Decades into the deadliest drug overdose epidemic in U.S. history, people are dying at higher rates than ever. Between 2017 and 2021, the number of overdose deaths involving opioids jumped from 47,600 to 80,411 — many more Americans than are killed each year by guns or cars. The surge has been largely driven by powerful synthetics like fentanyl, an opioid 50 times more potent than heroin, Vox reports. Provisional data from the Centers for Disease Control and Prevention show nearly as many opioid-involved overdose deaths in 2022, at 79,770. Overdoses in Black, American Indian and Latinx communities have been rising even faster, widening the mortality gap between white people and people of color. In 2020, Black men 65 and older died of overdoses at seven times the rate of white men in the same age range. Meanwhile, the number of Americans struggling with opioid addiction remains staggering. In 2022, 6.1 million people 12 and older had an opioid use disorder, according to the Substance Abuse and Mental Health Services Administration, while 8.9 million reported misusing opioids within the past year.
“We, as a society, have spent more than 100 years thinking of and building policies and systems and punishments to address addiction as if it were an issue of morality,” said Sarah Wakeman, senior medical director for substance use disorder at Mass General Brigham hospital. “And so even though now we’re starting to talk about it as a public health issue, our policies, our clinical approaches, our care models, our funding, really reflect this idea that we actually think people are doing something bad and so we should make it really hard on them.” This punitive mindset contributes to a disproportionate emphasis on detox, “which happens to be the most lucrative, least effective element of recovery,” as Walter Ling, a UCLA psychiatrist and neurologist whose research helped pave the way for FDA approval of buprenorphine and other opioid addiction medications, said in a recent op-ed. Even now, many drug rehab centers stress detoxification, meaning going off opioids rapidly