Opioid epidemic in the United States

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Disease Control and Prevention. Overdose deaths increased 28.5% from the same period a year earlier and nearly doubled over the previous five years. Opioids continued to be the primary cause of drug overdose deaths. Additionally, the drug is increasingly affecting younger populations. A 2018 study found that fentanyl is involved in the majority of opioid-related deaths and that deaths involving fentanyl were more likely to occur in younger age groups and among non-Hispanic white individuals. Furthermore, young adults are increasingly affected by nonfatal fentanyl overdoses in recent time periods along with these other deadly occurrences. Many sources point to fentanyl as the leading cause of teen overdose death. According to a 2022 study in the Journal of the American Medical Association, between 2010 and 2021, the number of teenage deaths caused by black-market fentanyl and related synthetic substances increased more than twentyfold, from 38 to 884. The drug is 50 to 100 times stronger than morphine and often cut with other drugs, meaning the user does not know they are taking fentanyl. The Drug Enforcement Administration (DEA) says 2.2 pounds represents half a million lethal doses. Synthetic opioids, primarily fentanyl, caused nearly two-thirds (64%) of all drug overdose deaths in the 12-month period ending April 2021, up 49% from the year before, the CDC's 's National Center for Health Statistics found.

916:. It is pure white, odorless and flavorless. The potency of fentanyl has led to the mistaken belief that exposure to fentanyl by touch can cause an overdose, a myth that has been repeated by media outlets and even government publications. As a result, the Drug Enforcement Administration has recommended that officers not field test drugs if fentanyl is suspected, but instead collect and send samples to a laboratory for analysis. "Exposure via inhalation or skin absorption can be deadly," they state. However, the American College of Medical Toxicity and the American Academy of Clinical Toxicology stated that, as of 2017, they were not aware of "emergency responders developing signs or symptoms consistent with opioid toxicity from incidental contact with opioids.". A 2021 article in the journal Health & Justice reported that "many of the reported fentanyl exposure incidents among police share the symptoms of a panic attack rather an opioid overdose," and a 2020 article from the Journal of Medical Toxicology stated that "the consensus of the scientific community remains that illness from unintentional exposures is extremely unlikely, because opioids are not efficiently absorbed through the skin and are unlikely to be carried in the air." 1152:

does not only impact access to social and economic resources. It also has an impact on public health and disrupts access to health care. The impact that racial segregation has health care spills over to the access of substance use services. This leads to Black Americans having a more difficult time when seeking treatment for opioid use. Structural racism has also led to the consistent misdirection of funds and the over-funding of criminal legal systems within predominantly non-Hispanic Black communities. Instead of funding being used to improve substance abuse treatment and prevention, funds have been used to criminalize drugs and impose harsh penalties on Black community members. The policies put in place years ago have led to stereotyping and fear within Black communities that prevents Black Americans from seeking substance abuse treatment. In America there are continual concerns regarding racial biases against non-Hispanic Black Americans when it comes to drug enforcement. Black Americans have historically been more criminalized for opioid related offenses, and despite calls for change there are still lasting impacts of this today.

2834:(DEA). The order allowed the Post access to the DEA Automation of Reports and Consolidated Orders System (ARCOS), a system that traces the manufacture, distribution and retail sale of every pain pill in the US. The Post's analysis of the data indicated 76 billion oxycodone and hydrocodone pain pills were distributed throughout the US 2006–2012. 57 billion (75%) of these pain pills were distributed by these companies: McKesson Corporation, Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart. Nearly 67 billion (88%) of the drugs were manufactured by SpecGx, a subsidiary of Mallinckrodt; Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals. The greatest number of pills/person were found in West Virginia – 66.5; Kentucky – 63.3; Tennessee – 57.7; and Nevada – 54.7. The highest opioid overdose rate 2006-2012 was in West Virginia. Rural communities were hit particularly hard. 306 pills/person/year were shipped to Norton VA; 242 to Martinsville VA; 203 the Mingo County WV; and 175 to Perry County KY. 1205: 881: 367: 339: 312:, in which people not qualifying for government programs are required to obtain private insurance, favors prescribing drugs over more expensive therapies. According to Professor Judith Feinberg, "Most insurance, especially for poor people, won't pay for anything but a pill." Prescription rates for opioids in the United States are 40 percent higher than the rate in other developed countries such as Germany or Canada. While the rates of opioid prescriptions increased between 2001 and 2010, the prescription of non-opioid pain relievers (aspirin, ibuprofen, etc.) decreased from 38% to 29% of ambulatory visits in the same period, and there has been no change in the amount of pain reported in the United States. This has led to differing medical opinions, with some noting that there is little evidence that opioids are effective for chronic pain not caused by 1148:

percentage change of opioid overdose deaths among Black Americans increased to 26.16 from 2012 to 2018 while White Americans only experienced an 18.96 increase from 2013 to 2016 and even had an annual percentage change decrease to 5.07 from 2016 to 2018. The challenges that non-Hispanic Black Americans face have a disparate impact on the rates of opioid-overdose related deaths when compared to non-Hispanic White Americans who have not dealt with the challenges of structural racism. Recent research has linked the rise in opioid-overdose deaths among Black Americans to the lack of safety, security, stability, and survival in their communities. Those missing pieces in these communities can be linked to a host of things including exposure to structural racism, lack of access to resources, and widespread mistrust in the healthcare system.

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increased marginally, while heroin-related deaths remained relatively stable. The demographic affected during this wave was younger, less frequently male, and more likely to be white and rural compared to the previous waves. However, it's worth noting that the third wave also witnessed an increase in opioid-related overdoses among Black and Hispanic individuals in urban areas who use drugs. The rise in fentanyl-related deaths is attributed to the fact that fentanyl is 50 to 100 times more potent than morphine, and it is often mixed into heroin or cocaine to increase potency at a low cost. Considering that Black Americans tend to consume cocaine more frequently than heroin or other prescription opioids compared to white populations, the increase in deaths is linked to the greater prevalence of fentanyl-laced cocaine.

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more over 106,000 in 2021, the greatest number of overdose deaths recorded in a 12-month period. Most of these deaths were caused by synthetic opioids other than methadone (mostly fentanyl or analogues) and methamphetamine. During this time, non-Hispanic Black and non-Hispanic American Indian populations had the highest rate of overdose deaths, and non-Hispanic American Indian and white populations had the greatest increase in overdose rates. Further, during the first year of the COVID-19 pandemic, overdose disparities widened between Black persons and White persons. For example, in 2020, overdose rates among Black men 65 years or older (52.6 per 100 000) were nearly 7 times those of White men of the same age (7.7 per 100 000).

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overdose, and NALs increase the distribution and accessibility of Naloxone. Research suggests that increasing naloxone access will be the second most effective intervention for reducing overdoses. Most states have the following three or varying degrees of Naloxone access: third party distribution, pharmacist prescribing power, and standing orders. The standing order for naloxone allows for its distribution to a patient if they meet a certain criterion, which is most often the prescription of an opioid. The effectiveness of this legislation has been disputed since its success depends on the change in behavior of people who are present during an overdose and the accessibility of naloxone.

67: 947: 579: 294:(defined as the practice of using multiple drugs at once or in succession) and stimulants is linked to the increased fatality rate with the ongoing opioid epidemic. Between 2012 and 2018, there was a threefold increase in mortality related to cocaine use and a fivefold increase in mortality related to psychostimulants like methamphetamine. This increase has primarily been observed in male populations from non-Hispanic American Indian, non-Hispanic Black, and non-Hispanic White populations. Researchers attribute the increase in illicit drug use to the CDC's recommendations to reduce opioid use through measures like tapering opioid prescribing. 850:

benzodiazepines. Benzodiazepines by themselves put older people at risk for falls and fractures due to associated side effects related to dizziness and sedation. Opioids by themselves put older people at risk of respiratory depression and impaired ability to operate vehicles and other machinery. Combining these two drugs together not only increases a person's risk of the aforementioned adverse effects, but can increase a person's risk of overdose and death. Benzodiazepines are also the second leading cause of teen overdose death after fentanyl. They killed 152 people in 2021, less than a fifth of fentanyl's death toll.

