More people died from opioid overdoses than by guns or car crashes in 2017, preliminary data shows

Posted on Dec 11, 2018 in Medical Rewind

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Preliminary data released by the Centers for Disease and Control paints a grim picture of America’s opioid crisis. Even as awareness has increased across the nation and opioid makers have vowed to stop pushing the drugs to physicians as they face lawsuits, estimates updated on Aug. 15 by the CDC show that there has been a 6.6 percent increase from 2016 – a year that had the highest opioid overdoses ever recorded.

As the estimate stands today, that means more people died from opioid overdoses than by guns or car crashes in one year in the U.S. To put 2017 estimates into a bleaker perspective, overdose deaths from opioid prescriptions were fives times higher in 2016 than they were in 1999.

When taking a more granular look at the data, one can find that some states such as North Carolina, New Jersey and Nebraska experienced an estimated 20 percent increase in overdoses.  Others, such as Massachusetts, Rhode Island and Vermont, were fortunate to report decreases in overdose-related deaths.
While this might be good news for those states whose numbers are decreasing, nationwide the crisis has increased. These numbers are not final, and they are based on provisional counts for 2017. Regardless, the crisis does not show signs of stopping soon.
“We are going in the wrong direction,” addiction expert Joe Schrank told Salon. “America is in the middle of a public health crisis no less severe than HIV.”

The numbers also show that President Donald Trump’s five-point opioid strategy did not exactly go to plan. In 2017, U.S. Health and Human Services (HHS) invested $900 million in opioid-specific funding to enlist support to state and local governments with resources to combat the epidemic.

One expert said it takes time for money to “translate into infrastructure.” “That’s particularly true for places where it wasn’t already there,” Chris Jones, the director of the National Mental Health and Substance Use Policy Laboratory, told The New York Times.
However, Schrank said there is no question that what the government is doing is not working. “We need to do what does work and what we know empirically is that medication-assisted treatment works,” he added, noting cannabis is a good alternative and can help those addicted to opioids in the recovery process.

Another expert told The New York Times that resources in some states might not be tapped into right away, because this epidemic is fueled by addiction, which continues to carry stigma. “Because it’s a drug epidemic as opposed to an infectious disease epidemic like Zika, the response is slower,” Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, told The New York Times. “Because of the forces of stigma, the population is reluctant to seek care. I wouldn’t expect a rapid downturn; I would expect a slow, smooth downturn.”

Indeed, the opioid epidemic could be a call to the country to reevaluate how it treats and views addiction. The American Society of Addiction Medicine characterizes addiction as a “primary, chronic disease of brain reward, motivation, memory and related circuitry,” yet it still can be recognized as a reflection of one’s character or standing in society.

In a piece for CBC News in Canada, physician Gabor Maté, wrote about how most opioid addicts turn to the drug to mitigate emotional pain.

“All my female patients reported sexual abuse in childhood, all the male patients abuse or neglect of one kind or another,” he wrote. “As large-scale international epidemiological studies have repeatedly demonstrated, childhood adversity is at the core of the emotional patterns and psychological dynamics that drive addiction.”

This news coincides with a new retrospective observational study published in The BMJ which showed a disconcerting trend regarding life expectancy in the U.S.:  an alarming decline among Americans in their 20s and 30s, which the authors suggest is related to the opioid epidemic.

“These declines are particularly troublesome in light of the U.S.’s poor performance in international rankings of life expectancy. The USA now has the lowest life expectancy levels among high income developed countries, and Americans fare poorly across a broad set of ages, health conditions, and causes of death compared with their counterparts in these countries,” the authors wrote. “Life expectancy trends in the USA appear to be strongly related to its ongoing opioid epidemic; while drug overdose mortality is high in several high income countries (eg, Sweden, Norway), it seems that the American epidemic has not yet spilled over to most other high income countries.”

It has been a slow build-up to the crisis the country finds itself in today. According to the CDC, prescription opioid sales nearly quadrupled from 1999 to 2014; during this timespan, overdose deaths from prescription opioids increased, as well. While opioid prescriptions should only be prescribed to cancer patients or those with a pain-related diagnosis, only an estimated one out of five fit the bill.

Big Pharma companies appear to be finally facing the consequences for pushing the drugs onto physicians, as well. In February, Pharma LP, an opioid maker that has been at the center of several lawsuits following America’s opioid crisis, said it would discontinue promoting opioids to prescribers.

“We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” the company said in a statement to Reuters. “Doctors with opioid-related questions will be directed to its medical affairs department.”

The company also pledged to turn its focus to “other potential non-opioid products.” “Its sales representatives will now focus on Symproic, a drug for treating opioid-induced constipation, and other potential non-opioid products,” the report added.

In the meantime, the U.S. Drug Enforcement Administration has made a peculiar announcement on the opioid crisis. On Thursday, a press release stated the DEA is proposing a significant manufacturing reduction in opioids.

“We’ve lost too many lives to the opioid epidemic and families and communities suffer tragic consequences every day,” DEA Acting Administrator Uttam Dhillon said in the release. “This significant drop in prescriptions by doctors and DEA’s production quota adjustment will continue to reduce the amount of drugs available for illicit diversion and abuse while ensuring that patients will continue to have access to proper medicine.”

Article from Salon.com | Nicole Karlis  August 19, 2018 5:00pm (UTC)