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Understanding the Scope of the Opioid Crisis in America

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This article is featured in the magazine, A Public Health Perspective on the Opioid Crisis. Download it now.

By Samer Koutoubi, M.D., Ph.D., Program Director and Faculty Member, Public Health, American Public University

Opioid addiction is one of the worse crises facing the United States. According to the Center for Disease Control and Prevention (CDC), on average, 115 Americans die every day from an opioid overdose. This epidemic has become a serious public health concern, which has grown rapidly since the late 1990s.

Impacts of the Opioid Crisis

Between 1999 and 2016, more than 630,000 people died from an overdose involving opioids, including both prescription and illicit opioids. In recent years, the epidemic has only worsened. Of the more than 63,600 total drug overdose deaths in 2016, around 66 percent of them involved an opioid. In 2016, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was five times higher than in 1999.

In addition to increasing overdoses and high death rates of opioid users, there are also innocent victims of this crisis. Between 2000 and 2012, there was a five-fold increase in the proportion of babies born with neonatal abstinence syndrome (NAS) because their mothers used opioids during pregnancy. During this time frame, it’s estimated that 21,732 infants were born with NAS —equivalent to one baby suffering from opiate withdrawal born every 25 minutes.

The opioid crisis is not only affecting our social lives and communities; it’s also taking a major economic toll. The CDC estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, which includes costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

Timeline of Escalating Crisis

According to the CDC, since 1999, there have been three waves contributing to the rise in opioid overdose deaths:

  1. The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
  2. The second wave began in 2010, with rapid increases in overdose deaths involving illicit opioids, namely heroin.
  3. The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids – particularly those involving illicitly manufactured fentanyl (IMF). The IMF market continues to change, and IMF can be found in combination with heroin, counterfeit pills, and cocaine.

Government Efforts to Stem the Opioid Crisis

The U.S. Department of Health and Human Services (HHS) is focusing its efforts on preventing, solving, and treating the opioid crisis. To do so, it announced the following five major priorities:

  1. Improving access to treatment and recovery services
  2. Promoting use of overdose-reversing drugs
  3. Strengthening our understanding of the epidemic through better public health surveillance
  4. Providing support for cutting-edge research on pain and addiction
  5. Advancing practices for pain management

The HHS also announced that $485 million in grants for their evidence-based prevention and treatment activities. Funding will support a comprehensive array of prevention, treatment, and recovery services depending on the needs of recipients.

The National Institutes of Health (NIH) is the nation’s leading medical research agency helping solve the opioid crisis. In 2018, it announced the launch of the HEAL (Helping to End Addiction Long-term) Initiative, a comprehensive trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. The NIH identified key strategies and research priorities capable of providing rapid and durable solutions to the opioid crisis including ways to improve treatments for opioid misuse and addiction as well as enhance pain management.

Combating the opioid crisis will only happen with the cooperation and effort of government agencies, public health organizations, and public and private sector entities. Now is the time to intensify and strengthen our surveillance activities and strive for up-to-date, cutting-edge research to solve the opioid crisis.

Start a public health degree at American Military University.

About the Author: Dr. Samer Koutoubi earned his Ph.D. in Dietetics and Nutrition from Florida International University in 2001. He earned his M.D. degree in 1988 from Iuliu Hațieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania. Dr. Koutoubi’s research focuses on coronary heart disease among tri-ethnic groups including African-Americans, Caucasians and Hispanics. His interest is in disease prevention and wellness, epidemiological research, cardiovascular disease and nutrition, homocysteine metabolism, lipoprotein metabolism, and cultural food and health. Dr. Koutoubi has also authored a number of articles in peer-reviewed journals and written a book review. He served as the Editor-in-Chief for The Internet Journal of Alternative Medicine and reviewed manuscripts for The Journal of Alternative and Complementary Medicine, Ethnicity and Disease Journal, European Journal of Clinical Nutrition, and The Journal of The National Medical Association. Dr. Koutoubi has written for several blogs, such as In Homeland Security, Online Learning Tips, MultiBriefs, Medium and Healthcare POV. He has also been quoted in national magazines and newspapers, including Natural Health Magazine, Energy Time, Well Being Journal, Northwest Prime Time and Natural Food Merchandiser. To reach the author, email For more articles featuring insight from industry experts, subscribe to In Public Safety’s bi-monthly newsletter.


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