OPIOID EPIDEMICFentanyl and the U.S. Opioid Epidemic

By Claire Klobucista and Alejandra Martinez

Published 18 April 2023

Opioid addiction and abuse in the United States has become a prolonged epidemic, endangering public health, economic output, and national security. Since 2000, more than a million people in the United States have died of drug overdoses, the majority of which were due to opioids.

Fentanyl and other opioids are fueling the worst drug crisis in the history of the United States. More than 1,500 people per week die from taking some type of opioid, according to the National Center for Health Statistics, making opioids by far the leading cause of fatal overdoses in the country. 

In recent years, the crisis has become defined by fentanyl, a synthetic opioid that is some fifty times more potent than heroin.

Analysts say the opioid problem started with the overprescription of legal pain medications, but it has intensified in recent years due to influxes of cheap heroin and synthetic opioids, including fentanyl, supplied by foreign drug cartels. The crisis has reached such a scale that it has become a significant drag on the economy and a threat to national security.

Authorities in the United States and many other countries where opioid deaths have spiked, such as Australia and Canada, are experimenting with different policies to combat the crisis.

What Drugs Are Contributing to the Crisis?
Opioids, a class of drugs derived from the opium poppy plant, can be divided into two broad categories: legally manufactured medications and illicit narcotics.

Opioid medications, including oxycodone, hydrocodone, morphine, and fentanyl are often prescribed to treat severe pain, while methadone is primarily used in addiction treatment centers. Opioids gained popularity among doctors in the 1990s for treating patients who had undergone surgery or cancer treatment, but in the 2000s physicians increasingly prescribed them for chronic conditions, such as back or joint pain, despite concerns about their safety and effectiveness.

For decades, the most commonly used illegal opioid was heroin. However, by the end of the 2010s, heroin use and overdose deaths involving the drug appeared to be declining, according to the Centers for Disease Control and Prevention (CDC).

In recent years, synthetic opioids, and fentanyl in particular, have been driving a dramatic spike in overdose deaths. After its development in the 1960s, fentanyl was legally manufactured and prescribed as an intravenous anesthetic. And while it remains an important drug in health-care settings, its illegal manufacture and distribution has become a major threat to public health. In March 2023, Department of Homeland Security Secretary Alejandro Mayorkas called fentanyl overdoses “the single greatest challenge we face as a country.”