U.S. National Opioid Crisis

Introduction

With over a million overdoses deaths since 2000, the U.S. opioid crisis has become one of the most challenging public health emergencies. In Wisconsin, overdose deaths involving fentanyl totaled more than 4,300 from between 2015 and 2021.

What once started with prescription of legal pain medications in the 1990s has quickly evolved into a full-blown epidemic. Cheap fentanyl, heroin and other synthetic opioids supplied by foreign drug cartels are the substances fueling the crisis.

In this article, we’ll explore the history of the epidemic, its origins, its supply chain, devastating impact, and ongoing efforts by the US government to address and prevent opioid misuse.

History of the opioid crisis

The opioid crisis can be traced back to the mid-to late-1990s.

Many pharmaceutical companies were desperately looking for new painkillers and began to push synthetic and semi-synthetic opioids to doctors.

The companies claimed the drugs were less addictive or non-addictive with no dangerous side effects, so doctors kept pushing them onto patients.

As the doctors saw no side effects to patients taking the pain killers, there was widespread growth in opioid prescription.

This overprescribing and spread of synthetic opioids directly fueled the drug addiction crisis America is dealing with.

Latest research and trends

Since 2011, many of the 50 US states have experienced substantial increases in drug and opioid overdose deaths.

Based on state trends, five states saw the largest growth in overdose deaths between 2011 and 2021, with West Virginia having the highest rates.

• California – from 5.0 to 17.8 per 100,000 people
• Florida – 8.4 to 28.9 per 100,000 people
• New York – 6.8 to 24.5 per 100,000 people
• Ohio – 11.2 to 40.1 per 100,000 people
• Pennsylvania – 6.2 to 32.8 per 100,000 people
• West Virginia – from 31.5 to 77.2 per 100,000 in 2021

Also, researchers found that early COVID-19 worsened the rate of these deaths.

From 2019 to 2021, the nationwide Fentanyl overdose death rate nearly doubled — 11.4 per 100,000 people in 2019 compared to 21.8 per 100,000 people in 2021.

What drugs are the major culprits?

The dangerous drugs in the US responsible for the crisis are primarily synthetic and semi-synthetic opioids.

These substances are formulated in a lab and prove to be more potent than natural ones. They include Fentanyl (50-100 times more powerful than Morphine) and Heroin.

Some other prescription opioids also involved in the epidemic include:

• Hydrocodone
• Methadone
• Oxycodone
• Codeine
• Morphine

Where are the drugs coming from?

According to the National Drug Threat Assessment 2024 by the Drug Enforcement Administration (DEA), most of the illicit opioids that kill Americans are produced abroad and smuggled through the southwest Mexican border.

The substance is produced in its final drug form before being passed through vehicles or traveling pedestrians in small, easily concealable amounts.

The Mexican drug cartels involved in the smuggling of illegally made Fentanyl and opioids into the US are the Sinaloa Cartel and the Jalisco New Generation Cartel. They manage most of the production and distribution networks while using American citizens to get the drugs across the border.

Before 2019, China was the leading source of fentanyl coming into the United States. The flow has significantly slowed down since the Chinese authorities banned the production of all fentanyl variants in 2019.

However, China still leads the race in the manufacture of fentanyl ingredients. Most of the fentanyl smuggled from Mexico is produced using ingredients sourced from China.

What are the causes of the opioid crisis?

The cause of the crisis can be traced back to 40 years ago. In the 1990s, pharma companies aggressively promoted prescription opioids to treat pain.

These painkillers grew popular and widespread overprescribing became a thing. This led to significant reductions in legitimate prescriptions with synthetic opioids flooding the market in 2016.

Since then, substance misuse and overdose deaths involving the co-use of stimulants (such as methamphetamine and cocaine) remain on the rise, and new threats continue to emerge.

How is the United States fighting the crisis?

Over the past decades, the United States has worked with several affected countries to restrict the flow of illegal opioids.

Between 2008 and 2021, the US government provided Mexico with $3.5 billion in security and counternarcotics aid through the Mérida Initiative.

President Joe Biden made the opioid crisis a policy priority by declaring synthetic opioid trafficking a national emergency. He also signed two executive orders to sanction any entity connected to the production and distribution of fentanyl.

Based on these orders, his administration sanctioned 25 Chinese firms believed to be involved in producing fentanyl ingredients in 2023 and added China to the list of major illicit drug production and distribution countries.

Domestically, the Biden administration has also made efforts to stem the flow of illicit opioids. Federal regulators added new limits on opioid prescriptions, doubled down on fentanyl seizures, and raised public awareness of the drug’s potency.

How to recognize an opioid addiction and what to do?

Regular intake increases the risk of an opioid addiction. It usually takes a couple of weeks for the user to become physically dependent on it.

An Opioid addiction can be recognized by the following symptoms:

• Physical dependence: The user undergoes a physiological change when using the substance regularly. If they eventually stop taking the drug, they experience withdrawal symptoms, including cravings and sweating.
• Frequent, risky use: If the user continues to use an opioid heavily even though it causes serious health, safety, financial or relationship issues, they’re battling an addiction.
• Cravings: The user faces an overwhelming urge to take the drug despite understanding the consequences to their well-being.

Other signs of an opioid use disorder that signals that the person might need help include:

• Weight loss
• Drowsiness
• Decreased libido
• Poor hygiene
• Poor sleep habits
• Regular flu-like symptoms
• Isolation from friends and loved ones
• Financial instability
• Poor exercise routine

If you suspect someone has an opioid overdose, please immediately call 911 or any opioids substance abuse helpline for care and attention.

The user be referred to an addiction treatment center or rehab facility near you for treatment, where they’ll be administered drugs to reduce cravings.

Treatment drugs, such as Naloxone or Buprenorphine, rapidly bind to opioid receptors and block the effects of opioid drugs. If they need help to increase focus and impulse control, get them Adderall alternatives that offer potential relief without the risk of dependency.

The user would also need counseling and behavioral therapy to address their opioid misuse.

Finally, connect them to support groups and relapse prevention training to help their continued recovery.