I was recently reading an article in the New York Times, noting that anywhere from 59,000 to 65,000 people died from drug overdoses in 2016, with nearly two-thirds of that figure coming from opioid abuse. I found this astounding for two reasons. First of all, the range. The problem is growing so quickly that we can’t even obtain accurate statistics. Secondly, because of the dramatic rise. The number of overdose in 2015 was 52,404 (approximately 33,000 of which were from opioids) as reported in Vox.com and in the Washington Post and 47,055 in 2014 (approximately 28,600 of which were from opioids) according to the US Surgeon General’s Report on Addiction (the “Report”). Overdose deaths are growing at a rapid rate, with virtually all of increase attributable to opioids alone.
There are so many competing reasons for the increase, that it’s difficult to keep track. According to federal data, 89 percent of people who meet the criteria for alcohol and drug use disorder don’t get treated. Some are in denial, others say it’s too inconvenient, many don’t even know that most-to-all of their treatment can be covered by insurance. Or can it? That’s another part of the problem. In theory and by the letter of the law, it’s supposed to work that way. Medicaid, for its part, uses about 25% of its budget for drug addiction treatment, $7.9 billion in 2014. However, private insurance company pushback in the form of denial of claims and an ever-growing tidal wave of bureaucratic paperwork has made collecting on insurance coverage an imposing nightmare. Moreover, the Mental Health Parity and Addiction Equity Act, designed to ensure fair treatment and coverage of addiction as a disease, like other chronic medical diseases, is routinely ignored without repercussions. There’s no one out there policing the insurance companies to do as mandated. Finally doctors are now only beginning to fully comprehend the consequences of their years of over-prescribing. Purdue Pharma, in particular, was legally pushing Oxycontin on doctors almost as aggressively as a street-corner thug hustling illicit drugs, making billions of dollars in the process. It took a long time for the medical community to truly appreciate just how addictive opioids actually are.
Now, President Trump and Attorney General Jeff Sessions have vowed to take this fight to the streets. The reasons is that while doctors around the country have begun minimizing the legal prescription of opioids, the slack is being taken up by sophisticated drug cartels. They see a huge opportunity in the market of addicts now being deprived of legitimate means to get their fix. Cheap black heroin, fentanyl and carfentanil (strong enough to take down an elephant) are being hawked within our communities. Trump believes that by building a wall and doubling down on the ‘war on drugs’ he can make a difference. It remains to be seen.
In the meanwhile, the problem is that we don’t have the luxury of time. The Report indicated that, on average, it can take as long as 8 to 9 years after an addict formally seeks help for recovery to take hold. Many opioid addicts will be dead long before that time frame. Recovering addicts need to better arm themselves against the temptations that are out there and take measures to distance themselves from them. A year-over-year, 10-15 percent increase in overdose deaths is intolerable, a 20% increase in opioid deaths unacceptable. This is really scary stuff. The more we know and understand drugs’ destructive power, the better chance we have to help people maintain their recovery and escape being the next nameless statistic.