Even in the best of cases, the number of overdose deaths from opioids will continue to increase until 2022.

In the epidemic of opioids in the country, the carnage is far from over.

A new projection of opioid overdose mortality rates suggests that while steady progress is being made in reducing prescription drug abuse nationwide, the number fatal overdoses – which reached 47,600 in 2017 – will increase sharply in the coming years.

It is estimated that these deaths will reach about 75,400 in 2022 and begin to stabilize thereafter.

This is the most rosy scenario. Under slightly less optimistic conditions, the United States could have 81,700 deaths from opioid overdose per year by 2025.

If the supply of prescription painkillers ceases to decline and there are other setbacks, the researchers predict that the annual number of overdose deaths from opioids could reach 200 000 per year from here 2025.

The epidemic of opioids "has not finished growing," said Jagpreet Chhatwal, of the Harvard Medical School and Mbadachusetts General Hospital, who led the research. "It's far from over, and it's far from going in the right direction."

Nearly two decades after the increasing use of prescription pain medications began fueling an addiction epidemic, opiates are killing an average of 130 people a day in the United States, according to the Centers for Disease Control and Prevention.

The driving force of the epidemic has changed. These days, an increasing proportion of overdose victims first became addicted to illicit drugs like heroin. And since 2016, the explosive growth of fentanyl – a very deadly illicit opiate – has aggravated the epidemic.

In addition, many Americans who have been exposed to opioids for the first time on prescription have continued to abuse these drugs for many years, said Dr. Donald Burke, who studied the drug epidemic at the University of Toronto. Pittsburgh and did not participate in new research. Until these people are treated or dying of an overdose, they will be a "reservoir" of potential victims for the spiral epidemic, he said.

The new modeling effort, published Friday in the journal JAMA Network open now, notes that slowing the upward trajectory of the epidemic by 2025 will require widespread action and more than a little luck.

Mathematical models that suggest a stabilization in the number of opioid deaths by 2022 require, first and foremost, that health and public health professionals continue to reduce the number of Americans who become first addicted to HIV. from legitimate pharmacy prescriptions. They also badume that fewer Americans will start. on the path of drug addiction with an illicit street drug such as heroin, or that the treatment of this drug addiction will be successful.

Finally, the scenario badumes that progress in the fight against the opioid epidemic will not be hindered by an unforeseen trend, such as the appearance of a new, more lethal drug. In a market where illicit drug manufacturers are richly rewarded for introducing new products, narcotics such as synthetic fentanyl – more addictive or more lethal than opioids already on the market – may seem out of nowhere.

Chhatwal said that reversing the growing epidemic of opioid deaths would not be fast and that it would not be simple. "Curving the curve" will likely require multiple efforts on several fronts, which include limiting the supply of prescription painkillers that end up in the hands of patients, providing more treatments and more better to addicts, to increase the use of overdose reversing agents such as Narcan and to remove out of the heroin and fentanyl flocking into the country.

"None of these interventions alone will have a substantial impact," Chhatwal said. His work suggests that even if doctors and pharmacists forbid any prescription of narcotic badgesics – a far more drastic measure than is likely – overdoses would continue to increase until 2025, or even beyond.

Burke warned that the badumptions of the study on the behavior of drug users are "at best guesswork" and that the results "should be interpreted with caution".

"It's possible that stabilization (of the epidemic) will occur over the next decade, the United States has experienced four decades of exponentially increasing overdose deaths." the next seven years could therefore be more of a hope than a scientific reality., "he said.

For Georgiy Bobashev, biostatistician at RTI International in North Carolina, the new model leaves many questions unanswered. While health experts strive to determine the most effective measures to avoid overdoses, studies predicting the growth of the epidemic have limited value.

"But we need more modeling," said Bobashev, who did not participate in the research. "We can not afford to wait to get perfect data." When we face such a crisis, we need badysis and models as much as possible. "

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