45: 270: 199: 1012:(CDC), death rates from synthetic opioids, including fentanyl, increased over 72% from 2014 to 2015. In addition, the CDC reports that the total deaths from opioid overdoses may be under-counted, since they do not include deaths that are associated with synthetic opioids which are used as pain relievers. The CDC presumes that a large proportion of the increase in deaths is due to illegally-made fentanyl; as the statistics on overdose deaths (as of 2015) do not distinguish pharmaceutical fentanyl from illegally-made fentanyl, the actual death rate could, therefore, be much higher than reported. 2105:'s interference with both social safety and health care delivery systems has intensified the opioid epidemic. US media, on national, state, and local levels, infer that overdose deaths are increasing. But there is no national reporting system on overdose mortality to confirm these reports. Conclusions on the relationship between increasing overdose fatalities and the COVID-19 pandemic will require more research. Studies, such as those by Wainwright et al. and Ochalek et al. estimate that opioid use and overdose deaths may be increasing, just as reported by the media. But more study is needed. 15287: 3108:

were related to reductions of mortality in Black and Hispanic populations. Rees et al. (2019) found that NALs were associated with a statistically significant decrease in non-heroin opioid-related deaths. The adoption of a GSL resulted in a decrease of 12–19%; early adopters of NALs or those that passed NALs before 2011 experienced an 18–29% reduction in overdoses. However, it was also found that NALs were only effective on the Western coast, and the Eastern and Southern US experienced little impact due to fentanyl not fully reaching the West in 2014.

328:, which bought 13 billion oxycodone and hydrocodone pills from 2006 through 2012 (about twenty percent of all such pills in US pharmacies). Though aggressive opioid prescription practices played the biggest role in creating the epidemic, the popularity of illegal substances such as potent heroin and illicit fentanyl has become an increasingly large factor. It has been suggested that decreased supply of prescription opioids caused by opioid prescribing reforms directed people who were already addicted to opioids to illegal substances. 261:

representing an almost 50% increase compared to previous years. This sharp increase can be attributed to the availability of heroin in the United States and its decreasing prices, which enticed a significant portion of individuals already dependent on opioids to switch to a more potent and cost-effective alternative. During this same period, there was also a reformulation of OxyContin that made it more difficult to crush and misuse, although the precise impact of this reformulation on the rise in heroin use remains uncertain.

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opioids. In addition, structural health care deficiencies from the provider and cultural beliefs against receiving care from the patient, as well as inadequate community support structures for substance misuse, contributed to high mortality rates. In 2015, American Indians/Alaska Natives had the greatest drug overdose mortality rates of any U.S. population, comparable to White Americans. In 2018, the opioid crisis continued to disproportionately affect non-Hispanic Whites and Native Americans with the

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million people in the United States were estimated to be affected by chronic pain; however, opioids were only reserved for acute pain experienced secondary to cancer or terminal illnesses. Physicians avoided prescribing opioids for other medical conditions because of the lack of evidence supporting their use, the concern of opioids having addictive properties, and the fear of being investigated or disciplined for liberal opioid practices. However, in 1980,

426: 414: 399: 1125:. The prevalence of opioid overdose deaths per 100,000 within the USA was highest for non-Hispanic White, followed by Black, Hispanic, and Asian/Pacific Islander individuals. During the first and second wave of the opioid epidemic, White American people were most affected by opioid overdose. While all groups were affected in the third and fourth wave of the epidemic, White Americans and non-Hispanic Black individuals saw the greatest rise in deaths. 3201: 236:." This was coupled with the promotion of opioids by pharmaceutical companies who insisted that patients could not become addicted. Opioids became an acceptable treatment for a wide variety of conditions, leading to a consistent increase in opioid prescriptions. From 1990 to 1999, the total number of opioid prescriptions grew from 76 million to approximately 116 million, making them the most prescribed class of medications in the United States. 772: 3527:. Hover cursor over the end of the graph in Figure 1A to get the latest number. Scroll down the page and click on the dropdown data table called "Data Table for Figure 1a. 12 Month-ending Provisional Counts of Drug Overdose Deaths". The number used is the "predicted value" for the 12 month period that is ending at the end of that month. That number changes as more info comes in. If there are problems use a different browser. 3221:" is a clinic that dispenses narcotics to patients without a legitimate medical purpose. This is done at clinics and doctors' offices, where doctors examine patients extremely quickly with a purpose of prescribing painkillers. These clinics often charge an office fee of $ 200 to $ 400 and can see up to 60 patients a day, which is very profitable for the clinic. Pill mills are also large suppliers of the illegal painkiller 12087:

Suboxone. Together with a $ 1.4 billion resolution with Indivior's former parent, Reckitt Benckiser Group PLC (RB Group), announced in 2019, and a plea agreement with Indivior plc's former CEO, Shaun Thaxter, announced last month, the total resolution relating to the marketing of Suboxone is more than $ 2 billion — the largest-ever resolution in a case brought by the Department of Justice involving an opioid drug.

584: 580: 3188:. Because federal funding has long been banned from being used for NEP, their prominence in the US has been minimal. However, in early 2016, in the face of the ever-increasing heroin crisis, Congress effectively rolled back those regulations and is now allowing federal funding to support certain aspects of NEP. NEP are cited by the CDC as a vital aspect of the multi-faceted approach to the opioid crisis. 582: 3087:, and aimed to end the War on Drugs and promote harm reduction. The conference brought "scholars, researchers, doctors and other health care providers, drug-treatment providers and a handful of police officials" from across North America and Europe together to discuss approaches in combatting heroin overdoses. While some strategies endorsed in the program, including needle-exchange programs and 103:(CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The second wave was from an expansion in the heroin market to supply already addicted people. The third wave starting in 2013 was marked by a steep 1,040% increase in the synthetic opioid-involved death rate as synthetic opioids flooded the US market. 583: 2633:

programs. J&J will pay $ 5 billion (US) over the next five years; the remaining $ 21 billion (US) will be paid by the other firms. The settlement, when approved by a "significant" group of states and local governments, will settle more than 4,000 individual legal actions. All four of the manufacturing firms disputed all allegations in the lawsuits.

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those deaths. In 2017 alone, there were 70,237 recorded drug overdose deaths; of those deaths, 47,600 involved an opioid. A report from December 2017 estimated that 130 people die every day in the United States due to opioid-related drug overdose. The great majority of Americans who use prescription opioids do not believe that they are misusing them.

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proven effectiveness. The national focus being on prescription of opioids for pain management is a leading cause for non-Hispanic Black Americans receiving unequal treatment opportunities. Data has shown that this is not the main issue in every city/state, which shows the need for a more local data driven approach to opioid abuse intervention.

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and do not explain this variability in prescribing. Researchers suspect that the variation results from a lack of consensus among elected officials in different states about how much pain medication to prescribe. A higher rate of prescription drug use does not lead to better health outcomes or patient satisfaction, according to studies.

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recovery through outreach from trusted staff. In addition, NEP that operate on a one-for-one basis help to drastically reduce the amount of discarded needles in public. Both the Center for Disease Control and National Institute of Health support the idea that NEP are a crucial aspect to a comprehensive approach to the opioid crisis.

2259:, or "drug czar". One interview in 2015 with the then Director of the White House Office of National Drug Control Policy under the Obama administration, Michael Botticelli, where he states that because opioid users are predominantly 'white and middle class', they "know how to call a legislator, fight with their insurance company." 3150:

community on how to use naloxone. Early implementation of programs that widely distribute THN kits across these areas can substantially reduce the number of opioid overdose deaths. Additionally, persons at risk for opioid overdose did not engage in riskier, compensatory drug use as a result of having access to naloxone kits.

