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Despite the awareness and media coverage, the peak of the opioid epidemic in the United States is still not met. According to the latest official health statistics, published Thursday, 70,237 people died last year from over-consumption of drugs, against 63,632 in 2016. Relative to the size of the population, this represented 21.7 deaths per 100,000 residents in 2017, up 9.6% from 2016 (19.8 per 100,000).
In detail: men account for two-thirds of the victims; the most affected age group is 35-44 (39 deaths per 100,000), followed closely by 25-34 (38.4) and 45-54 (37.7); the most affected states are West Virginia (57.8 deaths per 100,000 population), Ohio (46.3) and Pennsylvania (44.3).
Read also Report in West Virginia on the deadly road of opiates
As a direct result of this new overdose record, life expectancy at birth fell slightly in 2017 to 78.6 years on average. It was 78.7 in 2016 (the figure has been revised) and 2015 and 78.9 in 2014. After decades of steady growth, the trend has reversed in the past three years. Never since the end of the 1910s, marked by the First World War and the Spanish flu pandemic, has the United States experienced such a long period of stagnation or decline in life expectancy.
"We are losing too many Americans"
Less strong, but continuing for more than a decade, the increase in suicides also preoccupies the health authorities and contributes to the decline in life expectancy. It is now the tenth leading cause of death in the United States. Last year, the suicide rate was 14 deaths per 100,000 population, up 3.7% from 2016. That's more than 47,000 deaths in 2017.
"Life expectancy gives us insight into the overall health of our nation and these serious statistics must make us realize that we are losing too many Americans, too early and too often, in avoidable circumstances.", responded in a statement Robert Redfield, the director of the Center for Disease Control and Prevention (CDC), saying "trouble" by this "tragedy".
On the opioid side, opiates are involved in more than two deaths out of three, the others (about 27,000) being the result of overconsumption of cocaine, methamphetamine and other psychostimulants including MDMA. In the opioid category, which is largely responsible for the increase in mortality, the CDC distinguishes four sub-categories: heroin, methadone, natural and semi-synthetic opiates (such as oxycodone, a prescription painkiller but diverted to the market). black) and, finally, synthetic opiates, a new generation of drugs including tramadol and fentanyl, dozens of times more powerful than heroin, and the slightest error of dosage can be fatal. The singer Prince died in 2016.
The political clbad mobilized
In recent years, especially since the Mexican cartels, that of Sinaloa in mind, have rushed into this buoyant market, fentanyl, sold in pill or cut with heroin, floods the United States. Through the Mexican ports they control, the cartels import from China, India and South America the chemical precursors necessary for the manufacture of fentanyl. These precursors, or even the finished product, also transit by postal mail, especially between China and the United States.
Read alsoIn Mexico, cartels at the height
Since 2016, this new generation of synthetic molecules, made entirely in the laboratory, is responsible for the majority of opioid-related overdoses. According to CDC statistics, the synthetic opioid overdose mortality rate has risen sharply: 1 per 100,000 in 2013, 3.1 in 2015, 6.2 in 2016 and 9 in 2017.
Given the scale of the crisis, and after years of inaction, the US government is organizing the response. In the fall of 2017, Donald Trump raised the opioid epidemic to the rank of "public health emergency." A year later, on October 27, the President signed a set of laws (the "Support for Patients and Communities Act") adopted almost unanimously by the Senate and the House of Representatives, in a rare bipartisan consensus to Washington.
660 pages long, this text contains multiple measures of a sanitary and security nature. It provides, among other things, a tightening of postal controls to curb the import of fentanyl by mail, easier access to substitution treatment, the development of addiction treatment centers and the strengthening of medical research on the subject. In March already, the US Congress had allocated $ 3.3 billion (about € 2.9 billion) additional to the fight against opiates.
A first seizure in France
In July 2016, Barack Obama signed a first major law pbaded by Congress. This text aimed in particular at making naloxone (a product to be injected or inhaled that serves as an antidote for opioid overdose) more accessible, to reinforce prevention and to tighten the surveillance of medical prescriptions, to avoid the diversion of drugs. obtained legally by prescription.
Although the number of drug-related deaths again broke records in 2017, these efforts appear to be starting to pay off. According to preliminary CDC figures for the first months of 2018, the growth rate of overdoses seems to have slowed significantly. Over the period from April 2017 to April 2018, the increase would be 2.2%, much lower than in 2017 (10.4%) and especially 2016 (21.4%). "We are so far from the end of the epidemic, but perhaps we are at the beginning of the end"said at the end of October the US Secretary of Health, Alex Azar.
The ravages of opiates across the Atlantic must in any case encourage the rest of the international community to be extremely vigilant. A year ago, in the columns of the JDD, the head of the European police cooperation agency, Europol, warned against the imminent arrival of fentanyl on the French and European market. Fears confirmed last week: the narcotics brigade seized nearly 600 grams of Fentanyl in the XIXe district of Paris. A first in the Hexagon. According to the JDD, two people were arrested, including a 34-year-old chemist by training. He would have placed an order on the Darknet and shipped the precursor product from China.
Frédéric Autran
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