By Chris Adams
In the United States, the opioids prescription rate hit its peak in 2012 and has slid gradually since then. Progress?
It’s better than nothing. But the rate is still three times that in Europe, indicating that the U.S. still has a long way to go to curb its opioids habit.
In a session with National Press Foundation fellows, a top official with the U.S. Centers for Disease Control and Prevention documented the extent of the crisis, how it evolved, and what federal officials are doing to mitigate it.
Dr. Grant Baldwin, who directs the CDC’s Division of Unintentional Injury Prevention, documented the by-now familiar increase in opioids deaths in the nation. In 2000, his map of every county in the U.S. showed only a couple red spots registering the CDC’s highest death rate level.
By 2016, huge swaths of the country – in Appalachia, Florida, the Southwest, and a smattering of other regions – were dark red.
While there are some signs use of opioids has plateaued, deaths are still increasing – a sign of the potency of the new forms of illicit opioids.
Baldwin explained how there have in fact been three waves of opioids deaths. The first was from prescription opioids, such as oxycodone; the second was from heroin; and the third from synthetic fentanyl. All three waves have gone up in recent years, and the spikes in heroin and fentanyl deaths were particularly sharp from 2010 on.
From 2010-2016, Baldwin said, 47 states had an increase in their drug overdose mortality rate. West Virginia’s rate in both 2010 and 2016 was the highest in the country.
What can be done about it?
The CDC’s plan has several parts, including efforts to improve data to better track the epidemic, boost state public health efforts and collaborate with public safety officials to respond more quickly and effectively to the problem.
The agency has also has recently published its “CDC Guideline for Prescribing Opioids for Chronic Pain,” with recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings.
It’s not a rule, a regulation or a law, he said. But it is a recommendation to foster the most productive and safe interaction between doctors and their patients – and to keep opioids prescriptions to the minimum needed. “Start low and go slow,” the guideline says. “When opioids are needed for acute pain, prescribe no more than needed.”