Opioid Crisis in the United States
More recent review of the Opioid, drug, etc. crisis in the United States. It has been a while since I have written on or touched upon the Opioid crisis. This is about a six-minute rather simple read. It lays a foundation for addition information on the topic. I will try to break this down and add graphs depicting issues and the numeric of those issues.
This piece is taken from a CBO report:
“The Opioid Crisis: Federal Policy Approaches to Reduce Supply, Demand, and Harm”
Congressional Budget Office
The Opioid Crisis in the United States
Opioids are a class of drugs that interact with opioid receptors in the brain and body to relieve pain, slow certain bodily functions (such as breathing), and, in some cases, produce a sense of euphoria. Synthetic opioids, such as fentanyl, are produced and used both legally (when prescribed to treat severe pain) and illegally. Heroin, a highly addictive opioid, is illicitly produced and has no accepted medical use in the United States. Opioid use and misuse (the use of a prescription drug without a prescription or in a different way than prescribed) can lead to dependence, addiction, overdose, and death.
From 2015 to 2024, annual drug overdose deaths involving any opioid increased by 65 percent (from 33,100 to 54,700) in the United States, contributing to an accumulated total of more than 850,000 opioid-involved deaths since 2000. From 2023 to 2024, annual opioid-involved overdose deaths declined. Over-dose deaths dropped by about 30 percent. Use of synthetic opioids with and without other types of drugs (including alcohol) has contributed to the current crisis, which has become particularly severe among Black people, Native Americans, and men ages 25 to 64. An estimated 7 million to 8 million people in the United States were living with opioid use disorder in 2019.
The opioid crisis has affected health, economic factors, and social outcomes. The health consequences of chronic opioid use can be severe. The use of which is associated with cognitive impairments. Over time, injecting opioids can cause organ damage and infection with hepatitis B and C, HIV besides other blood-borne viruses. The economic and social effects of the crisis are widespread. Opioid-involved deaths have contributed to the decline in U.S. life expectancy beginning in 2015. In addition, the opioid crisis has impacted family structure, children’s well-being, and labor force participation.
To address the many facets of the crisis, lawmakers have enacted several laws spanning supply, demand, and harm reduction. Most provisions of the laws (enacted from 2016 to 2018) authorizing funding for opioid and drug-related interventions have expired or will expire in the next few years. More recently enacted opioid-related laws focus on enforcement to reduce the supply of illicit opioids. In addition to federal funding, a $26 billion settlement was finalized in 2022 between the attorneys general of nearly all states and pharmaceutical opioid distributors and one manufacturer to resolve legal claims against those companies for their roles in perpetuating the opioid crisis. State and local governments have started to receive funds from the settlement. Those funds are intended to support efforts to mitigate the adverse effects of the opioid crisis.
Trends in Overdose Deaths Involving Opioids
Recent increases in overdose deaths have been driven by deaths involving synthetic opioids, largely fentanyl (Figure 1). Over the past 10 years, overdose deaths involving synthetic opioids increased by 780% and, as of 2024, deaths involving synthetic opioids accounted for 89% of all opioid-related overdose deaths. In 2023, annual deaths involving synthetic opioids decreased for the first time since 2018, declining by 1.5% from 2022. The most recent provisional data about drug overdose deaths show that from 2023 to 2024, deaths involving synthetic opioids declined by 37%.
Synthetic opioids have been driving the recent surge in overdose deaths mainly because of their potency, unintentional consumption, and increased availability. Fentanyl is commonly mixed with other illicit drugs, and many people may be unaware that their drugs contain fentanyl. The use of synthetic opioids has also increased as their prices have fallen. Prescription opioids have become harder to obtain legally. The prices of fentanyl and related substances are low because fentanyl can be produced in a laboratory at low cost and because sales are facilitated by the internet. At the same time, federal and state interventions have reduced the availability of prescription opioids. The pandemic further exacerbated the opioid crisis by disconnecting people with OUD from traditional treatments and by increasing the demand for opioids.
The ongoing crisis is expanding beyond opioids, as seen in the recent trend of concurrent use of fentanyl and xylazine (a veterinary tranquilizer). Over the past few years, more drug overdoses and deaths have involved opioids in combination with either other opioids or nonopioid substances, including xylazine, benzodiazepines, and alcohol (function as central nervous system depressants), as well as stimulants (drugs that boosts alertness and energy [methamphetamine and cocaine]). For example, in 2020, ~40% of deaths involving illegally made fentanyl also involved stimulants. In 2023, methamphetamine was detected in 60% of fentanyl-positive urine drug test results. Cocaine was detected in 20% of those results. Use of opioids with other substances contributed to a higher risk of fatal overdoses and other adverse health outcomes recently because of the lack of effective treatment, lower rates of initiation, and shorter retention in OUD treatment among people who use multiple substances.
Demographic Breakdown of Overdose Deaths Involving Opioids
From the early 2000s until 2015, the rate of opioid-involved deaths rose fastest among non-Hispanic White and Native American or Alaska Native people. Through 2017 those two groups also had the highest rates of any racial group. Over the past decade, though, increases in opioid-involved deaths have accelerated among non-Hispanic Black and Native American or Alaska Native people Figure 2, top panel), whereas growth among non-Hispanic White people has slowed.
Since 2020, rates of opioid-involved deaths among non-Hispanic Black and Native American or Alaska Native people have exceeded deaths among non-Hispanic White people. Studies suggest that those trends are driven by higher rates of drug overdose deaths involving fentanyl. About 40% of the growth from 2010 to 2020 in opioid-involved deaths among non-Hispanic Black people, relative to non-Hispanic White people. This can be attributed to the disproportionate spread of fentanyl in metropolitan areas in the eastern United States, where more than half of all non-Hispanic Black people lived in 2010. From 2021 to 2023, the rate of opioid-involved deaths declined among non-Hispanic White people. It increased in all other racial and ethnic groups.
The breakdown of opioid-involved deaths by sex and age follows a different pattern. Over the past two decades, the rate of opioid-involved overdose deaths among men has been consistently higher than the rate among women. In addition, death rates among people ages 25 to 44 have been consistently higher than rates for people at older ages (among men, for the entire period in Figure 2, and among women, for about half of the period).
During the pandemic, opioid-involved death rates surged across all age groups, particularly among men (Figure 2, bottom panel). From 2019 to 2023, people ages 25 to 44 had the highest opioid-related death rates, and people ages 45 to 64 experienced the fastest growth in opioid-related death rates. Those figures suggest that the opioid crisis could have a large impact on the working-age population and, consequently, on labor market outcomes. (See Box 1 for a discussion about how the opioid crisis and related policies have affected labor market outcomes.)