For over two decades, the U.S. has been mired in an ever-worsening drug crisis that has reached every corner of the country. Nearly 1 million Americans have died from a drug overdose since the turn of the century, the overwhelming majority from prescription opioids, heroin and synthetic opioids such as fentanyl. The costs have been enormous; the pain almost too much to bear.
But with a new year comes new hope.
Amid the torrent of bad news stories, some good news has started to emerge. Last month, the U.S. Centers for Disease Control released provisional data indicating a small decline in drug overdose deaths over a three-month period. The progress has been uneven, with some states recording continued increases in overdose deaths. However, even a modest decrease in the overall death rate is cause for optimism.
At nearly the same time, a research team led by the University of Houston published the preliminary results of a new opioid vaccine designed to help those suffering from opioid use disorder. The vaccine works by blocking opioids’ ability to enter the brain, thus eliminating the drug’s “high,” and has proven effective in mice. Clinical trials in humans are expected in the coming months.
This comes as more than $26 billion in opioid settlement money is finally starting to make its way to communities afflicted by the drug crisis. How that money is allocated is yet to be determined, but represents an unprecedented opportunity to drive real, lasting change to public health and safety.
And despite one of the most politically contentious environments in recent memory, even Congress has found common cause to combat the drug crisis, collaborating on legislation to improve drug education and prevention, expand access to treatment, and boost the production and distribution of the overdose-reversing medication naloxone, among other proposals.
These are positive developments, but there is still much work to be done. Despite a renewed focus on the drug crisis, the overdose death rate remains stubbornly high with over 107,000 Americans succumbing to drugs in the last 12 months alone. And while the opioid crisis initially started with white, middle-aged Americans, it now disproportionately impacts young people and communities of color, which often have less awareness of the threat and access to substance use treatment.
Meanwhile, the illicit drug supply is becoming even more dangerous. The U.S. Drug Enforcement Administration recently issued a public safety alert indicating that six out of 10 fentanyl-laced fake prescription pills contain a potentially lethal dose of fentanyl, a 50 percent increase from last year. Perhaps even more alarming is the emergence of terrifying new drug combinations, including “benzo dope” – a mixture of fentanyl and black-market benzodiazepines such as diazepam and alprazolam — and “tranq dope” — a mixture of fentanyl and xylazine, an animal tranquilizer linked to severe skin ulcers, wounds and amputations, among other complications.
The U.S. should celebrate the progress that has been made in the fight against opioids, while at the same time recognizing it is far too soon to declare victory. The U.S. must channel this newfound sense of optimism to double down on counterdrug efforts and solidify the hard-fought gains rendered through years of tragedy. While help is on the way in the form of additional funding, authorities and medically assisted treatment, it has been slow to arrive and largely inadequate given the scale and urgency of the crisis. The U.S. must continue to pursue an all-of-the-above strategy to address the drug crisis while emphasizing those policies that have shown to be most effective in curbing drug use and overdose deaths.
The drug crisis did not begin — and will not end — overnight. It took years for the crisis to reach this point, and sadly, it will take many more for it to finally subside. But with a lot of work and a little luck, maybe — just maybe — this year will mark the beginning of the end.
Jim Crotty is the former deputy chief of staff at the U.S. Drug Enforcement Administration.