By: David Geller, CPCU, SCLA
This past March, the Centers for Disease Control and Prevention (CDC) released an analysis of data produced by 39 U.S. states and jurisdictions from 2017-2018. Notably, prescription-involved opioid overdose death rates dropped by 13.5%, but death rates involving synthetic opioids increased by 10%.
Of course, just like many of the emerging issues ISO tracks, there was some uncertainty regarding how opioid exposures may be affected from the COVID-19 outbreak. On the more positive end of the spectrum, the New York Times has reported that COVID-19 compelled the federal government to relax rules around the prescription of two common and effective treatments for opioid use disorder: methadone and buprenorphine. Instead of requiring daily visits, methadone clinics have reportedly been able to distribute four weeks of medication at once. Additionally, the article notes that doctors no longer had to meet with a patient in order to prescribe buprenorphine.
While these less stringent requirements could help mitigate the chances of overdose-related deaths, the Times did point out concern from some experts that this extended period of social isolation could make addicts more prone to relapse. Additionally, users that take these drugs alone may not have someone around to assist if there is an overdose. Lastly, the Times also mentions that individuals who have not been able to maintain normal consumption habits during the crisis could be at higher risk of overdosing in the future as their tolerance becomes reduced.
Also considered in the Times article are trends with the types of drugs that users now administer. While the number of opioids that have been prescribed in recent years has diminished, overdose deaths reportedly reached a record of 72,000 in 2019, and from the limited data available so far in 2020, the Times notes that drug deaths have gone up 13% in 2020 from the same period in 2019.
One factor that may be driving this spike is the dispersion of drugs into regions that previously didn’t have access to it. For example, fentanyl use had reportedly been primarily limited to the Eastern part of the U.S., but in recent years, overdose deaths in California, Arizona, and other Western states have been attributed to fentanyl and other synthetic opioids.
Fentanyl Trends: Keeping it out of U.S. Proving to be a Challenge
A separate New York Times article notes that, in 2016 and 2017, 97% of fentanyl that was seized by U.S. law enforcement came from China. In response, per the Times, China tightened the regulatory structure that had previously enabled mass shipments of fentanyl abroad. On May 1, 2019, 91 Chinese manufacturers and 234 individual distributors were placed under “‘strict supervision’” and were warned not to export fentanyl or related drugs. As a result, shipments of fentanyl to the United States from China had “declined significantly” from 2018 to 2019.
However, Vice had reported that these measures had led to an increase of fentanyl development in Mexico, which is potentially making more illicit drugs shipped to the U.S. more deadly. For example, the Times notes that contemporary methamphetamine, which is typically imported from Mexico, is now more frequently infused with fentanyl. And unlike opioids, in which overdose reversing drugs are available, meth overdoses reportedly can’t be treated.
Therefore, while the number of prescription opioids do appear to be dropping, evidence is growing that a range of drugs—specifically synthetic ones with dangerous chemicals—continue to grow in availability. Compound this ease of access with societal trends that may lead to increased isolation and potentially mental health issues, and it appears that the U.S. drug crisis will continue.