According to U.S. Deputy Attorney General Rod Rosenstein, drug overdoses are now the leading cause of death among Americans under the age of 50. Preliminary data for 2016 reveals the death toll from drug overdoses may be as high as 65,000, a 19 percent increase since the year before, and the largest annual increase of drug overdose deaths in U.S. history. Data from the National Institute on Drug Abuse suggests over 202,600 Americans died from opioids between 2002 and 2015.
Opioid abuse has also been identified as a significant factor in rising unemployment among men. A 2016 paper found nearly half of all unemployed men between the ages of 25 and 54 are using opioids on a daily basis. Two-thirds of them, about 2 million, are on prescription opioids. A follow-up study looking at the opioid epidemic’s impact on the American labor force suggests chronic opioid use accounted for 20 percent of the increase in male unemployment between 1999 and 2015.
Synthetic Opioid Use Is on the Rise
The most common drugs involved in prescription opioid overdose deaths include methadone, oxycodone (such as OxyContin®) and hydrocodone (such as Vicodin®). Tragically, synthetic opioids like fentanyl are also being abused by a rising number of people. Deadly overdoses involving fentanyl rose by 50 percent between 2013 and 2014, and another 72 percent between 2014 and 2015. Over 20,000 of the drug overdose deaths in 2016 were attributed to fentanyl and/or other synthetic opioids.
With a potency nearly 1,000 percent greater than morphine, synthetic opioids like fentanyl are very easy to distribute via mail. A single standard envelope can hold enough fentanyl to get 50,000 people high. Last summer, The New York Times reported the deaths of two 13-year-old boys who died after taking the synthetic opioid U-47700, also known as “pinky.” They got the drug from a friend who bought it on the dark web using bitcoin.
Fentanyl Flooding Into US Via Regular Mail
As recently reported by STAT News and ABC News, Chinese drug sellers are exploiting the federal government’s inability to track and identify shipments of illicit drugs sent via international mail.
They’re simply shipping fentanyl to the U.S. via the U.S. Postal Service, as this is a “virtually guaranteed route to not get caught” — this despite a 375 percent increase in international mail seizures between 2016 and 2017. (Interception and seizure of domestic packages containing opioids increased by 880 percent.) As explained by STAT News:
“Part of the reason for this confidence has to do with differences in how well Customs and Border Protection [CBP] can track packages from the various carriers … Much of CBP’s tracking is done using advanced electronic data — basic shipping information required on FedEx and other delivery services packages, but not required for USPS shipments. Only about 36 percent of USPS shipments have the advanced data, a fact which complicates CBP’s tracking efforts.
CBP flags potentially problematic shipments to the carriers, which find and turn over the packages for inspection. CBP can also ask USPS to monitor all packages from a specific country, but has struggled to address the large volume of shipments from China. Some sellers also routed their packages through other countries to avoid that detection.”
Federal Report Calls for Improvements to Identify and Track Illicit Drug Shipments
The potency of fentanyl makes exposure to even minuscule amounts an extreme hazard. As reported by CBS News in May 2017, a police officer nearly died after being exposed to fentanyl dust during a routine traffic stop. Fortunately, he survived, but needed no less than four doses of naloxone. Drug-sniffing dogs are also at risk, as inhaling just a few flakes of the drug can be lethal. It stands to reason the drug may also pose a risk to mail and customs workers, should the package rupture during transit or handling.
Disturbingly, a report by the Senate subcommittee on investigations suggests hundreds of millions of dollars of fentanyl are entering the U.S. via the Postal Service, as the federal government is simply not equipped to track or prevent it. A majority of these drugs are coming from China. Of six online sellers offering fentanyl, five are located in China while the location of the sixth is as yet unknown.
According to the report, more than 300 individuals based in the U.S. have received shipments from these vendors, and more than 500 Western Union transactions totaling $230,000 have been identified. While buyers were found in 43 states, Florida, Ohio and Pennsylvania received the greatest number of shipments.
The street value of these orders is estimated to be around $766 million. The investigation also concluded that at least seven individuals have died from overdosing after receiving a shipment of fentanyl from these vendors.
The bipartisan report is now calling for a number of improvements within the federal government, including advanced electronic data for all international mail. It also urges CBP to increase inspections of packages to identify shipments of illicit drugs, and to automate processing of packages from targeted locations.
Doctors Receive Kickbacks for Prescribing Opioids, Including Fentanyl
Another factor that contributes to rising opioid addiction is kickbacks to doctors for prescribing them. According to a study published in August 2017, between August 2013 and December 2015, more than 375,000 non-research opioid-related payments were made to more than 68,000 physicians, totaling more than $46 million. This means 1 in 12 U.S. physicians is collecting kickbacks from drug companies producing prescription opioids.
The top 1 percent of physicians received nearly 83 percent of the payments, and fentanyl prescriptions was associated with the highest payments. Many of the states struggling with the highest rates of overdose deaths, such as Indiana, Ohio and New Jersey, were also those showing the most opioid-related payments to physicians. In other words, there’s a direct link between doctors’ kickbacks and patient addiction rates and deaths.
While back pain has been cited as one of the most common reasons for opioid use, a significant number of people get their first opioid prescription from their dentist. This is particularly true for teenagers and young adults. Half of all opioids are also prescribed to people with mental health problems such as anxiety.
What these statistics are telling us is that doctors really need to take greater responsibility for their prescribing habits, and be far more prudent when it comes to handing out prescriptions for opioids. In many cases, an over-the-counter pain reliever may be just as effective, and far safer.
Opioids, Not Cannabis, Are a Priority, Federal Prosecutor Says
While many U.S. states have legalized marijuana either for medicinal and/or recreational use, on January 4, the White House administration rescinded the federal government’s policy to limit enforcement against marijuana sale in states where it is legal under state law.