President Trump warns drug addiction ‘a clear and present danger’ to the nation

People in the United States lost their lives to drug overdoses at a record rate in 2017, according to preliminary data released by the Centers for Disease Control and Prevention Monday.

There were 33,050 overdose deaths reported in 2017, which is a 4.5% increase from 2016, when 29,091 drug overdose deaths were reported, according to the preliminary data.

Fentanyl, which has been used more frequently as a legal opioid, fueled the increase in fatal overdoses. The drug accounted for more than 21,000 of the opioid overdose deaths in 2017, up from 9,600 in 2016. Nearly seven in 10 of those deaths were in the West and the Midwest.

Fentanyl, which is 50 to 100 times more potent than morphine, is an opiate narcotic often used by medical professionals as a pain reliever. It is a component of many prescription opioids and illegal drugs such as heroin and methamphetamines. But it’s recently become increasingly available, and doctors prescribe it more than they do other opiates.

At least 13 states saw fentanyl-related deaths increase in 2017, including Arizona, California, Connecticut, Illinois, Maryland, Michigan, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Virginia and West Virginia. By comparison, 22 states had declines in overdose deaths in 2017, including Massachusetts, New Hampshire, Ohio, Pennsylvania, Texas and Wyoming.

More than half of the overdose deaths (or 27,300) involved opioids. The opioid-related overdose death rate increased to 51.2 per 100,000 people in 2017, from 41.9 per 100,000 in 2016. Only AIDS-related deaths have exceeded overdoses on drugs in the past.

The preliminary report is based on data reported to the CDC’s National Center for Health Statistics from January to September 2017. The data, however, will need to be finalized by the end of December and incorporate most of the first half of 2018, when overdose deaths also increased by 4.5%.

The rise in opioid-related deaths is a “wake-up call,” said Eric Janszen, medical director for Burns & McDonnell, a pharmaceutical consulting firm in Boston.

But Janszen also cautions against using statistics to quickly decide which policies are needed to address this issue.

“We need to be cautious about what we do next,” Janszen said. “How are we going to get people to understand there’s an issue out there that’s going to be with us for years and years?”

For example, the CDC’s new guidelines for prescribing opioids didn’t affect overdose deaths, so the number is higher now than it was at the time of the guidelines’ release in June 2017. Janszen suggests that doctors use the guidelines as a tool to make their decisions, rather than relying on them alone.

That’s because the CDC doesn’t believe the guidelines will affect how much opioid patients get, since doctors’ prescribing habits have been changing for years. As a result, the guidelines are unlikely to cut opioid overdose deaths, he said.

Dr. Sarah Muñoz, a research scientist in the NIH’s National Institute on Drug Abuse who wrote an editorial published with the CDC’s report, echoes Janszen’s concerns.

“Over prescribing is not the fundamental issue here,” Muñoz said. “The high use of opioids in the US is rooted in the availability of opioids, not lack of prescribing.”

Muñoz worries that the Trump administration’s response to the epidemic is oriented more toward penalties rather than harm reduction — policies that she says “are more likely to cause harm to individuals than improve people’s health.”

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