of healthcare. Rhode Island also declined by more than 3 percent as it included improved access to opioid addiction drugs in its prisons and prisons. And Massachusetts saw a drop of about 1 percent, along with a public health campaign that has emphasized more treatment and fewer painkiller prescriptions.
These are not big declines. But they are significant because they're in New England states – the hardest hit by the opioid crisis, and have seen more and more overdose deaths in recent years. Public health interventions can also take time to take root as more people become aware of the risks of addiction and treatment is now truly available.
A consistent problem for many states was the lack of federal funds. Congress has increased opioid-addiction funding here and there in recent years, but the money made available to date is well below the tens of billions of dollars that experts consider necessary to fight the opioid epidemic completely and quickly. President Donald Trump has done little to change that.
Learn more about the solutions to the opioid epidemic in Vox's Explainer.