The Opioid Crisis

The night last summer when 17-year-old Jayla McBroom died of a fentanyl overdose, she returned late to her Washington, D.C., home, made a dance video in her room, posted it on social media, and went to bed.

In the morning, her mother tried to wake her but found her unresponsive and cold.

“I looked at her face and saw a white foam in her nostrils,” her mother, Shekita McBroom, told the Washington Post.

Jayla, described as a vibrant and athletic girl, had taken pills laced with the deadly synthetic opioid fentanyl. She’s now part of a distressing trend: a huge surge of overdose deaths since the Covid-19 pandemic began.

One night last summer, 17-year-old Jayla McBroom died of a fentanyl overdose. Late that evening, she returned to her Washington, D.C., home and made a dance video in her room. After she posted it on social media, she went to bed.

In the morning, her mother tried to wake her, but she didn’t respond and her skin felt cold.

“I looked at her face and saw a white foam in her nostrils,” her mother, Shekita McBroom, told the Washington Post.

Jayla, described as a vibrant and athletic girl, had taken pills laced with the deadly synthetic opioid fentanyl. She’s now part of a troubling trend: a huge surge of overdose deaths since the Covid-19 pandemic began.

In the 12-month period that ended in April, more than 100,000 Americans died of drug overdoses, up almost 30 percent from the year before, according to recently released data from the National Center for Health Statistics. That means more Americans died of overdoses than died of car crashes and gun fatalities combined. Since 2015, overdose deaths have more than doubled in the U.S.

“These are numbers we have never seen before,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse, of the overdose deaths. Most of these deaths are among people aged 25 to 55, in the prime of life, she adds. “This is a major challenge to our society.”

The loss of access to treatment facilities during Covid lockdowns, rising mental health problems amid pandemic stresses, and a wider availability of dangerously strong illegal drugs have all driven the most recent surge, federal researchers say.

In the 12-month period that ended in April, more than 100,000 Americans died of drug overdoses, according to recently released data from the National Center for Health Statistics. The number of drug overdose deaths increased by almost 30 percent from the year before. That means more Americans died of overdoses than died of car crashes and gun fatalities combined. Since 2015, overdose deaths have more than doubled in the U.S.

“These are numbers we have never seen before,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse, of the overdose deaths. Most of these deaths are among people aged 25 to 55, in the prime of life, she adds. “This is a major challenge to our society.”

There are several things fueling the most recent surge, federal researchers say. The pandemic is playing a major factor. That includes the loss of access to treatment facilities during Covid lockdowns and rising mental health problems amid pandemic stresses. A wider supply of dangerously strong illegal drugs has also contributed to the rise.

In particular, fentanyl—a synthetic painkiller that’s 100 times more potent than morphine—is to blame. It’s so powerful that ingesting an amount equal to a few grains of salt can be fatal. Fentanyl is cheap and made entirely in a lab, and Mexican drug cartels obtain it easily over the internet from China. They add it into heroin, cocaine, and methamphetamine (commonly known as “meth”) that’s smuggled into the United States to increase the drugs’ potency. Increasingly, fentanyl is added surreptitiously to other illegally manufactured drugs, including counterfeit pills, to enhance their potency.

“Many people are dying without knowing what they are ingesting,” Volkow says.

Fentanyl is to blame. This synthetic painkiller is 100 times stronger than morphine. It’s so powerful that ingesting an amount equal to a few grains of salt can be deadly. Fentanyl is cheap and made entirely in a lab. Mexican drug cartels can get it easily over the internet from China. They add it into heroin, cocaine, and methamphetamine (commonly known as “meth”) to increase the drugs’ potency. These laced drugs get smuggled into the United States. Increasingly, fentanyl is added secretly to other illegally manufactured drugs, including counterfeit pills. The addition also enhances the strength of these drugs.

“Many people are dying without knowing what they are ingesting,” Volkow says.

Doctors say that many of those who struggle with addiction became addicted after being given prescription opioids by medical providers for legitimate reasons, such as treating pain after surgery or an athletic injury. Some doctors—encouraged by opioid makers like Purdue Pharma, which produces OxyContin—have overprescribed the medications, contributing to the problem. (Purdue Pharma faces billions of dollars in lawsuits accusing the company of helping to fuel the nation’s opioid epidemic.)

