La crise des opioïdes aux États-Unis. D’un abus de prescriptions à une épidémie aiguë Potomac Paper, n° 35, décembre 2018
The opioid crisis in the U.S. has reached increasingly tragic proportions – accounting for two thirds of the 72,000 overdose deaths of 2017.
The epidemic started in the 1990’s, when opioid-based painkillers that were once only reserved for cancer patients were authorized for other types of chronic pain, ultimately benefiting pharmaceutical companies producing oxycodone. At first, the affected populations were those who could afford to go to the doctor: predominantly middle class, middle aged and white men and women, living in rural areas or the Rust Belt. Due to the strong addictive effect of the drugs, these patients and their relatives soon started to abuse the prescribed medicine. Only after 2010 did the authorities start to restrict access to opioid-based medications. But addicted users then turned to illegal opioids: first heroin, distributed by Mexican drug cartels, then synthetic opioids sold via the Internet or brought to the U.S. from laboratories in China. Much more potent, these synthetic opioids, such as Fentanyl or Carfentanyl, have caused a surge in overdose deaths.
As opposed to the victims of the crack epidemic in the 1980’s, who were mainly ethnic minorities that were met with repressive punishment under the law, the victims of the opioid crisis are seen as deserving therapeutic treatment. President Trump declared the epidemic to be a public health emergency in October of 2017. A budget of 6 billion dollars has been set to ensure better access to substitution treatments and to Naloxone, an effective antidote in case of overdose. While some laboratories have been punished, new generations of patients as well as doctors are also being educated to treat opioid drugs very cautiously.
Since 2017, the epidemic seems to have spread to all categories of the U.S. population and shows no sign of abating. Estimates point to at least 500,000 casualties in the coming decade.
This content is available in French: " La crise des opioïdes aux Etats-Unis. D'un abus de prescriptions à une épidémie aiguë."