Page 24 - DMN4Q21

FENTANYL
An editorial by Susan Adelman, MD
FENTANYL
An editorial by Susan Adelman, MD
Drug overdoses in the U.S. reached 93,331 in 2020, a record high, according to figures recently released by the CDC, and reported by the Commonwealth Fund on August 16, 2021. In 28 states, drug overdoses increased by over 30% in 2020. Ten of these states had increases of over 40%. Put another way, from 2015 to 2020,
the percentage of all U.S. deaths due to drug overdose rose from 1.9% to 2.8%, even in the middle of a Covid epidemic. Or perhaps it was in part because of it. We will come back to that.
In comparison, during that time, according to Johns Hopkins University, Covid caused 352,000 deaths in 2020.
Of these overdose deaths, synthetic opioids were responsible for over 60%. Today, that means fentanyl. Deaths from these synthetic opioids increased by some 20,000 – 54% - in 2020 alone. Overdose deaths among Blacks increased by 45%, double the rate for whites. The Council on Foreign Relations (CFR) published a report on September 8, 2021, saying that in the year 2019, more than 1,300 died each week in the U.S. from opioid overdoses. The total for that year was over seven
times the number of U.S. soldiers killed in Iraq and Afghanistan after 9.11.
The CFR also reports that with the opioid epidemic has come an increase in cases of hepatitis C, HIV, neonatal abstinence syndrome, and children put in foster care. Then there is the decline in the U.S. workforce. The Princeton economist Alan Krueger is quoted as saying, “it could account for 20% of the decline in participation among men and 25% of the women from 1999 to 2015.”
Where does this fentanyl come from? On Oct. 18, Natasha Yee of Cronkite News makes it clear. It comes from Mexico. Important components come from China, and in Mexico it is packaged directly, mixed with
other illegal drugs, or is incorporated into pills that are stamped to simulate legitimate medicines. She writes that fentanyl is one of the most profitable products trafficked by the Mexican cartels, since a gram of fentanyl sells for $150-200 on the street, ten times the price of marijuana. And any dose over 2 mg is lethal. She quotes a Brookings Institute report that border patrols seized more than 3,967 pounds of fentanyl in 2020, enough to kill the residents of a medium-sized city.
24 Detroit Medical News
Fourth Quarter 2021