“Teenagers are routinely being given opioids to this day when their wisdom teeth come out,” says Dr. Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University’s Heller School for Social Policy and Management.

Users often get hooked on prescription pills but then escalate to whatever will get them high, including injecting themselves with narcotics.

Doctors say that many of those who struggle with addiction became addicted after being given prescription opioids by medical providers. These medications treat legitimate needs, such as pain after surgery or an athletic injury. Some doctors have overprescribed the medications, contributing to the problem. They’ve done so after encouragement from opioid makers such as Purdue Pharma, which produces OxyContin. Purdue Pharma faces billions of dollars in lawsuits accusing the company of helping to fuel the nation’s opioid epidemic.

“Teenagers are routinely being given opioids to this day when their wisdom teeth come out,” says Dr. Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University’s Heller School for Social Policy and Management.

Users often get hooked on prescription pills. They then move on to whatever will get them high. That includes injecting themselves with narcotics.

Overdose deaths reached a peak nationally in the spring of 2020, during the pandemic’s most severe period of shutdowns. But public health experts say there was a prepandemic pattern of escalating deaths, as fentanyl became more entrenched in the nation’s drug supply, replacing heroin in many cities and finding its way into other drugs.

“Certainly, Covid didn’t help and likely exacerbated things, but we were seeing an increase before,” says Regina LaBelle, the acting director of the Office of National Drug Control Policy.

What can be done to address the opioid addiction crisis? Experts say it requires an investment in making drug treatment more accessible and providing more “harm reduction” strategies. The idea behind harm reduction measures is that it’s not always realistic to get drug users to stop right away, so in the meantime, the goal is to prevent them from doing lasting harm to themselves: Needle exchanges provide clean needles, so drug users are less likely to contract hepatitis C or H.I.V. Giving addicts rapid test strips that can detect fentanyl in illegal drugs can prevent people from accidentally overdosing.

Overdose deaths reached a peak nationally in the spring of 2020. That was the pandemic’s most severe period of shutdowns. But public health experts say there was a prepandemic pattern of rising deaths. They note that fentanyl had already become more common in the nation’s drug supply. As it spread, it replaced heroin in many cities and found its way into other drugs.

“Certainly, Covid didn’t help and likely exacerbated things, but we were seeing an increase before,” says Regina LaBelle, the acting director of the Office of National Drug Control Policy.

What can be done to address the opioid addiction crisis? Experts say it requires an investment in making drug treatment more accessible. They also say that more “harm reduction” strategies are necessary. The idea behind harm reduction measures is that it’s not always realistic to get drug users to stop right away. In the meantime, the goal is to keep them from doing lasting harm to themselves. Needle exchanges provide clean needles, so drug users are less likely to contract hepatitis C or H.I.V. Giving addicts rapid test strips that can detect fentanyl in illegal drugs can keep people from accidentally overdosing.

And increasing the availability of naloxone, a drug that can reverse an opioid overdose if given right away, can save lives. In New Jersey, for example, naloxone is now widely available from community organizations and pharmacists without a prescription. Officials say the distribution effort is a major reason overdose deaths in the state actually fell slightly last year, bucking the national trend.

“If you really want to see deaths come down, you have to make it much easier for someone who is addicted to opioids to access treatment,” Dr. Kolodny says. “It has to be easier to get treatment than to buy a bag of dope.”

And increasing the availability of naloxone can save lives. The drug can reverse an opioid overdose if given right away. Naloxone is now widely available without a prescription in New Jersey. People there can get it from community organizations and pharmacists. Unlike the national trend, overdose deaths in New Jersey actually fell last year. Officials say the Naloxone distribution effort is a major reason for the slight decrease.

“If you really want to see deaths come down, you have to make it much easier for someone who is addicted to opioids to access treatment,” Dr. Kolodny says. “It has to be easier to get treatment than to buy a bag of dope.”

With reporting by Roni Caryn Rabin of The New York Times.

With reporting by Roni Caryn Rabin of The New York Times.