Study: The drug overdose crisis in the United States is the worst among rich countries


The opioid epidemic in America has resulted in a record number of drug overdose deaths – 70,000 overdose deaths in 2017, resulting in more casualties each year than firearms, car accidents or HIV / AIDS. AIDS never recorded in the history of the United States. But a new study confirms that the number of overdose deaths is not just outside US historical norms. it is also beyond the norm among the rich countries of the world.

The study by Jessica Ho, a researcher at the University of Southern California, compared the United States to 17 other rich countries and found that the number of overdose deaths in America was higher than in other countries since more than 10 years.

Based on data from around the world, the study, published in Population and Development Review, found that in the mid-1990s, the rate of drug overdose deaths in the United States was largely identical to that of other developed countries. At the time, Sweden and Finland were leading the 18 countries rich in overdose deaths.

But when the opioid crisis erupted in the United States in the late 1990s – while pharmaceutical marketing and lobbying were pushing doctors to prescribe far more opioid painkillers, and that abuse and the Addiction were increasing – America was starting to outperform other countries in case of overdose.

A second wave of drug overdoses took off in the 2000s, when heroin flooded the illicit market. Drug traffickers have benefited from a new population of people who have used opioids but have lost access to painkillers or are simply looking for a better, cheaper place. A third wave of overdoses then began, as illicit fentanyl, a synthetic opioid, began to supplant heroin on the black market, resulting in a further increase in the number of overdoses, as fentanyls are generally more potent than heroin or other opioids consumed in a traditional way.

In 2015, the United States had the highest overdose mortality rate of any country studied by Ho – by far. The rate was 60% higher than that of Finland and Sweden, which were formerly among the top rich countries.

"On average, drug overdose mortality was 3.5 times higher in the United States than in peer countries, although this number ranged from 1.6 to 28 times higher," Ho wrote.

Here are what the trends look like for men, with the top 10 countries in 2003 marked by different colors and the rest colorless:

A graph showing drug overdose deaths among men in 18 rich countries.

Jessica Ho /Population and Development Review

Ho argued that the high overdose death rate in America is one of the reasons why the US lags behind in overall life expectancy: "On average, the expectation of life was about 2.6 years lower in the United States compared to other high-income countries in 2013. and drug overdose accounted for 12% and 8% of these gaps of 2.6 years, respectively . "

The Centers for Disease Control and Prevention have established similar links between the current drug overdose crisis and life expectancy, linking an increase in the number of overdose deaths in recent years to a the reduction in life expectancy in the United States in 2017.

A cautionary note under review: it only relies on data until 2015. Since then, the opioid crisis has worsened further, particularly as fentanyl has continued to spread illicit drug markets. As a result, the United States may be even worse off in recent years, although Ho has pointed to some evidence that Australia, Canada, and the United Kingdom seem to be following the same path.

There are real solutions to the opioid crisis

Experts in public health and drug policy say that there are solutions to the opioid crisis. First, the US could dramatically expand access to drug treatment – which, according to a 2016 report from the Surgeon General, remains inaccessible to the majority of people who need it. This should result in a dramatic increase in access to medications such as methadone and buprenorphine, considered the gold standard for treating opioid addiction, and halving the opioid mortality rate by half or more.

When France eased the restrictions imposed on physicians prescribing buprenorphine in response to its own opioid crisis in 1995, the number of people on treatment increased and the number of overdose deaths decreased by 79% over the four years following.

Beyond treatment, prescribers could also reduce over-prescription of opioid analgesics – to prevent more people from abusing drugs – while ensuring that patients who really need it have access. Harm reduction approaches, such as needle replacement and a broader distribution of the opioid overdose antidote, naloxone, would also be helpful.

Several states that have taken this type of measure, based on federal and federal data, have seen their number of overdose deaths drop or stabilize in 2017.

Vermont has seen its overdose mortality rate drop by about 6% in 2017 thanks to the continued expansion of a star system that integrates drug treatment with the rest of health care. Rhode Island also declined by about 2%, thanks in particular to better access to opioid-dependence drugs in its prisons and prisons. And Massachusetts has seen a decline of about 3%, as well as a public health campaign that has focused on more addiction treatment, including in the wards. urgency, and fewer prescriptions for analgesics.

These are not huge decreases. But they are important because they are in New England states, which are among the regions hardest hit by the opioid crisis, and have seen their number of overdose deaths increase steadily in recent years. Public health interventions may also require time as more and more people learn about the risks of addiction and that treatment is actually available.

A constant problem for many states is the lack of federal resources. Congress has increased funding for treating opioid addiction here and there in recent years, but the funds allocated so far are well below the tens of billions of dollars needed by experts to deal with the problem. epidemic of opioids. And despite lavish promises, President Donald Trump has done little to change that.

America continues to lead other wealthy nations in overdose deaths.

For more information on solutions to the epidemic of opioids, read The Vox Exploder.

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