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The opioid epidemic appears to be moving, geographically, from the rural and poor Rust Belt to the east coast.
Overdose deaths, particularly those due to synthetic opioids, have increased particularly rapidly in the eastern United States.
The number of people who died for opioids has at least doubled every three years between 1999 and 2016 in eight states: Connecticut, Illinois, Indiana, Indiana, the United States, and the United States. Massachusetts, Maryland, Maine, New Hampshire and Ohio.
While the opioid crisis is spreading, its public health identity has emerged as a white and poor problem in the Midwest, but a new study by Stanford University suggests redoubling efforts to limit drug use. overdoses of fentanyl in the east of the country.
Although the opioid epidemic in the United States has been stereotyped as a poor, white, Midwestern problem, its latest wave caused by fentanyl causes the largest and fastest increases in the number of deaths by overdose in urban black populations in Appalachia and the Northeast. of a new study of Stanford University in deep purple
Between 1999 and 2016, 351,630 Americans died of opioid-related causes.
These numbers increased only year-over-year, with mostly young lives (the average age of the deceased was only 40) and resulting in reduced life expectancy.
And the average victim was stereotyped as Midwestern, white, male, and poor.
According to most previous estimates, this region of the country experienced the largest increase in opioid overdoses.
Between July 2016 and July 2017, overdoses increased by 30% in the vast majority of US states (45), according to the National Institutes of Health (NIH).
In the Midwest, by contrast, overdoses increased by 70% over the same period.
But according to the new study published Friday in the JAMA Open Network, the epidemic is spreading east, pulled very clearly by synthetic opioids, including fentanyl.
Overall, the number of opioid deaths increased with average speed and intensity between 1999 and 2016 in many states east of Mississippi.
But the risk of death is perhaps higher for opioid users who use or take on fentanyl unexpectedly, the synthetic opioid that can be 80 to 100 times more potent than the opioid. heroin.
Increases in the number of synthetic opioid deaths have not only been numerous but have also increased rapidly in recent years in almost all states east of Mississippi.
And the largest increases were observed in the Appalachian and neighboring states of Kentucky, Ohio, West Virginia, Pennsylvania and Maryland.
Death rates from synthetic opioids have increased at least 41% per year, as have deaths in the most northeastern states of Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and Connecticut. .
"Although opioid-related mortality has increased steadily and exponentially since 1999, the types of opioids involved, as well as the places and people most affected, have changed over time," the authors wrote. of the study.
"It was previously thought that opioid-related deaths were concentrated in the white population in the Appalachian and Midwestern states."
But, as if the epidemic was reaching the end of the neglected heroin addiction epidemic of the 1970s, today's opioids are killing more and more black men and women in Urban.
"Specifically, research suggests that the opioid epidemic has evolved into a series of 3 interlaced but distinct epidemics, based on the types of opioids associated with mortality, ranging from overdose of prescribed opioids to death. 'heroine switching to fentanyl and opioid deaths, the study revealed.
"The evolution has also affected a larger number of populations, with the spread of the epidemic from rural areas to urban areas and a significant increase in opioid-related mortality observed in the black population. "
This means that the wider distribution of naloxone observed in the Midwest needs to be adopted and targeted at black communities living in inner-city slums of the east coast, which are rapidly becoming the new "hotspots".
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