174:. Traditionally, opioids have been prescribed for pain management, as they are effective for treating acute pain but are less effective for treating chronic pain. Clinical guidelines advise that opioids should only be used for chronic pain if safer alternatives are not feasible, as their risks often outweigh their benefits. 866:," reported that codeine is most widely used in a recreational way by men, Native Americans and Hispanics, urban students, and LGBT persons. The study also noted that all people who used "purple drank" reported using alcohol within the past month, and roughly 10 percent of cannabis users reported abusing "purple drank". 5394: 2589:. These chains are accused of not having enough trained staff and sophisticated systems to responsibly dispense opioids. Lawyers allege that pharmacies have not fulfilled their legal responsibility to act as a "last line of defense," and that the chains enable illegal street dealing of prescription opioids. 3146:, which prevents them from being activated by opiates. It binds more strongly than other drugs, so that when someone is overdosing on opioids, naloxone can be administered, allowing it to take the place of the opioid drug in the person's receptors, turning them off. This blocks the effect of the receptors. 2803:

addicts, often of heroin, reinforcing stereotypes of drug users and drug-using offenders. In newspapers, white addicts' stories are often given more space, allowing for a longer backstory explaining how they became addicted, and what potential they had before using drugs. In early 2016 the national desk of

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According to Forbes, the Sacklers are now one of America's richest families, with a collective net worth of thirteen billion dollars—more than the Rockefellers or the Mellons... While the Sacklers are interviewed regularly on the subject of their generosity, they almost never speak publicly about the

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Despite the illegality of injecting illicit drugs in most places around the world, many injectable drug users a report willingness to utilize overdose prevention centers. Those at especially high risk for overdose were significantly more willing. This observed willingness suggests that safe injection

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From 2000 to 2014, McClellan et al. (2018) found that opioid overdose mortality decreased by 14% and 15% when laws increased the engagement of layperson intervention, respectively, through an increase in NALs or GSLs. NALs were related to greater reductions in mortality in Black populations, and GSLs

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The price of opioid treatment may vary due to different factors, but the cost of treatment can range from $ 6,000 to $ 15,000 a year. Based on the research, most addicts come from lagging economic environment which multiple addicts do not have the support or funding to complete alternative medication

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Buprenorphine, on the other hand, is not covered by Medicaid or, often, even by private health insurers. Because buprenorphine must typically be paid for out-of-pocket, lower-income individuals are often priced out of the lower-risk MAT. In some areas this creates major disparities along racial lines

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began a survey of the laws and regulations around opioid treatment programs and medication-assisted treatment and found that they were barriers to getting people with opioid use disorders the treatment they need. Despite the fact that there is a shortage of opioid treatment programs across the United

2794:. Patrice A. Harris, chair of the AMA Opioid Task Force, urges increased participation by physicians, saying "what is needed now is a concerted effort to greatly expand access to high quality care for pain and for substance use disorders. Unless and until we do that, this epidemic will not end." 2661:

More than 2,600 lawsuits against the US pharmaceutical industry are still in the offing. The plaintiffs in those cases said the Ohio settlement allows them time to attempt to negotiate a national settlement. It also pressures the participants to work out a deal, as every partial settlement diminishes

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In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices (such as prescribing high doses of opioids or prescribing opioids long-term). These

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approved the SUPPORT for Patients and Communities Act (H.R. 6). The committee reached a final agreement on terms of the bill on September 25, 2018. The final agreement included provisions from multiple other acts, such as The Opioid Crisis Response Act of 2018, The Helping to End Addiction and Lessen

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Statistics reveal that during the COVID-19 epidemic, drug overdoses increased. According to statistics from the Centers for Disease Control and Prevention, there were 91,799 overdose fatalities in the United States in 2020, a more than 30% rise from 2019. Drug-related overdose fatalities increased to

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Prescription rates for opioids vary widely across states. In 2012, healthcare providers in the highest-prescribing state wrote almost three times as many opioid prescriptions per person as those in the lowest-prescribing state. Health issues that cause people pain do not vary much from place to place

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In 2014, roughly 12 percent of young adults between the ages of 18 and 25 reported abusing prescribed opioids. Non-medical prescription drug use rates have been increasing in teenagers with access to parents' medicine cabinets, especially as 12- to 17-year-old girls were one-third of all new users of

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individuals in 2020 and 2021. The percentage of individuals with documentation of prior treatment for substance use disorders was low, especially among Black individuals, at 8.3%. Overall, Hispanic, non-Hispanic Native Hawaiians, and non-Hispanic Asians experienced the lowest rate of overdose deaths.

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million worth of fentanyl was illegally sold online to the US by Chinese distributors. The drug is usually manufactured in China, then shipped to Mexico, where it is processed and packaged, which is then smuggled into the US by drug cartels. A large amount is also purchased online and shipped through

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The elderly are at an increased risk for opioid related overdose because several different classes of medications can interact with opioids and older patients are often taking multiple prescribed medications at a single time. One class of drug that is commonly prescribed in this patient population is

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The Centers for Disease Control and Prevention describe the U.S. opioid epidemic as having arrived in three waves. However, recent research indicates that since 2016, the United States has been experiencing the fourth wave of the opioid epidemic. The epidemic began with the overprescription and abuse

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required training, as well as apply for and receive a waiver from SAMHSA. Under regulation, physicians may not have more than 30 buprenorphine patients in their first year of prescribing the drug. They may apply to have this limit increased to 100 patients by year two and 275 patients by year three.

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In 2016, the CDC published its "Guideline for Prescribing Opioids for Chronic Pain", recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever

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During times of economic distress such as the COVID-19 pandemic or the 2008 recession, harmful rates of drug use has been seen to increase in populations experiencing joblessness and disadvantaged populations; moreover, Carpenter et al. found evidence that economic downturns lead to increases in the

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Healthcare professionals are also among those heavily affected by this epidemic. Studies have been done to determine how well nursing students, nurses, and even doctors are prepared to treat patients affected by opioid addictions. The studies have pointed to the fact that nurses and other healthcare

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Structural racism continues to have a lasting impact on predominantly Black communities in the United States. Racial segregation is one of the main forms of structural racism that has been linked to the increase in opioid-overdose related deaths among non-Hispanic Black Americans. Racial segregation

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identified the root causes of the increase in opioid deaths as high levels of poverty, income inequality, and unemployment due to deteriorating labor markets, a lack of access to social capital, a lack of access to healthcare, and high social isolation. They reported that opioid overdose deaths were

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In 2015, approximately 50% of drug overdoses were not the result of an opioid product from a prescription, though most recreational users' first exposure had still been by lawful prescription. By 2018, another study suggested that 75% of people who use opioids recreationally started their opioid use

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The potency and availability of opioids have made them popular as both medical treatments and recreational drugs. In 2018, the U.S. opioid prescription rate was 51.4 prescriptions per 100 people, equivalent to more than 168 million total opioid prescriptions. However, these substances also have high

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While opposition to NEP includes fears of increased drug use, studies have shown that they do not increase drug use among users or within a community. NEP have also been known to increase admittance into addiction treatment centers, offer counseling, housing support and help users begin the path to

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programs operate under the understanding that certain levels of drug use are inevitable and focus on minimizing adverse effects associated with drug use. In the context of the opioid epidemic, harm reduction strategies are designed to improve health outcomes and reduce overdose deaths. Because many

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is used similarly to methadone, with some doctors recommending it as the best solution for medication-assisted treatment to help people reduce or quit their use of heroin or other opiates. It is claimed to be safer and less regulated than methadone, with month-long prescriptions allowed. It is also

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compliance in the program. In rural Vermont, 48% of respondents in treatment reported they had missed an appointment due to travel challenges. Because of issues like these, it is estimated that, nationwide, only 10% of individuals who would be eligible to receive MAT actually receive the treatment.

