U.S. Opioid Overdose Epidemic
Nation in Crisis: The Opioid Epidemic
The Facts
In 2017, 11.4 million Americans misused prescription opioids.
Every day, more than 130 Americans die from an opioid overdose.
More than 42,000 people in the U.S. died from opioid overdoses in 2016.
Every day, more than 1,000 people are treated in U.S. hospital emergency departments for misuse of opioids, including heroin, fentanyl, Oxycontin, and other prescription pain relievers.
The CDC estimates that the total economic burden of the opioid epidemic in the U.S. is $78.5 billion a year.
At this time, the epidemic is arguably the nation’s foremost public health challenge.
How did it happen?
There are many upstream determinants of today’s opioid epidemic.
DEATHS OF DESPAIR: In the Great Recession of 2007-2009, the U.S. unemployment rate rose to 10%. The relationship between diminishing economic opportunity in some segments of the population – particularly middle-aged white men with a high school education or less – is associated with higher death rates, termed “deaths of despair.” A 1999-2014 nationwide study in the U.S. found that as county unemployment rates increased by 1%, opioid death rates increased by 3.6% and emergency department visits for overdose grew by 7%. It appears that economically dislocated workers are more likely to cope with anguish and despair by using opioids.
ILLEGAL OVERSEAS PRODUCTION: Illicit opioids are widely available and inexpensive in the U.S. Failed U.S. policies to curtail poppy production in Afghanistan have reduced the street price of heroin, and clandestine laboratories in China export illicit fentanyl to the Americas with few obstacles. The U.S. Drug Enforcement Agency expects the flow of these drugs into the U.S. will continue to increase.
BIG PHARMA’S ROLE: Major pharmaceutical companies have heavily promoted prescription opioid pain relievers, such as Oxycontin, with the explicit goal of changing physicians’ prescription practices. In 2007, Big Pharma executives pled guilty of deceiving the government, physicians and patients about the addiction risk of prescription pain killers such as Oxycontin. Currently, 41 State Attorneys General have filed lawsuits against opioid producers.
Big Pharma is politically powerful, with deep pockets. Over the last decade, the industry spent almost $2.5 billion in lobbying and campaign contributions to members of the U.S. Congress. Much of this money was used to lobby against laws regulating the production and distribution of opioid medications.
One pharmaceutical firm, Purdue Pharma, withheld critical information from law enforcement. According to an extensive 2016 Los Angeles Times investigation, Purdue Pharma did not inform the DEA or other law enforcement officials about 10 years of data it had collected, pointing to probable illegal OxyContin trafficking in the U.S. Basically, the company took no action to stop OxyContin diversion to the street drug trade.
POLITICS AND THE FEDERAL GOVERNMENT’S ROLE: Regulatory oversight of opioid production by pharmaceutical manufacturers was quietly eased during the Obama administration in 2016, with a new federal law that weakened the authority of the Drug Enforcement Agency. A Washington Post/CBS 60 Minutes investigation found that Congress and the White House passed the law by a unanimous consent procedure that required no debate and no Congressional vote.
IS THE EPIDEMIC COMING TO TEXAS? Texas has had lower rates of opioid overdoses and deaths than many other states. Advisories warn, though, that it may only be a matter of time before the epidemic reaches our own local communities and threatens the lives of people here at home.
U.S. Opioid Overdose Epidemic
Photo Wall Exhibit – EAD 701
References Supporting Exhibit Content
School of Public Health
February 2019
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