The social element of the opioid crisis

November 6, 2017

Editor's note: The statistics referenced in this article are published as part of Sen. Lee's Social Capital Project.

The United States has suffered through opioid crises before but never like this.

First in the 1970s and then in the 1990s, opioid-related deaths spiked across the country, but the current crisis is bigger — much bigger.

In 2016, approximately 64,000 people died from drug overdoses, surpassing all-time death rates for car crashes, HIV and guns. Two-thirds of those 64,000 deaths were caused by opioids.

These are just some of the data points our team at the Joint Economic Committee uncovered in its latest Social Capitol Project report, “The Numbers Behind the Opioid Crisis.”

One reason for the severity of this crisis, our research finds, is that this time, Americans can buy opioids legally. In the 1960s, four out of five heroin addicts began their addictions with heroin. But this time, three out of four heroin addicts either obtained their opioids through a doctor or someone else’s prescription. Drugs obtained freely from friends and family with legal prescriptions account for 40 percent of prescription opioids taken by opioid abusers.

Not only are opioids legal to buy this time around, but most of the time they are also free for the user — another person, usually the taxpayer, picks up the bill. In 2010, patients paid just 19 percent of the cost of opioids purchased in the United States. Insurance companies paid 25 percent, Medicare paid 26 percent, Medicaid paid 13 percent and other government programs paid 16 percent.

These third-party payments helped fuel an explosion in opioid prescriptions. By 2016, nearly 215 million prescriptions were filled for 61.8 million patients, or nearly one-fifth of the population. Patients have been showered with pain pills: In 2015, doctors prescribed almost enough opioids in the median U.S. county to give each resident a two-week supply.

The fallout from this drug explosion has been staggering. Opioid-related deaths have quadrupled since 1999. Between 2015 and 2016 alone, deaths from synthetic opioids more than doubled. Here in Utah, the opioid death rate increased by 118 percent while suburban emergency rooms saw a 171 percent increase in opioid-related visits.

Unfortunately, it appears the worst of this crisis is yet to come. While abuse of prescription opioids seems to be falling with a recent drop in opioid prescription rates, deaths from prescription opioids continue to rise. Users also appear to be switching to even stronger narcotics. Early 2016 data suggest that fentanyl — a synthetic drug 25 to 50 times more powerful than heroin — has surpassed heroin in overdose deaths, skyrocketing 540 percent in three years.

These deaths have not been evenly distributed. Some populations have been harder hit than others.

Those with no more than a high school education make up just 40 percent of the population in the United States, but in 2015, they accounted for 68 percent of opioid-related deaths.

Never-married and divorced Americans make up just 32 percent of the population, but in 2015, they accounted for 71 percent of all opioid-related deaths.

And single men with just a high school education have an opioid death rate almost three times higher than single women with the same education.

Clearly, there is a strong social component to our opioid crisis. Individuals who do not have a strong family or good job appear to be much more at risk of succumbing to addiction.

As we look for ways to solve this crisis, we should keep these social components in mind. More research is needed, but it does appear that loving families help addicts recover from addiction. More importantly, families appear to be a strong defense against becoming addicted in the first place.

Op-Ed originally published in the Deseret News