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Other individual-level barriers may include transportation, especially for those who live in rural areas. The nearest Opioid Treatment Program (OTP) could be up to an hour away, and when daily methadone doses are required for treatment, this may interfere with the success of the MAT or the client's

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Individual-level barriers to accessing medication-assisted treatment also exist. The federal regulations regarding program admission into treatment programs are considered "high-threshold." Individuals seeking treatment must meet several criteria to be eligible for treatment. These criteria require

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concluded that there is little evidence that drug-monitoring databases are having a positive effect on the number of drug overdoses in the US. Researcher Chris Delcher also concluded that "there was a concurrent rise in fatal overdoses from fentanyl, heroin and morphine" due to ease of availability

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As of 2019, half of all US states have "homicide-by-overdose" or "drug-induced homicide" (DIH) laws. While these laws date back to the 1980s, they were originally used infrequently. Prosecutions dramatically increased in the 21st century. (In 2000, there were 2 prosecutions; in 2017, there were 717

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Dozens of states are suing pharmaceutical companies, accusing them of causing the epidemic. Suits filed by almost 2,000 cities, counties, and tribal lands have been rolled into a single federal case scheduled to be heard in Fall 2019. In the first state case to reach a decision, on August 26, 2019,

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Other studies have looked at treatments for OUD during the COVID-19 pandemic. For example, one JAMA Internal Medicine research letter from December 2020 found that since the COVID-19 national emergency declaration, "the number of individuals filling buprenorphine prescriptions has plateaued but has

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In one study, a decision analytical model of the US population aged 12 years or older found that "under the status quo, an estimated 484,429 individuals were projected to die of fatal opioid overdose" between 2020 and 2029. However, a combination of "reducing opioid prescribing, increasing naloxone

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billion, most of which was attributed to health care and criminal justice spending, along with lost productivity. By 2015 the epidemic had worsened with overdose and with deaths doubling in the past decade. The White House stated on November 20, 2017, that in 2015 alone the opioid epidemic cost the

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Medication-assisted treatments like buprenorphine have been proven to help treat substance use. The facilities that offer this treatment tend to be in communities with predominantly non-Hispanic White populations and they are rarely seen in predominantly non-Hispanic Black communities despite their

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died of drug overdoses related to opioids. William D. Bodner of the Drug Enforcement Administration's Los Angeles field division and special agent in charge of the investigation into Miller's death said in a statement, "The tragic death of Mac Miller is a high-profile example of the tragedy that is

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In 2016, around 64,000 Americans died from overdoses, 21 percent more than the approximately 53,000 in 2015. By comparison, the figure was 16,000 in 2010, and 4,000 in 1999. While death rates varied by state, in 2017 public health experts estimated that nationwide over 500,000 people could die from

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hosted over forty promotional conferences at three select locations in the southwest and southeast of the United States. Coupling a convincing "Partners Against Pain" campaign with an incentivized bonus system, Purdue trained its salesforce to convey the message that the risk of addiction was under

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in a controlled manner, decreasing the likelihood of relapse, though some jurisdictions allow for indefinite maintenance on a dose at which the patient is comfortable. It is not accessible to all addicts. It is a regulated substance, and requires that each dose be picked up from a methadone clinic

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PDMPs allow pharmacists and prescribers to access patients' prescription histories to identify suspicious use. However, a survey of US physicians published in 2015 found only 53% of doctors used these programs, while 22% were not aware these programs were available. Following the implementation of

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Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments. Equally important is the improved training of medical practitioners and their

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emergency". Federal and state interventions are working on employing health information technology in order to expand the impact of existing drug monitoring programs. Recent research shows promising results in mortality and morbidity reductions when a state integrates drug monitoring programs with

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Between 1999 and 2017, Non-Hispanic Black populations in medium-small metropolitan regions saw a growth of opioid overdoses at 12.3%, while non-Hispanic whites in non-metropolitan areas had an increase of 13.6% annually. Urban Black Americans had the largest rise in overdose rates between 2013 and

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Heroin use has been increasing over the years. An estimated 374,000 Americans used heroin in 2002–2005, and this estimate grew to nearly double where 607,000 of Americans had used heroin in 2009–2011. During the first two waves of the opioid epidemic, heroin use increased among non-Hispanic Whites

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In 2021, there was an increase in overdose deaths; more than 106,000 drug-related overdoses occurred, including deaths caused by both illegal and prescribed opioids. Of this, 70,601 deaths were caused by synthetic opioids primarily fentanyl. Additionally, 32,537 overdose deaths involved stimulants

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Several studies have been conducted to find out how opioids were primarily acquired, with varying findings. A 2013 national survey indicated that 74% of people who recreationally use opioids acquired their opioids directly from a single doctor, friend, or relative who received their opioids from a

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As of 2018, some retailers had begun experimenting with the use of blue light bulbs in bathrooms in order to deter addicts from using such spaces to inject opiates. Blue lights are said to make finding veins to inject more difficult. However, a 2013 study has found that the use of blue lights are

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that would have resolved litigation against the pharmaceutical companies over their distribution of the addictive painkillers. A letter from the attorneys general of Ohio, Florida and Connecticut (among others) said the settlement, as "currently structured," was not acceptable to the states. This

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Counties in northeast Ohio were the plaintiffs and alleged the chains had "substantially contributed to the crisis of opioid overdose and deaths…." in the counties. In November 2021, a 12-person jury, after five and a half days of deliberation, held the retailers accountable for contributing to a

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The US Food and Drug Administration (FDA) has taken another approach to this epidemic: requiring manufacturers of long-acting opioids to sponsor educational programs for prescribers. The FDA hoped that these educational programs would help deter off-label and overprescribing; however, it is still

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have been the hardest hit. According to Rita Noonan from the CDC, in rural areas, the overall death rate for accidental injuries is 50% higher than in urban areas. Differences in a multitude of factors, such as income, social supports, and accessibility to health care resources, have led to rural

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Prescription opioids are considered a better financial choice for treating pain than surgery. This resulted in an increased use of prescription opioids by individuals living in communities that were underserved medically or did not have health insurance. Overdose death rates increased across most

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Though previous statistics show that non-Hispanic White Americans have been affected by the opioid epidemic more than other racial/ethnic groups in the United States, recent statistics show that non-Hispanic Black Americans are experiencing a sharper increase in opioid-overdose deaths. The annual

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In addition to these federal criteria, each state may have its own criteria individuals must meet. The US GAO also cited the cost of treatment and lack of health insurance coverage for MAT as barriers for many addicted to opioids. While methadone treatments are covered by Medicaid for low-income

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Media coverage has largely focused on law-enforcement solutions to the epidemic, which portray the issue as criminal, whereas some see it as a medical issue. There has been differential reporting on how white suburban or rural addicts of opioids are portrayed compared to black and Hispanic urban

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Four major drug manufacturers and distributors, J&J, McKesson, Cardinal Health, and AmerisourceBergen, have agreed to a settlement announced by a group of state attorneys general in July 2021. The settlement, $ 26 billion (US), will be used on the prevention of opioid addiction and treatment

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experienced a five-fold increase in opioid-overdose deaths between 1999 and 2015, with Native Americans having the highest increase of any demographic group. With the belief that there would be a low risk of addiction, Indian Health Service physicians, like doctors nationwide, readily prescribed

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to make the pills extremely difficult to crush or dissolve in water to reduce non-medical use of OxyContin. The FDA approved relabeling the reformulated version as abuse-resistant. OxyContin use following the 2010 reformulation declined slightly while no changes were observed in the use of other

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reached a nearly $ 600 million settlement with 49 of 50 U.S. states in 2021 over the firm's role in driving opioid sales for Purdue Pharma and other pharmaceutical companies. In 2016, the opioid epidemic was killing on average 10.3 people per 100,000, with the highest rates including over 30 per

