The Deadliest (Yet Most Preventable) Drug Crisis in U.S.History

Drug overdose is now the leading cause of accidental death in the United States, with opioids driving this epidemic. In 2017, there were 72,000 reported overdose deaths, and opioids contributed to at least two-thirds of these deaths. While the opioid epidemic may have been sparked by prescription drugs, the advent of highly potent synthetic opioids over the last few years—estimated to be 50-10,000X more potent than morphine—has spiraled the opioid epidemic into a much deadlier crisis.

The opioid crisis evolved in three distinct waves. The epidemic was born in 1991 following a sharp increase in the prescribing of opioid analgesics for the treatment of pain. The increase in opioid prescribing was influenced by assurances by pharmaceutical companies that prescription opioids were non-addictive and safe for the treatment of chronic pain. Deaths involving prescription opioids reached epidemic proportions in 1999, marking the first wave of the death toll.

As legislative efforts to reduce opioid prescribing took effect in the early-to-mid 2000s, prescription opioid use declined, and heroin emerged as a cheaper, more potent alternative. The rapid rise in heroin-related deaths became apparent in 2010, marking the second wave of the opioid epidemic. Heroin-related deaths continued to dominate epidemic until 2013, when illicitly manufactured fentanyl (IMF) emerged.

One of the largest contributors to the crisis is our criminal justice system. Despite the known dangers and ineffectiveness of forced abstinence, jails and prisons are notorious for imposing this approach on inmates with addiction. Forced abstinence precipitates physical withdrawal which often leads to severe and overwhelming cravings, while simultaneously reducing one’s physical tolerance for opioids.

With the recent availability of adulterated of heroin containing highly toxic and deadly synthetic opioids, addicts are up to 40-129X more likely to suffer a fatal overdose in the first two weeks following incarceration. These post-release fatalities have fueled massive spikes in the death toll and is why the criminal justice system's role in this crisis cannot be overlooked.

Please visit our Jails & Prisons page to learn more about how our criminal justice system is contributing to the malignancy of theopioid crisis, as well as our Medication-Assisted Treatment page to learn about how to effectively treat opioid addiction, reduce overdose fatalities, and bring this d eadly crisis to a halt.