Epidemic of opioid overdose deaths surged during pandemic

In tears, Courtney Ross told a courtroom in Minnesota that her relationship with boyfriend George Floyd involved a “classic story” of addiction to opioids.

“Addiction, in my opinion, is a lifelong struggle and something that we dealt with every day,” she said during the fourth day of the criminal trial of Derek Chauvin, a now-former Minneapolis Police Department officer charged with murdering Mr Floyd, whose death galvanised an international movement for justice for the killings of Black Americans by police.

Her remarks – among several emotional testimonies that underscored the powerlessness and distress felt by many Americans who have experienced police violence – has also revived national coverage of a crisis that has killed more than 800,000 Americans over two decades.

Amid the deaths of more than 550,000 Americans within the last year from Covid-19, the epidemic of fatal drug overdoses has largely receded from public view, despite the rising numbers of drug overdose deaths and their long shadow on the families and communities impacted by them.

Opioids, narcotics used for treating severe pain, have accounted for more than 70 per cent of all drug-related overdose deaths in the US in recent years.

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“We both had prescriptions” – one for her ongoing neck pain and another for Mr Floyd’s persistent back pain, Ms Ross said on Thursday. “After the prescriptions were filled, we got addicted and tried really hard to break that addiction many times.”

Addiction is “something that doesn’t come and go,” she said. “It’s something we dealt with forever.”

The US recorded a dramatic spike in the number of drug-related deaths in 2020.

Roughly 88,000 people within a 12-month period ending in August 2020 died from drugs, according to the acting head of the White House Office of National Drug Control Policy.

That is nearly 20,000 more drug-related deaths than reported in all of 2019.

“Illicitly manufactured fentanyl and synthetic opioids are the primary drivers of this increase,” Regina LaBelle told reporters on Thursday.

That figure, based on provisional data from the US Centres for Disease Control and Prevention, also marks an even-higher estimate than the one reported in December, which reflected total drug-related deaths over a 12-month period that ended in May of last year.

The spike in deaths “suggest an acceleration of overdose deaths during the pandemic”, the CDC reported in December.

That report found that deaths from synthetic opioids surged by more than 50 per cent compared to the previous period, killing nearly 52,000 Americans.

Within the last two decades, nearly 841,000 people have died from a drug overdose, according to the CDC. The rates have steadily risen every year since 1999.

In 2010, more than 38,000 Americans died from a drug overdose.

That number more than doubled by the decade of the decade.

In 2019, 70,630 people died from drug-related overdoses. Opioids were involved in nearly 50,000 of those deaths. Roughly 28 per cent involved prescription opioids.

The number of annual opioid-related deaths has more than doubled since 2010, when more than 21,000 people were killed by opioid use.

According to the National Institute on Drug Abuse, roughly 21 to 29 per cent of patients who are prescribed opioids for chronic pain misuse them, and between 8 and 12 per cent of people using opioids to treat chronic pain develop a use disorder.

Roughly 80 per cent of people who have used heroin first misused prescription opioids, the agency reported.

The current crisis followed an explosion of prescription opioids bolstered by a pharmaceutical industry that assured doctors that the medication would not become addictive.

In some cities, the rates of overdose-related deaths eclipsed murder rates. Hospitalisations from overdoses surged. Lethal batches of heroin cut with fentanyl circulated throughout the US, and an ongoing war on drugs that has heavily criminalised drug use and rejected harm-reduction policies has left Americans relying on illicit markets.

Cities boosted the use of the overdose-reversal drug naloxone, or Narcan, among first responders, or made it available at pharmacies and other services.

The Justice Department, state attorneys general and other officials across the US have sought to hold drug manufacturers accountable – thousand of lawsuits have targeted members of the Sackler family, owners of Purdue Pharma, which made more than $10bn selling opioids, and the company has laid out a bankruptcy plan to pay to settle them.

Separately, the company, which made OxyContin, pleaded guilty to criminal charges related to the marketing of its signature product, including illegal kickback schemes with doctors and an electronic medical company to push its drug.

In a February proclamation recognising National Poison Prevention Week, President Joe Biden said “two out of three opioid-involved overdose deaths involve synthetic opioids, including illegally manufactured fentanyl.”

“When used in combination with other drugs, with or without the user’s knowledge, it can be poisonous and deadly,” he said.

During his campaign, the president pledged to cut off the flow of fentanyl into the US “especially from China and Mexico”.

The White House is expected to unveil a seven-pronged plan to curb the rate of drug overdose deaths, the National Drug Control Policy office announced on Thursday.

“New data suggest that Covid-19 has accelerated the epidemic, and increases in overdose mortality have underscored systemic inequities in our nation’s approach to criminal justice, prevention, treatment and recovery,” the administration announced.

The plan touches on harm reduction strategies, creating “recovery-ready workplaces”, and evidence-based drug treatment and youth intervention programmes, following the president’s pledge to shift the government’s response to the crisis from law enforcement and into healthcare.

The recently passed American Rescue Plan – a $1.9 trillion package to combat the economic fallout from the coronavirus pandemic – contains $4bn for the Substance Abuse and Mental Health Services Administration.

Mr Biden has also spoken at length about his family’s experience with drug abuse – his son Hunter’s latest memoir reflects on the depths of his addictions and deep-rooted unease and anxiety that followed.

“That kind of insecurity is almost universal among those with real addiction issues – a feeling of being alone in a crowd,” he writes. “I’ve always felt alone in a crowd.”

If you are experiencing feelings of distress and isolation, or are struggling to cope, The Samaritans offers support; you can speak to someone for free over the phone, in confidence, on 116 123 (UK and ROI), email jo@samaritans.org, or visit the Samaritans website to find details of your nearest branch.

If you are based in the USA, and you or someone you know needs mental health assistance right now, call National Suicide Prevention Helpline on 1-800-273-TALK (8255). The Helpline is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week.

This article was amended on 17 May 2021 to change a reference to ‘the Sackler family’ to ‘members of the Sackler family’.