350: 293:

The fourth wave, which is reported to have begun in 2016, is characterized by polysubstance use and increased use of stimulants like methamphetamines and cocaine. The availability and use of illicit fentanyl continue to be the leading cause of fatalities, but the recent rise of polysubstance use

260:

The second wave of the opioid epidemic began around 2010 and is characterized by the surge in heroin use and overdose deaths. Between 2005 and 2012, the number of people who used heroin nearly doubled, growing from 380,000 to 670,000 individuals. In 2010, there were 2,789 fatal heroin overdoses,

239:

Mirroring the positive trend in the volume of opioid pain relievers prescribed is an increase in admissions for substance use disorder treatments and opioid-related deaths. This illustrates how legitimate clinical prescriptions of pain relievers are being diverted through an illegitimate market,

106:

In the United States, there were approximately 109,600 drug-overdose-related deaths in the 12-month period ending January 31, 2023, at a rate of 300 deaths per day. From 1999 to 2020, nearly 841,000 people died from drug overdoses, with prescription and illicit opioids responsible for 500,000 of

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There are currently two types of laws in place to reduce opioid overdoses through increased bystander intervention: Good Samaritan Laws (GSLs) and Naloxone Access Laws (NALs). GSLs allow a bystander to not face civil damages when acting in good faith to provide emergency care in the event of an

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Accredited programs are also able to administer buprenorphine, provided that those prescribing and administering the drug have completed the 8–24 hours of SAMHSA training. Office-based physicians who wish to prescribe buprenorphine for the treatment of opioid use disorder must also complete the

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While media coverage has focused more heavily on overdoses among whites, use among African, Hispanic and Native Americans has increased at similar rates. Deaths by overdose among white, black, and Native Americans increased by 200–300% from 2010 to 2014. During this time period, overdoses among

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As overdose deaths involving heroin more than quadrupled since 2010, what was a slow stream of illicit fentanyl, a synthetic opioid 50 to 100 times stronger than morphine, is now a flood, with the amount of the powerful drug seized by law enforcement increasing dramatically. America is awash in

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It is a fact that the People's Republic of China is the source for the vast majority of synthetic opioids that are flooding the streets of the United States and Western democracies. It is a fact that these synthetic opioids are responsible for the overwhelming increase in overdose deaths in the

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There were fewer than 3,000 overdose deaths in 1979, when a heroin epidemic was raging in U.S. cities. There were fewer than 5,000 recorded in 1988, around the height of the crack epidemic. More than 64,000 Americans died from drug overdoses last year , according to the U.S. Centers for Disease

319:

The annual opioid prescribing rates have been slowly decreasing since 2012, but the number is still high. There were about 58 opioid prescriptions per 100 Americans in 2017. Characteristics of jurisdictions with a greater number of opioid prescriptions per resident include small cities or large

223:

The first wave, which marked the start of the epidemic, began in the 1990s due to the push towards using opioid medications for chronic pain management and the increased promotion by pharmaceutical companies for medical professionals to use their opioid medications. During this time, around 100

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One of the first serious efforts to spread the harm reduction practices to combat heroin overdoses in American and beyond occurred in a conference in Seattle in January 2001 called "Preventing Heroin Overdose: Pragmatic Approaches." The conference was co-sponsored by the Alcohol and Drug Abuse

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reached an agreement in October 2019 where they will pay two Ohio counties a combined US$ 215 million. As part of the deal, Israel drug manufacturer Teva will also provide US$ 20 million in cash and US$ 25 million worth of Suboxone, an opioid addiction treatment. Cuyahoga County

900:

As of 2021, America's drug epidemic was the deadliest it had ever been, according to federal data. More than 100,000 people died of drug overdoses in the United States during the 12-month period ending April 2021, according to provisional data published November 17, 2021, by the US Centers for

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When opioids like hydrocodone are taken as prescribed, for the indication prescribed, and for a short period of time, then the risk of non-medical use and addiction is small. Problems have surfaced over the last decade however, due to its wide overuse and misuse in the setting of chronic pain.

277:

According to the CDC, the third wave of the opioid epidemic began in 2013; and concluded in 2016. This wave coincided with a significant increase in overdose deaths involving synthetic opioids, particularly illegally produced fentanyl. During this period, deaths related to prescription opioids

12086:

Indivior Solutions today pleaded guilty to a one-count felony information and, together with its parent companies Indivior Inc. and Indivior plc, agreed to pay a total of $ 600 million to resolve criminal and civil liability associated with the marketing of the opioid-addiction-treatment drug

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Take-home naloxone overdose prevention kits have shown promise in areas exhibiting rapid increases in opioid overdoses and deaths due to the increased availability of fentanyl and other synthetic opioids. Many counties offer naloxone training programs with the aim of educating the surrounding

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Treatment with methadone maintenance has been generally shown to significantly reduce mortality among opioid addicted populations. Its efficacy in reducing opioid use and positive treatment outcomes has been established, and is generally considered to be the "gold standard" of care for opiate

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During 2019–2020, non-Hispanic American Indian/Alaska Native and non-Hispanic Black individuals experienced the greatest increases in drug overdose mortality rates. Additionally, when accounting for the age-adjusted death rate, non-Hispanic American Indian/Alaska Native and non-Hispanic Black

2854:. For addicted persons who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral. Neither is guaranteed to successfully treat opioid addiction. Which treatment, or combination of treatments, is most effective varies from person to person. 2785:

The Opioid Task Force 2018 Progress Report states that between 2013 and 2017 opioid prescriptions have decreased by 22.2%, which includes a 9% decrease from 2016 to 2017 alone. The AMA Opioid Task Force also reports a 389% increase in physician participation in PDMPs. Further, physicians are

2443:

In September 2019, President Trump issued an executive order to block shipments of fentanyl and counterfeit goods from other countries, where illegal distributors were using regular mail for deliveries. While China was a focus for the action, the order included any nation where it was either

2031:, and the economic burden are major issues caused by the epidemic, which has emerged as one of the worst drug crises in American history. More than 33,000 people died from overdoses in 2015, nearly equal to the number of deaths from car crashes, with the deaths from heroin alone outnumbering 232:(NEJM) challenged these notions. The letter advocated for more liberal use of opioids in pain management, which the World Health Organization eventually supported. In addition, medical organizations began to push for more attentive physician responses to pain, referring to pain as the "fifth 3246:. For many opioid users, heroin was cheaper, more potent, and often easier to acquire than prescription medications. According to the CDC, tighter prescription policies by doctors did not necessarily lead to this increased heroin use. The main suppliers of heroin to the US have been Mexican 2957:

has been used for opioid dependence since 1964, and is the most-studied of the pharmacological treatment options. It is a synthetic long-acting opioid, so it can replace multiple heroin uses by being taken once daily. It works by binding to the opioid receptors in the brain and spinal cord,

488:, addicted soldiers returned from Vietnam, where heroin was easily bought. Heroin addiction grew within low-income housing projects during the same time period. In 1971, congressmen released an explosive report, The World Heroin Problem, on the growing heroin epidemic among US servicemen in 2677:

Homicide by overdose is the act of giving someone a specified controlled substance which causes that person to die. They are considered an easy way to murder an addict as no one will suspect it's anything but a routine overdose. However states are charging people even when the overdose was

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Hydrocodone is second among the list of top prescribed opioid painkillers, but it is also high on the list of most frequently used for recreational use. In 2011, the non-medical use of hydrocodone was responsible for more than 97,000 visits to the emergency room. In 2012, the Food and Drug

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In 2016, opioid overdoses took the lives of approximately 91 Americans each day. Roughly half of these deaths were caused by prescribed opioids. Given the complexity of the topic and the difficulty of controlling factors while researching, there is much speculation the differences between

