A drug overdose occurs when a person takes more of a substance than their body can handle. A person can overdose on many different drugs, but the opioid crisis in the US has seen a resurgence of overdose deaths from the drugs heroin and fentanyl. Meanwhile, the government of California is frantically trying to find solutions to reduce these numbers with the proposal of safe injection sites.
‘In the past two years, the increase in overdose deaths has affected the entire country. With statistics showing that overdose deaths in California have seen the biggest spike, service providers are also seeing an increase of calls for opiate treatment requests,’ says Bryan Alzate, CEO of United Recovery California.
California is home to some of the best addiction treatment centers in the country based on staff-to-client ratios, facilities and methodologies. Looking at the opioid crisis we are in today, specifically the spike in overdoses in California, we need to take an honest look at the situation. To find a long-term solution, we must ask: how did we get here?
The Opioid Crisis
Heroin is made from morphine, which is made from the seeds of the opium poppy plant. Heroin and other opioids produce euphoric effects in the user, making them easily abused. Due to the psychoactive nature of these chemicals, they work by directly altering brain chemistry. Ingesting opiates like morphine, heroin, and fentanyl can change a person’s thoughts, awareness, behavior, and moods.
People who are suffering from chronic pain or mental health issues may become reliant on these powerful opioids. The rewarding effects of these drugs will most likely increase their quality of life in the beginning. Sadly, this effect is not only unsustainable, but addiction can wreak havoc on a person’s life. When a person abuses a substance for a long time, they develop a tolerance to the drug. This means they will have to increase the dosage of the substance, raising the risk of overdose.
Furthermore, substance abuse causes a person to become physically and/or mentally dependent on drugs like heroin. Drug dependence traps a person in the cycle of addiction. If they wish to stop taking the drug, they will experience withdrawal symptoms that can be impossible to bear alone.
The opioid crisis in the US has come in waves. The first wave occurred in the mid-1990s when the FDA approved the opioid oxycontin for prescription pain relief. This decision saw millions of people become addicted to opioids, a legacy that has evolved into the epidemic we face today. After this, the second wave of the crisis saw the sale and production of heroin skyrocket. This was in part due to the demand created by people who were already addicted to opioids.
When someone is physically dependent on a substance like heroin, the withdrawal symptoms can be too overwhelming to withstand. A recent study has shown that people going through drug withdrawal are more likely to share needles. It also found they are more likely to experience a non-fatal overdose. Showing the gravity of the withdrawal experience, this demonstrates how a person can progress from abusing prescription drugs to using illicit opioids.
The third wave of the opioid crisis that has occurred in recent years has been largely due to the presence of the opioid fentanyl. Fentanyl is synthetic, but it is derived from the naturally occurring opioid morphine. While it is available legally as a lozenge or transdermal patch, most of the overdose deaths involving fentanyl are from illegally manufactured sources.
The New Wave
We can see that this is not a new issue. It has undoubtedly been evolving since that first wave in the 1990s, but the opioid crisis appears to have exploded in the past two years. Opioid-related overdose deaths have reached record levels, with the Centers for Disease Control and Prevention (CDC) reporting shocking statistics. In their latest report, they found that from April 2020 to April 2021, there were over 100,000 overdose deaths in the US. In the twelve months prior to this time period, overdose deaths were 28.5% lower, at 78,056 people lost. There is a probable explanation for this massive spike in deaths: the global COVID-19 pandemic.
In California specifically, drug overdoses increased by 22.2% in 2021. The Betty Ford Center, a rehab facility located in California, admitted more residential patients in March 2022, than ever before. The reality of the situation is that the pandemic brought a lot of emotional and financial hardships to many people. There was a myriad of factors at play, such as people being in lockdown, forcing social isolation, and increasing bouts of depression. Also, there were periods of intense uncertainty about the future, causing understandable anxiety. Furthermore, many people lost their jobs, small business owners were under a lot of pressure to survive, and the economy as a whole was severely impacted.
Further Impacts of the Pandemic
Mental illnesses, such as depression and anxiety, are long understood to be predictors of drug abuse. While this surge in figures from 2020 to now seems somewhat shocking at first, upon closer inspection of the environment that created them, they make a great deal of sense.
The pandemic was also a burden on the health care system. As the demand for health care increased, the resources for those struggling with addiction were limited.
Another unfortunate byproduct of the pandemic was the restricted access for drug traffickers to the US. Because access was restricted, traffickers adapted to these limitations by increasing the sale of fentanyl. Fentanyl is high in potency and easier to transport than less dangerous drugs, so fentanyl has become more present in this population than ever before. As fentanyl is relatively cheap to buy, drug dealers adapted to this new environment by mixing more expensive drugs like cocaine with fentanyl. A person who, for example, takes cocaine regularly might know what dosage is typically safe for them with pure cocaine. Not realizing they have bought cocaine mixed with fentanyl, they could accidentally overdose on the same dose they usually take.
One can hope that as the pandemic dissipates, so too will these shocking figures. Unfortunately, the opioid crisis is not likely to go away on its own. Some suggestions for the future include providing people with drug testing kits to ensure drug purity, improving access to addiction treatment centers, and making overdose drugs such as Narcan more widely available. As we know that mental health issues are a massive predictor of potential substance abuse, making mental health treatment more accessible and less stigmatized could make a big difference in the long term. Hopefully, with positive change, we will see a decline in these shocking numbers. Every drug overdose death is preventable and addiction recovery is possible.