Decline in opioid deaths masks new danger of drug overdoses by designers

Drug overdose deaths are decreasing in the United States.

This discovery is hailed as a sign that we may have reached a turning point in the ceaseless epidemic of opioid death and drug dependence that has ravaged the country for three decades.

But the slight setback masks a worrying new trend that suggests many dangers for the future.

While deaths have declined significantly in east-coast states such as Ohio and Pennsylvania, states in the western United States have witnessed a worrying surge in the number of overdose deaths.

The Centers for Disease Control and Prevention reported earlier this month preliminary figures showing that overdose deaths in the United States last year had declined for the first time in nearly three decades. The number of deaths due to a drug overdose has been increasing every year since 1990 and reaches a total of 70,000 in 2017. Last year, it dropped to about 68,000. The reduction in the number of deaths due to the drug Heroin and prescription painkillers were at least partially responsible for the reduction. The CDC estimates that in 2019, the number of overdose deaths nationwide could still decrease by 3.4% over last year.

But in the west of the country, the growing popularity of cracked cocaine with fentanyl – known in the street as speedball – or combinations of methamphetamine and fentanyl – known as gaffe – is at the forefront. 39, originated from an increasing number of new overdose deaths.

The fledgling fashion of these dangerous combinations of opioids heralds the danger ahead. There is good reason to expect that the popularity of these deadly arrangements will spread to communities and cities across the country.

The most important risk may be the resurgence of methamphetamine as a widely used drug of choice.

Nationally, overdose deaths of methamphetamine and similar drugs increased 7.5 times between 2007 and 2017. About 15% of all drug overdose deaths involved methamphetamine in 2017. Of those, 50% of those who died from this drug were goofballs where methamphetamine was mixed with methamphetamine. opioid.

Fentanyl and methamphetamine have each benefited from synthetic manufacturing processes that make these two drugs much cheaper and easier to create. The ubiquitous supply is contributing to the sharp increase in the flows of these two illicit drugs in the United States. Methamphetamine comes mainly from Mexico, while China is the largest source of synthetic fentanyl.

The growing popularity of speedballs and goofballs could trigger an upsurge in overdose deaths at a time when widespread prescription opioid drug abuse was showing signs of stabilization.

Fatal overdoses attributable to prescription medications alone have been relatively stable in recent years, although the number of deaths related to illicit narcotics – mainly fentanyl – has steadily increased since 2014. In 2016, fentanyl and similar illicit narcotics that carfentanil were involved in almost 50% of cases. death related to the disease, overtaking opioid prescription as the main drug killer.

Although the opioid epidemic began with prescription drugs such as OxyContin, it has evolved in recent years into a crisis characterized by increased use of illicit drugs.

The latest data can show that the trend is accelerating.

At one point, most people who became addicted to opioids became dependent for medical reasons. Their first exposure was by prescription. Now, more of the new addiction is fueled by people who will be exposed for the first time to opioids through an illicit drug such as fentanyl.

An addiction crisis for prescription drugs may give way to a new, perhaps larger, disaster.

Dr. Gottlieb is a contributor to CNBC and was a commissioner of the Food and Drug Administration from 2017 to 2019.