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In 2001, New Mexico was the first state to create a NAL, which granted third-party prescribing and criminal immunity to prescribers. By 2017, all states had a NAL in place. Connecticut first implemented a GSL in 2011, and it has been updated yearly since 2014. Some research suggests that

2822:(ALiEM) and posted a discussion board about the opioid epidemic. The discussion acquired a little over 1000 readers and lasted roughly 14 days. There were four questions posted on the discussion that encouraged readers to share their opinions on how opioids should be prescribed and used. 962: 995:. Its use has caused a spike in deaths among users of heroin and prescription painkillers, while becoming easier to obtain and conceal. Some arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl. According to former CDC director 1164:

This is especially concerning considering the epidemiology of opioid affliction among white women, who are at a greater risk because they receive more prescription medications than men. According to the NIH (2018), "The opioid epidemic is increasingly young, white, and female" with

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It is still difficult for providers to prescribe opioids for medication-assisted treatment despite the data that show individuals addicted to opioids have better outcomes with that than abstinence-based treatment programs. Programs are required to be accredited by SAMHSA or the

3184:(NEP), also known as syringe services programs, as "community-based programs that provide access to sterile needles and syringes free of cost and facilitate safe disposal of used needles and syringes". NEP were first established in the US in the late 1980s as a response to the 1083:

One study found that, although relatively uncommon, "the presence of fentanyl in the stimulant supply increased significantly between 2011 and 2016, with the greatest increases occurring between 2015—2016; the presence of these products was concentrated in the U.S. Northeast."

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stating that "America is awash in opioids; urgent action is critical." Soon after, many state governors declared a "state of emergency" to combat the opioid epidemic in their own states, and undertook major efforts to stop it. In July 2017, opioid addiction was cited as the

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Hydrocodone can be prescribed under a different brand name. These brand names include Norco, Lortab, and Vicodin. Hydrocodone can also exist in other formulations where it is combined with another non-opioid pain reliever such as acetaminophen, or even a cough suppressant.

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Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine, according to SAMHSA, can be prescribed or dispensed in physician offices. Patients can thereby receive a full year of treatment for a fraction of the cost of detox programs.

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unclear if these programs truly have a positive effect on reducing opioid prescriptions. In March 2019, two FDA specialists publicly demanded that the FDA suspend new opioid approvals, alleging that the FDA's oversight of opioid approvals had been dangerously deficient.

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stated that for the first time, pharmacists, nurses, and physicians would have training made available on appropriate prescribing of opioid medicines, because opioid addiction had become the "FDA's biggest crisis". Trump nominated his then deputy chief-of-staff,

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entered the market in the 1970s, but acceptance took several years and doctors were apprehensive about prescribing them. Until the 1980s, physicians had been taught to avoid prescribing opioids because of their addictive nature. A brief letter published in the

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The CDC's "Guideline for Prescribing Opioids for Chronic Pain" offers many non-pharmacological options as alternatives to prescribing opioids. Physical therapist interventions is an example that is offered in regards to an alternative to prescribing opioids.

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of prescription drugs. However, as prescription drugs became less accessible in 2016 in response to CDC opioid prescribing guidelines, there was an increase in demand and accessibility to cheaper, illicit alternatives to opioids such as heroin and fentanyl.

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pain sufferers are also depressed, a challenge of harm reduction is that some applications, such as the use of drugs to reverse or avoid opioid overdose can nullify the effects of antidepressant medications which depend on the natural human opioid system.

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towns, cities with more dentists and primary care doctors per capita, cities with a higher percentage of white residents, cities with a higher uninsured/unemployment rate, and cities with more residents who have diabetes, arthritis, or a disability.

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One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone. If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen. Each of those pills is a potential overdose

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racial and ethnic groups due to county-level income inequality, particularly among Black and Hispanic individuals. In 2020, overdose rates were more than twice as high in counties with greater inequality compared to counties with lower inequality.

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Advance the practice of pain management to enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related

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Hydrocodone was declared the most widely prescribed opioid between 2007 and 2016, and in 2015 the International Narcotics Control Board reported that greater than 98% of the hydrocodone consumed in the entire world was consumed by Americans.

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with the higher-risk treatment utilized by lower-income individuals - disproportionately represented by people of color - and the lower-risk treatment only accessible to higher-income individuals - disproportionately represented by whites.

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In 2011, the federal government released a white paper describing the administration's plan to deal with the crisis. Its concerns have been echoed by numerous medical and government advisory groups around the world. In July 2016, President

190:. Also, in 2018, after being prescribed an opioid medication, about 10.3 million people ended up misusing it, and 47,600 people died from an overdose. More than 650,000 Americans have died of drug overdoses since the opioid epidemic began. 2624:

particular offer was part of the proposed $ 50 billion (US) agreement to find a resolution to over 2,000 lawsuits from both local and state governments attempting to recoup billions of dollars they have spent combatting the crisis.

2883:, the Supreme Court ruled that doctors could no longer prescribe narcotics to aid in treating a narcotic use disorder. Thus, morphine dispensaries emerged in communities to fill the treatment gap and were the early precedents to modern 539:

published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home. The original author,

464:

In the 1950s heroin addiction was still fairly uncommon among average Americans, many of whom saw it as a frightening condition. The fear extended into the 1960s and 1970s, although it became common to hear or read about drugs such as

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There have been attempts to shut down pill mills. 250 pill mills in Florida were shut down in 2015. Since the implementation of pill mill laws and drug monitoring programs in Florida, high-risk patients (defined as those who use both

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Accessing treatment, however, can be difficult. The strict regulation of opioid treatment programs dates back to the early 20th century. Before 1919, physicians prescribed milder forms of opiates to help wean patients off opium. In

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responsible for creating a "public nuisance" under state law, and ordered the company to pay a fine of $ 572 million. The company said they will appeal. Two other drug makers had previously settled with the state of Oklahoma.

99:. It has been called "one of the most devastating public health catastrophes of our time". The opioid epidemic unfolded in three waves. The first wave of the epidemic in the United States began in the late 1990s, according to the 11692: 8233: 8136: 1221:

2017, with younger (aged 55 years) and older adults seeing increases of 178% and 87%, respectively. However, Black individuals living in urban areas had the largest rise in fentanyl-related fatalities during the same time period.

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According to the United States Drug Enforcement Agency in 2023, China continued to be the primary source of fentanyl being imported into the United States, killing over 100 Americans every day. Over a two-year period, close to $

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From 2005 to 2009, Mexican heroin production increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in 2009. Between 2010 and 2014, the amount seized at the border more than doubled. According to the

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staff to better recognize patients at potential risk of developing nonmedical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients. As of April 2017,

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but decreased among non-White groups; additionally during this time, the vulnerability for overdose shifted to younger age groups. In 2014, it was estimated that more than half a million Americans had an addiction to heroin.

738:, and 80% of heroin addicts began abusing prescription opioids. Many people addicted to opioids switch from taking prescription opioids to heroin because heroin is less expensive and more easily acquired on the black market. 11179: 10009: 3104:

Connecticut's GSL has not affected overdose deaths but has resulted in positive behavioral changes with an increase of 9 calls; however, deaths may still continue to increase in spite of the increased awareness from GSLs.

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such as fentanyl and fentanyl analogs, 15,482 were associated with heroin use, 17,029 with prescription opioids (including methadone), 13,942 with cocaine use, and 10,333 with psychostimulants (including methamphetamine).

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Support cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms;

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was amended with the Secure and Responsible Drug Disposal Act, which allows pharmacies to accept controlled substances from households or long-term care facilities in their drug disposal programs or "take-back" programs.

