Deadly Drugs: America’s opioid epidemic is worsening – The Economist

America’s opioid epidemic is worsening

States are losing the battle against deadly drugs like heroin and fentanyl

Mar 6th 2017 – by THE DATA TEAM

ON TUESDAY February 28th, in an address to a joint session of Congress, Donald Trump vowed to end America’s “terrible drug epidemic”. When discussing America’s social ills, Mr Trump has a tendency to exaggerate. But on the subject of drugs, the president’s characteristically dark and apocalyptic tone may well have been warranted.

In 2015 more than 52,000 Americans died of drug overdoses, according to the Centres for Disease Control and Prevention. That is an average of one death every ten minutes.    

Approximately 33,000 of these fatal overdoses—nearly two-thirds of them—were from opioids, including prescription painkillers and heroin. Although the absolute death toll from opioids is greatest in big cities like Chicago and Baltimore, the devastation is most concentrated in rural Appalachia, New England and the Midwest (see map). Many of the victims hail from white middle-class suburbs and rural towns.

The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful than morphine. By 2012 it was one in three.

States have since cracked down on prescription opioid abuse, creating drug-monitoring programmes and arresting unscrupulous doctors. Pharmaceutical companies have reformulated their drugs to make them less prone to abuse. Unfortunately, as the supply of painkillers has dropped, many addicts have turned instead to heroin (see chart), which is cheap and plentiful. In 2014 more Americans sought treatment for heroin than for any other drug. In 2015, as total opioid deaths grew by 15%, heroin deaths increased by 23%.

To stem the tide of deadly overdoses, states rely increasingly on naloxone, a drug that reverses heroin’s effect on the brain and jump-starts breathing in addicts who have overdosed. First approved by the Food and Drug Administration in 1971, naloxone has been used by doctors and paramedics for decades. In recent years, states struggling with a surge in overdose deaths have passed laws making the drug available to police officers, firefighters and addicts’ friends and family. A recent working paper suggests that such laws—which are now on the books in 45 states and in Washington, DC—reduce opioid-related deaths by 9-11%.

That is still not enough. Data released in recent months show that the opioid epidemic is worsening, driven largely by the rise of fentanyl, a synthetic opioid painkiller 50-100 times more powerful than morphine. In 2016 fatal overdoses increased by 26% in Connecticut, 35% in Delaware, and 39% in Maine. During the first three quarters of 2016, deadly overdoses in Maryland jumped by a whopping 62%, prompting the state’s governor to declare an official state of emergency. Mr Trump’s promise to end the scourge of opioid abuse in America is looking more challenging by the day.

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  • Albert  On March 11, 2017 at 12:14 am

    ……..”Trump’s promise to end the scourge of opioid abuse in America is looking more challenging by the day.

    Former President Clinton said the current political trend might take this country to the edge of destruction. Before we perish here is a good money making opportunity for capitalist Guyanese who deal in the stock market.

    Trump selection to head the FDA intent to lower the cost of manufacturing drugs. One way to do this is to allow drug manufacturers to reduce the experiments in production and bring drugs to the market faster and cheaper. Additional experiments would be with the patients in the public taking the drugs. If too many die or get more sick then a drug could be withdrawn and taken back to the drawing board. Same as they do with new motor vehicles.

    Bottom line buy selective biotech manufacturing drug stocks. Example immu,pgnx,arry.

    A capitalist mind at work.

  • Gigi  On March 11, 2017 at 9:46 pm

    Albert, the bulk of BIG PHARMA expenses are on advertising and retaining a cabal of lawyers and not on experiments. Consumers are used as guinea pigs for their drug trials, especially with drug ads swamping every space and medium available. Here’s another ugly fact, when a advertised and prescribed drug ends up having serious negative consequences for its intended treatment, BIG PHARMA simply rebrands the drug and market it for another treatment.

    Here’s how it works, say a drug is released on the market to reduce high blood pressure but it ends up causing adverse reactions in numerous patients and has to be pulled from the market. What the drug company now does is simply rebrand/rename the drug and issue it as a new drug now used for reducing say diabetes or heart burn. Often times, too, the same drug is market under different names to treat different ailments. This has being going on for many years now. The cabal of powerful lawyers make it difficult for patients to sue by dragging out cases for years on end until family members either die or give up. American democracy at work!

    Many of the citizens in third world countries have been used as experiments in order to sell the products. Prisoners in Chile under Pinochet and in cahoots with the US govt were deliberately infected with syphilis in order to experiment with a cure. If you ever want to know what goes on in prisons with mentally ill prisons and in mental institutions, listen to what these people say even if you think they are crazy. You’ll find that most of what they’re saying is not crazy at all.

  • Albert  On March 12, 2017 at 12:45 am

    Gigi:…….”the bulk of BIG PHARMA expenses are on advertising and retaining a cabal of lawyers and not on experiment

    This is not about big pharma. Their ad and legal costs are largely out of the control of the FDA and they deal with drugs that are already manufactured.
    In the US drug manufacturing goes through three trial stages. They use a sample of voluntary clients who could often be a few dozens to over a hundred.
    Depending on the drug these trial stages can often take many years and could be costly. The FDA look at the results and must give approval to move up the trial stages and must give approval for a drug to be release on the market.
    The administration under Trump could reduce the trial stages to bring a product earlier on the market and use us patients as the guinea pigs. More risks but a cheaper product. For instance, the drug been manufactured with the stock symbol ESPR has been approve for stage 3 trial, which should take several years. The stock price is soaring because it is expected the new FDA head will cut down the trial stages and thus reduce production cost

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