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Some good news: Opioid deaths on the decline…but why?






In the US, opioid abuse has become and epidemic. However, in the past year, there is some hope that this epidemic is starting to reverse. Opioid deaths have fallen by 16.9% in the past year.

Why have deaths fallen? According to The Economist, no one is sure:

One possibility is a supply shock…the amount of fentanyl in pills they intercept has fallen. Some reports suggest the Sinaloa cartel, a huge Mexican organised-crime group, has stepped back from smuggling fentanyl because of American pressure. In July two high-ranking members, including the son of El Chapo, one of Sinaloa’s founders, were arrested. Experts however say it is far too early to be sure.

Another possibility is that the decline represents a return to pre-pandemic norms… When covid-19 hit, opioid overdoses soared. It is hard to say why, but feels intuitive: hospitals were full of covid patients, many treatment centres had shut, and more people were experiencing the sort of traumatic losses that can make them turn to drugs.

[Third, the] epidemic may simply be “burning out”, suggests Professor Ciccarone. The theory is that the most vulnerable have already died, that those left behind understand the danger from fentanyl, and so new addicts do not replace them.

Whatever the reason, let’s hope that this trend towards fewer drug-related deaths continues.

US opioid Epidemic: A Brief History

The CDC describes the opioid abuse epidemic as having 3 waves.

First wave (prescription opioids (1999-2009): The first wave began with increased prescribing of opioids in the 1990s. Overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increased starting around 1999 but have declined in recent years.Second wave: heroin (2010-2012): The second wave began in 2010, with rapid increases in overdose deaths involving heroin. However, in recent years, heroin overdose deaths have been decliningThird wave: synthetic opioids (2013-present): The third wave began in 2013, with substantial increases in overdose deaths involving synthetic opioids, particularly those involving illegally made fentanyl and fentanyl analogs (IMFs). IMFs have saturated the illegal drug supply. They are often found in powder form or pressed into counterfeit pills and can be mixed into other drugs. More recently, non-opioid sedatives, such as xylazine, have been found mixed into IMFs.





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