In 2017, drug overdoses killed 72,000 Americans, a 10 percent increase over 2016 and yet another record, according to the latest provisional federal estimates.
That single year toll would be more than double the American deaths attributed to the Korean War, and almost 1.25 times those caused by the Vietnam War. The New York Times reported that 2017’s overdose deaths were “higher than the peak yearly death totals from HIV, car crashes or gun deaths.”
The newspaper said experts, analyzing the numbers, blamed them on a few reasons (see NYT chart above): “A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.”
Abuse of powerful prescription painkillers opened the floodgates for Americans to seek out and consume even more potent synthetic versions, notably the drug fentanyl. It not only is highly addictive, it also packs a wallop, with experts estimating it is 50 to 100 times more powerful than morphine. The opioid crisis also has come to encompass the abuse of illicit street narcotics, especially heroin. They have become drugs of choice for prescription painkiller abusers who seek a bigger high but encounter problems with supply and cost of medications that doctors, hospitals, pharmacies, and insurers slowly have grown more cautious about.
As the CDC has found, according to the New York Times, “overdose deaths involving synthetic opioids rose sharply, while deaths from heroin, prescription opioid pills and methadone fell.”
Fentanyl is relatively easy to make, and experts say it is flooding this country from less regulated or bootleg labs overseas, particularly in China. Fentanyl is proving lethal to increasing numbers of abusers because, with or without their knowledge, it also is getting mixed or cut into other illicit drugs they take. As the New York Times reported:
Unexpected combinations of those drugs can overwhelm even experienced drug users. In some places, the type of synthetic drugs mixed into heroin changes often, increasing the risk for users. While the opioid epidemic was originally concentrated in rural, white populations, the death toll is becoming more widespread. The penetration of fentanyl into more heroin markets may explain recent increases in overdose deaths among older, urban black Americans; those who used heroin before the recent changes to the drug supply might be unprepared for the strength of the new mixtures. ‘Even when you think you’re doing better, all it takes is one bad batch of fentanyl in any state and you’re going to have deaths,’ said Mark Levine, a physician and the health commissioner of Vermont.
To get a sense of how lethal fentanyl can be in combination with other drugs, just consider that Nebraska — one of many states that has struggled to find acceptable injections to carry out court determined death sentences — just executed a prisoner convicted of two murders using the synthetic opioid. That case, of course, raised considerable questions, not just over the death penalty but also whether the untested medications were humane and acceptable under the law. (By the way, one of the drugs used in the fatal mix was a tranquilizer — one of the very combinations that experts have warned patients never to take with an opioid).
In my practice, I see not only the harms that patients suffer while seeking medical services but also their struggles to access and afford safe, effective, and even excellent medical care, especially when doctors, hospitals, insurers, and Big Pharma sent medication prices sky high and pushed on the public an array of powerful, addictive, and dangerous drugs.
Politicians and policy-makers in the nation’s capital — whether laboring still to put together coherent and effective laws and funding or pondering legal measures to better battle opioid abuse — are lagging in the strong campaign that will be necessary to stop so many Americans from dying from the nightmare that Big Pharma, doctors, hospitals, insurers, and others set loose on the public, purportedly in the name of reducing pain but, evidence has shown, as much in mendacious profit seeking.
We’re marching on to some crucial midterm elections, and with an array of health care issues racing to the fore — including battling opioid addiction and ensuring the affordability and access of medical care — we all need to register and to vote.