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In addition, the COVID-19 pandemic has marked the start of health care policies that, should they be adopted permanently, could not only lessen the effects of the pandemic on overdoses, but also make overall treatment of

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Those taking fentanyl-laced heroin are more likely to overdose because they do not know they also are ingesting the more powerful drug. The most high-profile death involving an accidental overdose of fentanyl was singer

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Target the availability and distribution of overdose-reversing drugs to ensure the broad provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk

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Pergolizzi JV, LeQuang JA, Taylor R, Raffa RB (January 2018). "Going beyond prescription pain relievers to understand the opioid epidemic: the role of illicit fentanyl, new psychoactive substances, and street heroin".

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and opioids, those who have been using high opioid doses for extended periods of time, or "opioid shoppers" that obtain their opioid painkillers from multiple sources) have shown significant reductions in opioid use.

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The National Safety Council calculated that the lifetime odds of dying from an opioid overdose (1 in 96) in 2017 were greater than the lifetime odds of dying in an automobile accident (1 in 103) in the United States.

114:

variables, health behaviors, and accessibility to healthcare are responsible for a higher death rate. Teen use of opioids has been noticeably increasing, with prescription drugs used more than any illicit drug except

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Deaths from fentanyl in 2016 increased by 540 percent across the United States since 2015. This accounts for almost "all the increase in drug overdose deaths from 2015 to 2016", according to a study published in the

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directly subsidizes producers of fentanyl precursors and analogues through tax rebates and other incentives. Since 2019, the Chinese government has removed online records of subsidies for fentanyl-related producers.

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billion in state grants to fight the opioid epidemic, was passed by Congress by a wide bipartisan majority (94–5 in the Senate, 392–26 in the House of Representatives), and was signed into law by President Obama.

366: 13115: 8068: 2391:(HEAL) Substance Use Disorders Act of 2018, and the Synthetics Trafficking and Overdose Prevention (STOP) Act of 2018. The House and The Senate passed the final draft on September 28 and October 3, respectively. 825:(Opana ER) from the US market, because the drug's benefits may no longer outweigh its risks, this being the first time the agency has asked to remove a currently marketed opioid pain medication from sale due to 12522: 4638: 2743:

pill mill laws and prescription drug monitoring programs in Florida, there was a large decline in opioid prescriptions written by high-risk prescribers (those prescribing the top 5th of opioids by volume). The

11203: 3008:, meaning it will block the effects of the opioid medication. This combination medication can reduce a person's opioid withdrawal symptoms while they are discontinuing opioids after a period of long-term use. 666:

treatment admissions related to opioid pain relievers all increased substantially. By 2015, there were more than 50,000 annual deaths from drug overdose, causing more deaths than either car accidents or guns.

15395:; a corrupt regulatory agency beholden to the industry it was tasked with regulating; a punitive legal paradigm that criminalises drug users instead of helping them; an abstinence-only approach to treating 12486: 7965: 2286:

Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term

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combined. In 2014, roughly 6 percent of teenagers between the ages of 12 and 17 reported abusing prescribed opioids. Deaths from overdose of heroin affect younger people more than deaths from other opiates.

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I am ordering all carriers, including FedEx, Amazon, UPS and the Post Office, to search for and refuse all deliveries of fentanyl from China (or anywhere else!). Fentanyl kills 100,000 Americans a year.

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Critics of overdose prevention centers say they enable and exacerbate drug use. Data from 2014 suggested that safe injection sites could reduce overdoses while not increasing the number of drug users.

12301: 3023:. It has similarly been shown that medical treatments tend to get better results when accompanied by behavioral treatment. For opioid dependence, popular non-pharmacological treatment options include 13473: 12234: 8114: 7695: 2251:. On August 10, 2017, President Trump agreed with his commission's report released a few weeks earlier and declared the country's opioid crisis a "national emergency". Trump nominated Representative 12138: 6204: 11258: 8332: 12394: 2540:

intended for cancer patients experiencing breakthrough pain, and for defrauding Medicare and private insurance carriers. The company declared bankruptcy about two weeks after they lost the case.

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As of 2018, legislation in the US did not allow for the opening of overdose prevention centers; there were no government-sponsored sites but several efforts were underway to try to create them.

862:

Codeine is a prescription opiate used to treat mild to moderate pain. It is available as a tablet and cough syrup. A 2013 study on the concoction of codeine with alcohol or soda, also known as "

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daily, though some jurisdictions allow take home doses. This can be inconvenient as some patients are unable to travel to a clinic, or wish to avoid the stigma associated with drug addiction.

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However, on October 17, 2017, Marino withdrew his nomination after it was reported that his relationship with the drug industry might be a conflict of interest. In July 2017, FDA commissioner

802:

of oxycodone in 1996. However, drug users quickly learned how to simply crush the controlled release tablet to swallow, inhale, or inject the high-strength opioid for a powerful morphine-like

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The top line represents the yearly number of benzodiazepine deaths that involved opioids in the United States. The bottom line represents benzodiazepine deaths that did not involve opioids.

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While buprenorphine/naloxone is indicated for the treatment of opioid use disorder, it does contain an opioid which means a person may be at risk of developing dependence to it as well.

2958:

activating them, reducing withdrawal symptoms and cravings while suppressing the "high" that other opioids can elicit. The decrease in withdrawal symptoms and cravings allow the user to

2895:

which is a lengthy, time- and resource-consuming process including intensive training and site visit reviews. To stay in operation, they must submit to re-accreditation every 1–3 years.

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The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act was introduced by the

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Veilleux JC, Colvin PJ, Anderson J, York C, Heinz AJ (March 2010). "A review of opioid dependence treatment: pharmacological and psychosocial interventions to treat opioid addiction".

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million in fines after being prosecuted for making false claims about the risk of opioid use disorder associated with oxycodone. In 2010, Purdue Pharma reformulated OxyContin, using a

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reported that while Mexican cartels are the main source of heroin smuggled into the US, Chinese suppliers provide both raw fentanyl and the machinery necessary for its production. In

13747: 8044: 6555: 5841: 11661: 11171: 9948: 6382: 3047:. Since addictive behavior is a learned behavior in opioid dependence, cognitive behavioral therapy aims to promote positive motivation to change that behavior. Studies such as the 11783: 11753: 10001: 8502: 7031: 5561: 240:

leading to misuse, addiction, and death. With the increase in volume, the potency of opioids also increased. By 2002, one in six drug users was prescribed drugs more powerful than

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Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response as the epidemic evolves;

12808: 11953: 11280: 10476: 14782:"The Significance of Harm Reduction as a Social and Health Care Intervention for Injecting Drug Users: An Exploratory Study of a Needle Exchange Program in Fresno, California" 10062: 2726:

The greater "social acceptance" for using these medications (versus illegal substances) and the misconception that they are "safe" may be contributing factors to their misuse.

2655: 1028: 186:. When people continue to use opioid medications beyond what a doctor prescribes, whether to minimize pain or induce euphoric feelings, it can mark the beginning stages of an 13776: 8533: 8310: 2532:

In May 2019, in the first successful prosecution of top pharmaceutical executives for crimes related to the prescribing of opioids, the founder and four former executives of

14708:

Potier C, Laprévote V, Dubois-Arber F, Cottencin O, Rolland B (December 2014). "Supervised injection services: what has been demonstrated? A systematic literature review".

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Kariisa M, Seth P, Jones CM (August 2, 2022). "Increases in Disparities in US Drug Overdose Deaths by Race and Ethnicity: Opportunities for Clinicians and Health Systems".

8009: 5223: 533:", generated much attention and changed this thinking. A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis. The 11723: 11445: 9573: 3324: 2993:

is a combination medication that has been approved by the FDA in 2002 for treatment of opioid dependence. It is a combination medication that contains two separate drugs:

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sponsored a bill in the memory of the doctor who would not over-prescribe; the Dr. Todd Graham Pain Management Improvement Act is intended to address the opioid epidemic.

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began an investigation with assistance from fired Drug Enforcement Administration regulator Joseph Razzazzisi on the rapidly increasing numbers of opioid related deaths.

