Opioid epidemic in the United States

There is an ongoing opioid epidemic (also known as the opioid crisis) in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.^[2]

In the United States, there were approximately 109,600 drug-overdose-related deaths in the 12-month period ending January 31, 2023, at a rate of 300 deaths per day.^[3] From 1999 to 2020, nearly 841,000 people died from drug overdoses,^[4] with prescription and illicit opioids responsible for 500,000 of those deaths.^[5] In 2017 alone, there were 70,237 recorded drug overdose deaths; of those deaths, 47,600 involved an opioid.^[6]^[7] A report from December 2017 estimated that 130 people die every day in the United States due to opioid-related drug overdose.^[8] The great majority of Americans who use prescription opioids do not believe that they are misusing them.^[9]

The problem is significantly worse in rural areas, where socioeconomic variables, health behaviors, and accessibility to healthcare are responsible for a higher death rate.^[10] Teen use of opioids has been noticeably increasing, with prescription drugs used more than any illicit drug except cannabis: more than cocaine, heroin, and methamphetamine combined.^[11]

Background

Opioids are a diverse class of strong, addictive, and inexpensive drugs, which include opiates (i.e., morphine and codeine), oxycodone (OxyContin, Percocet), hydrocodone (Vicodin, Norco), and fentanyl. Traditionally, opioids have been prescribed for pain management, as they are effective for treating acute pain but are less effective for treating chronic pain. Clinical guidelines advise that opioids should only be used for chronic pain if safer alternatives are not feasible, as their risks often outweigh their benefits.^[12]

The potency and availability of opioids have made them popular as both medical treatments and recreational drugs.^[8]^[13]^[14] In 2018, the U.S. opioid prescription rate was 51.4 prescriptions per 100 people, equivalent to more than 168 million total opioid prescriptions.^[15] However, these substances also have high risks of addiction and overdose, and long-term use can cause tolerance and physical dependence.^[16] When people continue to use opioid medications beyond what a doctor prescribes, whether to minimize pain or induce euphoric feelings, it can mark the beginning stages of an opioid addiction.^[17] Also, in 2018, after being prescribed an opioid medication, about 10.3 million people ended up misusing it, and 47,600 people died from an overdose.^[8] More than 650,000 Americans have died of drug overdoses since the opioid epidemic began.^[18]

The top line represents the yearly number of benzodiazepine deaths that involved opioids in the United States. The bottom line represents benzodiazepine deaths that did not involve opioids.^[1]

Opioid involvement in cocaine overdose deaths. Yellow line is cocaine and any opioid. Light green line is cocaine without any opioids. Yellow line is cocaine and other synthetic opioids.^[1]

U.S. yearly deaths involving other synthetic opioids, predominately Fentanyl^[1]

Opioid epidemic in the United States

Background

Diseases of despair

List of countries by prevalence of opiates use

List of deaths from drug overdose and intoxication

Opium in Iran

The Crime of the Century

Dopesick

United States drug overdose death rates and totals over time

Response to the Opioid Crisis in New Jersey

United States sanctions against China

China and the opioid epidemic in the United States

Wilful Blindness (2021 book)