Experts and laypeople alike have been horrified by the slow escalation of the opioid crisis over the past decade. Now, new figures from the Centers for Disease Control and Prevention suggest that the number of overdose deaths may have recently begun to level off. Although this plateau in the overdose rate was celebrated in the media, a more nuanced look at the situation suggests that the crisis is far from over.
Recent Plateau in Drug Overdose Deaths
Public health officials and medical professionals carefully watch the statistics related to opioid overdose deaths to detect patterns over time. For the past few years, overdose deaths have sharply increased, signaling the escalation of the opioid epidemic. In late October 2018, the CDC released preliminary data suggesting that the overdose death rate had finally begun to plateau. From 2016 to 2017, the number of Americans dying from drug overdoses rose from 64,000 to 72,000, an increase of nearly 13%. However, the new provisional data from the CDC shows that opioid deaths stopped rising near the end of 2017. This trend continued into the beginning of 2018, suggesting that the rate of opioid deaths may finally have started to slow.
However, even the administration official presenting the statistics to the public was quick to urge caution when interpreting the statistics. Alex Azar, secretary of the U.S. Department of Health and Human Services said that the findings were “hardly a victory,” given that opioids continue to kill 115 Americans each day. He went on to say, “We are so far from the end of the epidemic, but we are perhaps at the end of the beginning.”
Potential Reasons the Overdose Death Rate Has Hit a Plateau
One possibility is that the new figures reflect a true decline in the rate of opioid abuse and dependence in the United States. Unfortunately, this is not likely the case, as the HHS secretary’s remarks illustrate. Thousands of people are still living with opioid addiction. They have simply replaced their addiction to pain pills or heroin with a dependence on medications.
The public health response to the opioid crisis has focused heavily on medications such as buprenorphine (Suboxone) and naltrexone (Vivitrol). These medications are opioid antagonists, meaning that they bind to opioid receptors very tightly, blocking the effects of other opioids. The catch is that people following medication-assisted treatment programs must continuously take the medications lest they experience a relapse. In effect, they’ve swapped one drug for another.
This also shows the folly of relying on overdose death statistics to illustrate the broader opioid epidemic. People in medication-assisted treatment programs may not be dying of overdoses at a higher rate, but their bodies continue to be dependent on opioids to function. Does that really mean we’ve stopped the opioid crisis? Of course not! Focusing solely on overdose deaths hides the thousands of people who struggle daily with their opioid use.
Moving Forward to Address the Opioid Crisis
Congress and the president have been quick to tout the sweeping opioid bill that was signed into law in late October. The new law makes it difficult for drug traffickers to send fentanyl through the mail, expands coverage for substance abuse under Medicare and Medicaid, and provides some funding to expand treatment programs. However, the law funnels much of the treatment dollars toward medication-assisted treatment programs (e.g., suboxone or methadone clinics).
This shows the short-sightedness of the public health response to the opioid crisis. Rather than helping people stop using the drugs they have become dependent on, we simply replace them with another drug. This is the definition of insanity — trying the same thing over and over, expecting different results. Sadly, the people suffering from opioid addiction are the ones who pay the price for this misguided policy.
It’s time for a smarter approach. We need investment in treatment programs that truly work. Programs such as the Waismann Method® emphasize medical detoxification from opioids, followed by an individualized emotional assessment to address the factors that perpetuate addiction. By combining science with compassion, we are able to help people work toward a sustained recovery from opioids. We believe that rather than masking the opioid problem by giving a person more drugs, we must help our patients work through the underlying issues (e.g., pain, loss, trauma, abuse) that caused them to use drugs in the first place. Sadly, without expanded access to treatment programs like this one, the people struggling with opioid abuse will continue to suffer.