Deadly Drug Policies

The death rate for young Americans has increased by 8 percent between 2010 and 2015, according to a recent analysis by the Washington Post—and the driving force behind this increase is the current opioid epidemic.

From the Post: “Since the beginning of this decade, death rates have risen among people between the ages of 25 and 44 in virtually every racial and ethnic group and almost all states, according to a Washington Post analysis. The death rate among African Americans is up 4 percent, Hispanics 7 percent, whites 12 percent and Native Americans 18 percent. The rate for Asian Americans also has increased, but at a level that is not statistically significant.”

The Post looked at mortality data from the Centers for Disease Control and Prevention (CDC).  For context, the 10 leading causes of death in 2015 were heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide. These account for 74.2 percent of all deaths in the United States.

But the death rate for Americans in the prime of their life (age 24-44) has risen from 139.8 per 100,000 in 2010 to 151.3 in 2015.

According to the Leandris Liburd of the CDC, “The data is very concerning… The rise in mortality is likely due to multiple factors, and opioids are certainly a part of the problem.”

The only group in the 25-44 age span whose death rate is not climbing, according to the Post, “is people with four-year college degrees.”

Overdose deaths from drugs are more than double those for blacks and steadily increasing, but there is also evidence of large increases in African American overdose deaths, particularly from the use of fentanyl and fentanyl mixed with cocaine. Users often do not know if it has been added to what they believe to be heroin.

Fentanyl is more dangerous than heroin or morphine and is fast-acting. This acceleration in the effects of an overdose reduces the time available to resuscitate and save an individual.

In early 2017, the CDC released data on Drug Overdose Deaths in the United States from the period of 1991 – 2015. Drug overdose death rates rose in 2015 to a level 2.5 time greater than in 1999. Some key facts include:

• The four states with the highest age-adjusted drug overdose death rates in 2015 were West Virginia (41.5), New Hampshire (34.3), Kentucky (29.9) and Ohio (29.9).
• In 2015, the percentage of drug overdose deaths involving heroin (25%) was triple the percentage in 2010 (8%).
• For drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl and tramadol, the percentage increased from 8% in 2010 to 18% in 2015.

The CDC observes that there has been a change in the pattern of the drugs involved in these deaths, with deaths due to natural and semisynthetic opioids (morphine, codeine, hydrocodone and oxycodone) and from methadone decreasing, while deaths from heroin and synthetic opioids (fentanyl, fentanyl analogs and tramadol) other than methadone increasing.

In other words, the opioid crises is due to the manufacture and over-sale of new and more potent synthetic pharmaceutical painkillers. These new pharmaceuticals are highly profitable to their manufacturers and distributors. They are profitable in part due to their severe dependence liability and potential for addiction, and in part due to their high cost.

When patients can no longer afford the cost, they turn to the illegal market for heroin as an alternative. But, as referenced above, diversion of fentanyl also makes the use of heroin more dangerous.

Drug policy in the United States has been subject to two major flaws in the last century.

One problem, getting a lot of attention lately, has been the emphasis of punishment over treatment, and the related issue of funding for drug treatment programs.

The other problem has been the longstanding fixation on marijuana, particularly the criminalization of sales and use and the obsession of using criminalization as a primary tool to send a discouragement message about use.

A primary responsibility of the DEA is to monitor the manufacture and sales of pharmaceutical drugs in the United States to prevent diversion to illicit markets; this includes the responsibility to police and prevent profiteering by the pharmaceutical industry.

One of the factors considered in how the DEA regulates and monitors drug sales is their safety for use under medical supervision.

Steady increases in the death rate for Americans in the prime of their lives, increases driven by overdose deaths related to the manufacture and sale of synthetic opioids, raises profound questions about the true nature and impact of drug policy in the United States.

The problem here is not that people in America like to use cannabis. The problem is that pharmaceutical companies like to make money from opioids. And unlike cannabis use, this problem is killing people throughout the United States.