Federal officials have confirmed that 2021 will go in the record books as a calamitous time in the battle against the opioid painkiller abuse and overdose crisis, with more than 100,000 U.S. lives lost this year alone to a long-running public health nightmare.

In case anyone might suffer “compassion fatigue” or fail to see how unacceptable this mess has become, news articles in major media offered disconcerting contextual statements, including:

• 2021’s toll will be the highest of any single year in the crisis, which has killed more than 500,000 Americans over a decade
• The opioid crisis worsened significantly, so much so that its deaths increased by 30%, year over year
• Overdose deaths in the United States exceeded more than the (also increasing) toll of car crashes and gun fatalities combined
• Overdose deaths have more than doubled since 2015
• The people who died — 275 every day — would fill the stadium where the University of Alabama plays football. Together, they equal the population of Roanoke, Va.
• The new data shows thereare now more overdose deaths from the illegal synthetic opioid fentanyl than there were overdose deaths from all drugs in 2016.
• Drug Enforcement Administration chief Anne Milgram noted that fentanyl seizures have increased substantially to 12,000 pounds in 2021. That is enough to give every American “a lethal dose” of the powerful opioid, Milgram said. Increased use of methamphetamine is also a factor, she said.

The opioid crisis — fostered for years by Big Pharma, doctors, nurses, hospitals, insurers, and others in the U.S. health care system — has entered its latest and notably bad stage with easily and cheaply made, exceedingly powerful synthetic painkillers like fentanyl flooding the country. Public health and law enforcement officials have warned that criminals are tainting an array of illicit street products, now including marijuana, with fentanyl, promising a higher high to buyers. They may not realize, though, that dosage of so potent a drug can be tough to control. It can be lethal, especially to the unsuspecting.

The opioid horror, which has addicted far too many, debilitating them and savaging communities across the country, started with Big Pharma hype and misinformation about its prescription painkillers. Drug makers flooded the country with pills. These, in turn, opened the door to strong, familiar, and lethal street drugs, notably heroin and meth.

Chinese chemical companies were too willing to help criminals on this side of the Pacific with ingredients and product to put fentanyl front and center in the opioid crisis, where it is causing havoc now. Fentanyl manufacturing has shifted to our own shores, as well as to Mexico, officials say.

The coronavirus pandemic, of course, worsened matters, shutting down treatment programs. It fueled the isolation, loneliness, joblessness, and uncertainty that caused abuse and overdoses of drugs to skyrocket (see graphic above, courtesy of the Washington Post, whose news article is accompanied by excellent visuals about the opioid crisis’ terrible toll).

The Biden Administration has said it will act with urgency to attack the crisis, including untangling red tape and supply issues affecting medications that can reverse opioid overdoses and save lives. Federal, state, and local authorities have said they will both crack down on illicit drug dealing as well as boosting treatment programs for those addicted and debilitated by opioids.

None of this will be free. Billions of tax dollars will be spent to try to reverse the wreckage caused by opioids and street drugs. Legal wars continue in the courts, too, as state, county, and local governments, Indian tribes, and individuals seek justice in the civil system, especially by pursuing lawsuits against Big Pharma.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous drugs, notably prescription painkillers.

We may have thought in the last presidential administration that the tide finally had turned, and our opioid crisis might be going away. Preliminary data from the latter part of ’21 may suggest to some that the 100,000-plus deaths of the year constituted a high-water mark and the worst, again, may be passing.

We must not, though, waver or back down in our commitment to help those who suffer with chronic pain and those who have been hooked or killed by deadly medications that they were promised would help them.