Study of 600,000 drug deaths since 1979 upends what we think about the opioid crisis

An addict prepares heroin, placing a Fentanyl test strip into the mixing container to check for contamination.
An addict prepares heroin, placing a Fentanyl test strip into the mixing container to check for contamination. AP

The opioid crisis gripping the U.S. today has captured everyone’s attention — from the president and Congress, all the way down to mothers in rural communities who have lost children to overdoses and addiction.

Today there are new and powerful synthetic drugs like Fentanyl, and opioid abuse is cropping up in communities that weren’t hard hit in previous drug crises. That can make the opioid crisis seem like a completely new phenomenon — divorced from previous drug epidemics. But a new study published this week in the journal Science suggests the opioid crisis is actually part of a broader, deeper and decades-old drug abuse trend that kills more and more Americans yearly.

Despite shifting geographic epicenters and ever-changing drugs of choice, researchers said one thing connects fatal overdoses over the last 40 years: The death rate has grown exponentially and relatively smoothly, according to researchers at the University of Pittsburgh.

Even more alarming? Drug use in the U.S. could get exponentially more deadly if it keeps tracking that path — and as a result of drugs we may not even be aware of today, said lead author Dr. Donald Burke, according to NBC News.

That’s because even if opioid abuse is successfully beaten back, new drugs are likely to replace it, much like opioid deaths have eclipsed deaths from cocaine and other drugs in older (or ongoing) epidemics, researchers said.

Taken together, those deaths from year to year create a “smooth exponential curve,” meaning the rising death rate is actually “a composite of multiple distinctive subepidemics of different drugs ... each with its own specific demographic and geographic characteristics.”

“One possible interpretation [of the study] is that if we address the current drugs that are causing an epidemic, without addressing the root causes, other drugs will take its place,” Burke said, Gizmodo reports. “So we need to do both. We need to take care of the immediate issues of the opioid epidemic, but also understand what’s driving the drug use, and address those deeper issues.”

Burke suggests a cause for the exponentially worsening death rate, as well as a solution.

“U.S. society needs to pay attention to the loss of the sense of purpose, the widening economic disparities, the loss of community,” said Burke, according to NBC.

The study also dug into the geography and demography of drug deaths in the U.S.

Before 2010, most who died of drug overdoses were in their 40s or 50s, and were using prescription drugs or cocaine. But since then, heroin and Fentanyl deaths have become more common — and have killed those in their 20s to 40s, researchers said.

The study also found that, from 1999 to 2016, “heroin hotspots have changed from being closely clustered around large cities to being distributed more widely, especially in the Northeast and the Southwest.”

Prescription opioid abuse, which began in the southwest and Appalachia, spread to the rest of the west, as well as Oklahoma, Florida and states in the Northeast, researchers said. Cocaine started off most common in large cities, but has spread.

One region did appear relatively unscathed by the epidemic, researchers said: The North Central states were a “cold spot” for all the drugs the researchers looked at, while other regions were “hot spots” for one or more drugs.

At least one expert who wasn’t associated with the study agreed with Burke’s conclusion about tackling the underlying societal problems that may be driving drug abuse and deaths, the Los Angeles Times reports.

“To prevent new drug epidemics, we can’t keep focusing on one drug or another or wait to respond until overdose deaths reach epidemic levels,” said Linda Richter, the Center on Addiction’s director of policy research and analysis, according to the newspaper.

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