Drug Policy

America’s opioid crisis

The drug-fuelled epidemic needs solutions fast

August 28th 2017 | Pittsburgh | Will Tomer

Photograph by Gatehouse Media

A recent article in The New Yorker painted a troubling and vivid portrait of the opioid crisis facing many areas of the nation. In her piece, Margaret Talbot details a number of graphic overdoses that have taken place in West Virginia, the U.S. state with the highest rate of opioid overdoses per 100,000 people (39.3). What is the cause of this phenomenon, and what can be done to alleviate it?


Dark numbers

The Center for Disease Control and Prevention reports that in 2015, there were more than 52,000 Americans killed by drug overdoses – or one every 10 minutes.

According to The Economist, about 33,000 of those can be attributed to opioids, the most common of which are prescription painkillers and heroin. While major cities feel some of the weight, it is actually areas such as Midwest America and Appalachia which are being truly devastated by this crisis.

In certain parts of the country, including Talbot’s focus of Berkeley County in West Virginia, overdoses are a daily occurrence. They seem to be taking place almost anywhere and at anytime. “Many addicts are collapsing in public – in gas stations, in restaurant bathrooms, in the aisles of big-box stores”, writes Talbot.

Graphic by The Economist

The number of overdoses has shot up dramatically around the country over the past several years as heroin has started to be laced with powerful prescription medications such as fentanyl. In the 21-country area surrounding Toledo, Ohio, there were only 8 overdose deaths in 2010. In the first six months of 2016, that same number was 127 deaths.

The burden placed upon paramedics has been so extreme that even entire teams of paramedics working 24-hour shifts are unable to reach every overdose in a timely manner. In those cases where they do, the main course of action is to administer a potentially life-saving dose of Narcan – a drug used to counteract the effects of an opiate overdose. Classes are now being offered to average citizens in areas with high overdose rates so that they know how to administer the drug themselves should the situation arise.


Pharmaceutical roots

The issue can be traced, at least in part, to the explosion in powerful prescription medications in the United States. In 1991, the number of opioid medications (Oxycontin, Vicodin, etc.) supplied to pharmacies was 76 million. In 2011, that number was 219 million.

Perhaps even more telling is the fact, according to The Economist, “in 2002 one in six users took a pill more powerful than morphine. By 2012 it was one in three.” Pharmaceutical companies and doctors have begun scaling back the prescriptions for painkillers, but that has turned people already hooked on opiates towards drugs like heroin instead, which is substantially cheaper than any prescription opioid.

Photograph via Getty Images

Certain officials, such as Governor Hogan, have pledged money and attention to the issue. Even U.S. President Donald Trump commented on America’s “terrible drug epidemic” during his speech before Congress in February, and in one of his few positive moves he set up a commission on drug addiction and offered $500 million to combat the problem.

Making matters worse is the aforementioned fentanyl, a synthetic painkiller that is 50 times more powerful than heroin. The result is a dramatic increase in fatal overdoses in a number of states. In Maryland, Governor Larry Hogan declared a state of emergency after the combination of heroin and fentanyl killed 1,468 Maryland residents in the first nine months of 2016, a 62% increase from previous year.


Solutions exist

It is not as if this is a problem we are mentioning for the first time. Highly regarded publications, including those cited in this article, have offered enormous spaces devoted to discussing this enormous issue.

Among others, The Economist firmly advocates the decriminalization of all drugs to replace America’s deeply-flawed policy of prohibition with a focus on health treatment and safe use centres:

Banning drugs is not just ineffective, it is also counterproductive. Fentanyl is a nasty substance, but prohibiting all illicit drugs, whether they are new or established, prevents the research that could distinguish between those which are more and less harmful. It also leads to topsy-turvy outcomes. Marijuana, which cannot lead to overdoses and which can be used as an effective pain-relief medicine, is classified by the federal authorities in America as a more dangerous drug than fentanyl, which is used in very controlled doses by cancer patients and abused fatally across the country.

It takes guts to legalise drugs when so many are dying from them. But it is better that addicts take safe doses of familiar substances under sanitary conditions than for them to risk their lives enriching criminals. Switzerland followed the legalisation path after a heroin epidemic in the 1980s, treating drugs as a public-health problem. Since then drug-taking and drug-related deaths have fallen. America should follow suit.

Every day that passes, 78 Americans die from an opioid overdose. And every day that passes without real solutions to this very real problem, those deaths will linger over the heads of those that have seen the problem, acknowledged it, and then decided to mire in inaction and rhetoric.

Edited by Bartu Kaleagasi and Xavier Ward

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