Key Numbers and Statistics About the Scope of the Epidemic
The United States is in the midst of an opioid overdose epidemic. As reported by the Centers for Disease Control and Prevention (CDC), prescription and illicit opioids (including prescription opioids, heroin, and fentanyl) take the lives of 128 people every day and nearly 67,267 deaths in 2018 involved an opioid.
CDC reports a 13.5% decrease in deaths involving prescription opioids and 2% decrease in overall opioid-involved deaths from 2017-2018. However, rates of deaths involving other opioids, specifically heroin and synthetic opioids other than methadone, increased by 10%.
The decline in methadone death rates, a trend observed since 2008, can be, according to CDC, attributed to efforts to reduce methadone use for pain, including Food and Drug Administration warnings, limits on high dose formulations, and clinical guidelines. The increase in natural/semisynthetic opioid death rates, on the other hand, illustrates an ongoing problem with diversion of prescription opioids.
Abuse of prescription opioids and transition to heroin
Several factors are likely to have contributed to the severity of the current prescription drug abuse problem. The National Institute on Drug Abuse (NIDA), in testimony to Congress, attributed it primarily to the drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies. These factors together have helped create the broad “environmental availability” of prescription medications in general and opioid analgesics in particular.
According to the CDC, an average of 41 people died each day from overdoses involving prescription opioids, totaling nearly 15,000 deaths in 2018.
Because prescription opioids are similar to, and act on the same brain systems affected by heroin and morphine, they present an intrinsic abuse and addiction liability, particularly if they are used for non-medical purposes. NIDA attributes the transition to abuse of heroin to the emergence of chemical tolerance toward prescribed opioids, perhaps combined in a smaller number of cases with an increasing difficulty in obtaining these medications illegally, and last but not least, to the fact that heroin is cheaper and in some communities easier to obtain than prescription opioids.
Heroin abuse, like prescription opioid abuse, is dangerous both because of the drug’s addictiveness and because of the high risk for overdosing. In the case of heroin, this danger is compounded by the lack of control over the purity of the drug injected and its possible contamination with other drugs (such as fentanyl, a very potent prescription opioid that is also abused by itself).
Fentanyl Leading the Statistics
As reported by CDC, over 31,000 people died from overdoses involving synthetic opioids (other than methadone) in 2018.
Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. CDC concludes that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.
For additional, up-to-date trends, statistics, and information related to the opioid pandemic, see the following links: