“It’s huge, it’s historic, it’s unheard of, unprecedented, and a real shame. It’s a complete shame”
That quote, reported by the New York Times and made by Daniel Ciccarone, a professor of medicine at the University of California, San Francisco, tragically summarizes the latest federal data on the opioid abuse and drug overdose crisis. As the newspaper and others reported:
“Drug overdose deaths rose nearly 30% in 2020 to a record 93,000, according to preliminary statistics released … by the Centers for Disease Control and Prevention. It’s the largest single-year increase recorded.”
These were not only the only sad realities of the opioid crisis during the pandemic, as the New York Times reported:
“Several grim records were set: the most drug overdose deaths in a year; the most deaths from opioid overdoses; the most overdose deaths from stimulants like methamphetamine; the most deaths from the deadly class of synthetic opioids known as fentanyls.”
While the coronavirus pandemic savaged the country with more than 600,000 deaths, drug overdose deaths stalked too many users, with their annual fatalities outpacing those for car wrecks, gun violence, and HIV-AIDS (see startling New York Times illustration, above). Keith Humphreys, a psychiatry professor at Stanford University and an expert on addiction and drug policy, reflected on 2020’s awful toll and told the Washington Post:
“Every one of those people, somebody loved them. It’s terrifying. It’s the biggest increase in overdose deaths in the history of the United States, it’s the worst overdose crisis in the history of the United States, and we’re not making progress. It’s really overwhelming.”
The Wall Street Journal summarized the disturbing confluence of the pandemic and the opioid crisis, thusly, quoting Brendan Saloner, associate professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health:
“The surge [in overdoses and deaths], the 2020 data show, was driven largely by a proliferation of fentanyl, a powerful synthetic opioid whose use has spread across the nation. The pandemic amplified the epidemic of overdoses, bringing on social isolation, trauma, and job losses, according to addiction experts and treatment providers. Overdose deaths began rising in the fall of 2019 with the spread of fentanyl, but really took off starting in March 2020, when pandemic-driven shutdowns and physical-distancing measures set in. ‘It’s really one of those things where 2020 turbocharged something that was already wildly out of control,’ Dr. Saloner said.”
In the area around the nation’s capital, authorities have sounded alarms about recent, rising overdose deaths, fueled by dealers spiking all kinds of drugs sold on the street — including purportedly more powerful marijuana — with fentanyl.
Fentanyl is a powerful pain killer, developed for late-stage cancer patients. It is relatively easy to make, proliferating early in illicit supplies from chemical factories in China and now made closer to home. It is difficult for experts to dose properly, raising giant concerns about criminals tainting illicit drugs with tiny but lethal amounts of it.
Dealing with the huge challenges posed by the opioid crisis soon may fall for the first time on a medical doctor — Rahul Gupta. He led West Virginia’s response to its opioid crisis, and President Biden has nominated him to run the Office of National Drug Control Policy. He would be the first M.D. to serve as the so-called federal drug czar, and his nomination drew mixed reviews from experts in the field.
This is what the New York Times reported of his background:
“The son of an Indian diplomat, Dr. Gupta was born in India and grew up in Washington, D.C. He completed medical school at the University of Delhi when he was 21 … He is currently the chief medical officer at March of Dimes, the maternal health advocacy organization, and has several academic appointments. As West Virginia’s commissioner of public health and state health officer from 2015 to 2018, Dr. Gupta won praise for his aggressive response to the state’s opioid crisis, one of the worst in the nation for years running. Mr. Biden’s choice of Dr. Gupta may also be politically strategic: He is an ally of Senator Joe Manchin III, the moderate West Virginia Democrat whose vote is crucial to the president’s legislative agenda. But Dr. Gupta also drew criticism in his state job for failing to stop Charleston from closing its syringe exchange program — a crucial component of a strategy to prevent drug-related deaths known as ‘harm reduction,’ which has been embraced by the Biden administration. Instead of helping drug users achieve abstinence, harm reduction aims to lower their risk of dying or acquiring infectious diseases like HIV, including by giving them sterile syringes. Research has found that the practice works.”
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 by dangerous drugs, notably Big Pharma’s prescription products. Drug makers, doctors, nurses, insurers, and many others played their own awful roles in fostering this crisis. We cannot allow it to keep exploding, harming far too many people with addiction, debilitation, and death.
The crisis has scourged rural and ex-urban communities, flooded with millions of excess pills. Now that it has opened the doors to major problems with fentanyl and illicit drugs, the opioids mess is starting to savage the cities and suburbs.
We have much work to do to halt this problem, pronto, because, as the pandemic has taught us all too well, unchecked public health menaces can blow up and grow increasingly difficult to handle. We can’t let this happen.