For the first time since 1990, the number of annual drug overdose deaths in the US has declined. The 5 per cent fall reported by the Centers for Disease Control and Prevention (CDC) is almost entirely due to a drop in deaths from prescription opioid painkillers. Does this mean the opioid crisis has peaked?

The early data predicts that there were 68,500 drug overdose deaths in the US in 2018, down from 72,000 the previous year. But it is unknown whether overdose deaths will continue to fall.  The CDC data shows that overdose deaths from fentanyl, synthetic opioids, cocaine and methamphetamines are still increasing, which is an ominous sign.

Drug overdose deaths in the US related to prescription opioids rose from just over 3,400 in 1999 to about 17,000 in 2017. This dramatic upwards trend reflects a nation-wide epidemic of opioid use and abuse. Recent data from the US Drug Enforcement Agency revealed that between 2006 and 2012, 76 billion oxycodone and hydrocodone pain pills – two common prescription opioids – were distributed in the US. That’s about 248 pills per person!

The epidemic has hit US states differently, and these new numbers bear that out. Deaths continued to rise in some eastern states where the use of illicit fentanyl, a highly potent synthetic opioid, is spreading. But deaths are dropping in some midwestern states where local governments have expanded treatments for addiction and monitoring of prescriptions.

Even with this recent reduction in overdoses, tens of thousands of people are overdosing on opioids each year. The recent decrease may be due to increased availability of naloxone – which blocks the effects of opioids and is used by emergency medical practitioners to reverse an overdose – and better training to use it.

If emergency treatment, rather than reduced drug use, is largely behind the fall, this would mean an increasing number of US adults are living with substance abuse disorders. Prescribing restrictions mean many of these are likely being pushed towards using street drugs.  (an edited version of an article by Chelsea Whyte, New Scientist. Aug 2019)

However you look at it 68,500 drug overdose deaths (in 2018) are tragedies as well as a scandal.  If this number were lost to physical violence it would be called a war. I sympathise with those in constant pain, but knowingly pushing or enabling the use of habit-forming drugs should be classed a crime.  Writing as someone in constant mild back pain, my personal prescription is exercise and physical therapy with a very occasional ibuprofen to reduce swelling.  Live with it.  It’s part of getting older (or, at least, that’s my philosophy, Epicurean or not).