The Opioid Crisis—Not Just Opioids Anymore

Abstract

Now in its second decade, the opioid epidemic has claimed more than 800 000 lives in the US, more than the combined total of all deaths in all US wars and armed conflicts from the Revolutionary War to the present. Starting in approximately 2013, with the introduction of substantial quantities of the inexpensive and highly potent synthetic opioid fentanyl, the opioid epidemic entered a particularly lethal phase, with the death rate increasing more than10-fold. In 2020, the most recent year for substances known to be currently present in the drug supply. Second, it informs testing and treatment decisions. Third, it forms the basis for public policy decisions, such as a need to increase access to harm-reduction techniques, including naloxone distribution, test dosing, staggered administrations, safe injection sites, or fentanyl testing strips.