TThe US campaign against drugs that led to an epidemic of opioid overdose –Prescription opioids– He largely succeeded. According to data from the American Medical Association (AMA) On September 8her opium recipes Projection In every state over the past decade, it has fallen by nearly 50% nationally.
However, efforts to prevent overdose deaths are a fiasco. According to federation data. Deaths from drug overdose over a 12-month period exceeded 100,000 for the first time in April 2021, with about 75% of those deaths involving opioids.
Many factors have contributed to this, but the fundamental problem is that the development of the drug market has outpaced efforts to stop drug overdoses. The prices for these drugs have never been cheaper. Daniel Cicaroni, a professor who researches the opioid crisis at the University of California-San Francisco, says the effectiveness of these drugs has never been higher.
If prescription pills were the first wave of the opioid epidemic, the second wave began in the late 2000s, amid a growing awareness of the dangers posed by prescription opioids, according to Ciccarone. The states and the federal government have also implemented programs such as Monitor prescriptionsHealth care workers quickly reduced the number of opioid prescriptions they issued in order to protect their patients — and their medical licenses. However, this rapid reversal meant that many patients were suddenly cut off from prescribed opioids. They’ve received insufficient help to get off opioid medications or deal with persistent pain, and many have turned to the illegal drug market, including heroin, says Nabaron Dasgupta, who studies opioid overdose and substance use disorder at the Gillings School of Global Public Health. University of North Carolina. .
Many people are still left behind, he says: “There are a lot of people who have been abandoned who have been taking painkillers, who are no longer able to access adequate pain management and are therefore increasingly taking to the street. We hear these stories every day. “.
However, in late 2010, the United States appeared to have reached a tipping point: overdose deaths appeared to have stabilized nationally, and even decreased in states such as MinnesotaAnd the Rhode IslandAnd the MassachusettsAfter strict preventive efforts. A wide range of new programs, including public education, expanded access to medications for opioid use disorder, such as buprenorphine, and naloxone distribution programs, may have led to lower deaths, says Thomas Stopka, associate professor of public health and community medicine at Tufts University School of Medicine. The decrease may also be attributed to The rise and fall of carfentanil– an opiate Stronger than fentanyl—In the late 2000s, says Ciccarone.
During this period, the market for illegal drugs continued to shift. First, there was the rise of the synthetic opioid fentanyl, which in its legal form is often used to relieve pain during and after surgeries, but is valued on the illicit market because it is cheap to manufacture, easy to transport, and raises blood sugar. This is stronger (but shorter) than heroin. The drug manufacturing industry has also become more divided in the wake of crackdowns on poppy cultivation and the manufacture of fentanyl, says Dasgupta, with much production shifting to Mexico, where there have been more “small manufacturers who have less interest in quality control, and are trying to make a quick buck.” .
Fentanyl and its homologues (chemically similar drugs), which first appeared on the East Coast and gradually moved to the West, played a major role in the increase in mortality. The potency of different variations can vary greatly, making it difficult for drug users to regulate their doses. This becomes an even greater threat when the materials are mixed together.
The supply and use of drugs has also become more dangerous. Fentanyl is increasingly being used along with stimulants such as methamphetamine and cocaine. By the time the substances are on sale, they are often combined with other drugs. Several experts, including Ciccarone, say it’s not clear if this is intentional. The result, however, is that many drug users, and even their sellers, have no idea what is in the drugs they buy. This is particularly dangerous because it means that users cannot adjust the level they are consuming based on their individual tolerance to opioids. People who do not take opioids regularly and who have not developed tolerance may take the drug by mistake. In addition, in addition to fentanyl and its analogues, drugs may contain a variety of other chemicals, including animal sedative xylazine New psychoactive substances such as opiates nitazine.
covid-19 pandemic Made the situation worse. Some experts have argued that the drug supply has become more corrupt over the past few years, as drug distributors have preferred materials that were more robust by volume. The epidemic has also cut off the road for many people From the social safety net, occupations, and normal life, exacerbating the mental health issues and feelings that play a role in substance use disorder. “Humans have been infected,” Ciccarone says. “We felt isolated, and scared. Our social networks were damaged, our safety nets damaged. This only leads to more deaths.”
Going forward, the AMA and substance abuse experts argue that the key will be to lift the barriers that prevent people from accessing substance use disorder treatments, including medications for opioid use disorder such as buprenorphine. It will also be necessary to expand access to life-saving tools, including reverse drug overdose naloxone (also known as Narcan)replacement injections, and fentanyl test strips.
Ciccarone says that saving lives requires a significant investment of both financial resources and public attention. While deaths from overdose will rise and fall, he says, the factors that drive many people to take drugs — trauma and suffering — won’t go away. “There are no magic bullets,” he says. “You need the bold, consistent, and level Marshall Plan attention to America’s drug consumption problem.”
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