Along with the COVID-19 pandemic and its instantly recognizable waves of infected and dead, there is another deadly plague in this great nation, which has also recently reached its highest peak of casualties. The opioid epidemic. And although tens of thousands of people are dying from previously unknown types of narcotics in this tsunami of addiction and disappearance, the American public is still talking about the waves of the opioid epidemic that occurred years ago. , and watch Hulu’s “Dopesick,” of course.
But, what exactly is going on? In the past few months, two major announcements have been made to the public by critical federal institutions that are not drama-prone and I will go into detail on both. But what they had to say was nothing short of tragic. First, on September 27, the Drug Enforcement Agency (DEA) issued a Public Safety Alert, the first such document in six years. The agency warned of the seriousness of the problem of drug overdoses, reporting that there were more than 93,000 deaths from this cause in the United States alone in 2020, most from opioids. This is a sharp increase from 2019 with more than 70,000 deaths and 2018 with 67,000. The DEA says the rise was caused by sales of illicit drugs on social media and trading platforms electronically and organized by international criminal networks, both of which specifically targeted young people. And then, even more shockingly, the Center for Disease Control and Prevention (CDC) issued an urgent advisory Press release on November 17, with the title “Drug Overdose Deaths in the US Top 100,000 Annually”. The time period in question counted the victims from April 2020 to April 2021, and the drug that caused the 100,306 deaths should be a symbolic straw that causes us to see this as everyone’s problem.
So why don’t we talk about it more? The DEA’s call for the public to take the matter seriously did national news but was also quickly forgotten. The CDC’s warning suffered a similar fate, though the huge round number they pointed to may have struck a chord with the public at the time, but more likely not. How to explain this never seen danger of drugs? That people don’t get high, they just die.
I would say that in the United States, one of the reasons for ignorance on this issue is ignorance about counterfeit pharmaceuticals, lack of knowledge of the dangers they pose, or even what they are . And it is these fake drugs that are the primary driver of tens of thousands of unnecessary deaths. Counterfeit or falsified drugs are almost perfect copies of legal prescription drugs. Sometimes they look even better than the actual product and have been historically bound with potency pills, slimming products, anabolic steroids and other so-called “lifestyle” drugs. However, there has been a change specific to the United States in recent years that has required criminals to adapt to market needs. You see, federal and state governments in the United States insisted that doctors stop overprescribing opioids, based on CDC guidelines that redefined pain management.
Therefore, it can be assessed that because of this, the already hooked masses turned to ISPs for their next fix. Fake pill customers have changed, and nowadays, instead of drugs to improve their appearance or effectiveness, they prefer prescription opioids. As a result, illegal manufacturers have started mass producing and distributing new types of counterfeit pills that you would usually get from pharmacies.
That’s not to say the government isn’t trying to fix all of this, and in such a dynamic area of public health, there’s been a recent pushback to once again change the approach to opioid prescribing so solve at least some of the problems raised above. There are novelties eagerly awaited CDC guidelines it will redefine the way pain is treated and it will surely help alleviate the needs of many patients who have turned to the black market for the management of their pain.
But the problem of counterfeit drugs will not go away on its own, I can attest to that myself. Personally, I have worked or better yet, struggled in this field for over a decade in Europe and around the world and continue to do so during my Humphrey Fellowship at Emory University. I have always had to face an uphill battle to raise awareness of the seriousness of the situation in terms of illicit drugs. I feel compelled to warn the public again and again of the grueling consequences of this problem. Based on restrictive estimates by the World Health Organization and Interpol, the perpetrators of these de facto crimes against humanity profit more than 200 billion dollars a year, killing more than 250,000 unsuspected patients around the world, the majority of them children. However, there is something surprisingly new and wrong with fake drugs in the United States.
The most dangerous element of the current counterfeit prescription drug problem in the United States is that well-known opioids like oxycodone, hydrocodone and alprazolam, or stimulants like amphetamines, are not only fake and poor quality, but also mixed with undesirable deadly substances. The most dangerous of these secret ingredients is heroin’s synthetic cousin: fentanyl. The drug is up to 100 times more potent and deadly in a dose of less than two milligrams – small enough to fit on the tip of your pencil. Criminals put fentanyl in their counterfeit drugs to Craft their product stronger and more addictive, but without precision of actual pharmaceutical production. As a result, up to two out of five pills to have the potential to kill. Essentially, every time someone buys these pills and puts one in their mouth, it’s like they’re unknowingly playing pharmacological Russian roulette.
With all of this in mind, it is evident that there is a lack of knowledge about the true nature of the latest opioid epidemic wave in the United States, not only among addicts, but also the general public. This problem cannot and should not be limited to the addict level, because even someone taking an opioid for the first time can die after just one pill. We need to educate, campaign and engage communities or just speak out in our social circles about counterfeit prescription opioids to understand the nature, sources and danger of these fake drugs. But we must speak now, or thousands more lives will be at risk.
Pavle Zelic is a Humphrey Fellow from Serbia.