2093:

professionals are highly undertrained in this area. As a result, many specific education programs have been proposed and implemented into nursing education institutions.

12203: 8475: 8065: 7989: 2339:, said that "America is awash in opioids; urgent action is critical." The crisis has changed moral, social, and cultural resistance to street drug alternatives such as 2062:

were killed in a murder-suicide over the refusal of Dr. Todd Graham, 56, to renew the opioid prescription for the wife of Mike Jarvis, 48. United States Representative

356:

Opioid involvement in cocaine overdose deaths. Yellow line is cocaine and any opioid. Light green line is cocaine without any opioids. Yellow line is cocaine and other

9606: 8826: 4803: 4630: 2224: 14029: 11200: 11001: 9667: 8286: 12478: 11124: 8991:

Vital Signs: Drug Overdose Deaths, by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020

7961: 3724: 2318: 629: 12667: 12260: 12073: 9808: 9136:"Identifying drivers of increasing opioid overdose deaths among black individuals: a qualitative model drawing on experience of peers and community health workers" 6488: 6453: 6153: 6125: 5529: 2983:

is an implantable form of buprenorphine lasting six months. Rates of buprenorphine use increased between 2003 and 2011, with sales increasing, on average, by 40%.

2101:

After slight decreases in opioid fatalities 2017–2018, overdose deaths in the US increased in 2019, due largely to an increase in non-medical use of fentanyl. The

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Knight K (December 2017). "Women on the Edge: Opioids, Benzodiazepines, and the Social Anxieties Surrounding Women's Reproduction in the U.S. "Opioid Epidemic"".

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which was signed into law by President Obama on April 19, 2016, and may have decreased the DEA's ability to intervene in the opioid crisis. In December 2016, the

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began marketing heroin commercially in 1898. Beginning around 1920, however, the addictiveness was recognized, and doctors became reluctant to prescribe opiates.

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Centers for Disease Control and Prevention (CDC) (November 4, 2011). "Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008".

651:

While rates of overdose of legal prescription opiates have leveled off in the past decade, overdoses of illicit opiates have surged since 2010, nearly tripling.

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McClellan C, Lambdin BH, Ali MM, Mutter R, Davis CS, Wheeler E, et al. (2018). "Opioid-overdose laws association with opioid use and overdose mortality".

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A chart outlining the structural features that define opiates and opioids, including distinctions between semi-synthetic and fully synthetic opiate structures

14640:

León C, Cardoso L, Mackin S, Bock B, Gaeta JM (January 2018). "The willingness of people who inject drugs in Boston to use a supervised injection facility".

12293: 3983: 2468:

In July 2020, Indivior Solutions, Indivior Inc., and Indivior plc agreed to pay $ 600 million to resolve liability related to false marketing of Suboxone to

675:, half of the overdoses were accidental, while a third were intentional. The remainder were unknown. Many of the deaths are from an extremely potent opioid, 13465: 13306: 12226: 9751: 8111: 7935: 7691: 6785: 6116:"The Family That Built an Empire of Pain: The Sackler dynasty's ruthless marketing of painkillers has generated billions of dollars—and millions of addicts" 3368: 1204: 1057:, two thirds of the fatal drug overdoses involved fentanyl, and most do not know that they are taking fentanyl. In 2017, a cluster of fentanyl overdoses in 880: 15020: 12130: 12065: 7489: 12363: 11515: 11250: 9689:

Paulozzi LJ, Mack KA, Hockenberry JM, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC (July 4, 2014).

9688: 6084: 445:. Opiates soon became known as a wonder drug and were prescribed for a wide array of ailments, even for relatively minor treatments such as cough relief. 9740: 8329: 8183: 6725: 925:

the US Postal Service. It can also be purchased directly from China, which has become a major manufacturer of various synthetic drugs illegal in the US.

12386: 11348: 6845: 5824: 5634: 11576: 9867: 8640: 7432: 6534: 3308: 3285: 875: 13497:"Variation in use of buprenorphine and methadone treatment by racial, ethnic, and income characteristics of residential social areas in New York City" 12099: 8416: 7265: 838:

Administration (FDA) rescheduled it from a Schedule III drug to a Schedule II drug, recognizing its high potential for non-medical use and addiction.

10947: 10622: 9789: 8735: 4172:"Fourth Wave of Opioid (Illicit Drug) Overdose Deaths and Diminishing Access to Prescription Opioids and Interventional Techniques: Cause and Effect" 2089:

distribution, and expanding treatment for opioid use disorder was associated with an estimated 179,151 lives saved when compared to the status quo."

806:. In fact, Purdue's private testing conducted in 1995 determined that 68% of the oxycodone could be extracted from an OxyContin tablet when crushed. 530: 225: 11379: 11220: 7858: 7383: 2658:. The settlement averted what would have been the first federal trial over the US opioid crisis. The defendants offered no admission of wrongdoing. 1050:, a home-operated drug lab with six pill presses was uncovered by federal agents; each machine was capable of producing thousands of pills an hour. 15293:

Oliver, J. E., & Carlson, C. (2020). Misperceptions about the 'Opioid Epidemic:' exploring the facts. Pain Management Nursing, 21(1), 100–109.

15279: 12010: 10976: 8088: 6747: 6686: 3956: 1073:

million in revenue. The profitability of this drug has led dealers to adulterate other drugs with fentanyl without the knowledge of the drug user.

12750:"Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients: A comparative interrupted time series analysis" 10449: 10402:"Vital signs: characteristics of drug overdose deaths involving opioids and stimulants: 24 states and the District of Columbia, January-June 2019" 7610: 6905: 2444:

manufactured or shipped from. Trump claimed that the Chinese government had not done enough to stop the smuggling of fentanyl manufactured there:

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United States. It is a fact that if the People's Republic of China wanted to shut down the synthetic opioids industry, they could do so in a day.

12894: 11545: 8206: 4423:

Turk DC, Brody MC, Okifuji AE (1994). "Physiciansʼ attitudes and practices regarding the long-term prescribing of opioids for non-cancer pain".

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were convicted by a federal jury in Boston in connection with bribing medical practitioners to prescribe Subsys, a highly-addictive sublingual

2139: 722:

smuggling fentanyl into the United States. The Biden administration also targeted Chinese companies importing chemicals used to make fentanyl.

13628:"Methadone maintenance treatment and mortality in people with criminal convictions: A population-based retrospective cohort study from Canada" 11597: 11089: 8374: 6664: 6139:

family business, Purdue Pharma—a privately held company, based in Stamford, Connecticut, that developed the prescription painkiller OxyContin.

2762:(AMA) has created an Opioid Task Force for helping physicians to combat the epidemic. The AMA has suggested 6 actions for physicians to take: 662:

levels." Nearly half of all opioid overdose deaths in 2016 involved prescription opioids. From 1999 to 2008, overdose death rates, sales, and

15477: 15457: 11470: 9465:"Racial/ethnic differences in opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States, 1999−2017" 7881: 7728: 6594: 5732: 5694: 5154:"Dynamics of drug overdose in the 20th and 21st centuries: The exponential curve was not inevitable, and continued increases are preventable" 4973:"Racial/ethnic differences in opioid-involved overdose deaths across metropolitan and non-metropolitan areas in the United States, 1999−2017" 3773: 3138:(Narcan) can be used as a rescue medication for opioid overdose or as a preventive measure for those wanting to stop using opiates. It is an 11048: 10266: 13744: 8450: 8034: 7352: 7179: 5845: 2907:

States, many clinicians do not want to start their own because the time and effort required to comply with the regulations is prohibitive.

11653: 9938: 8933: 6374: 5774: 15169: 11775: 11745: 8498: 7023: 6577: 5558: 3319: 2735:(PDMPs) exist in every state. A person on opioids for more than three months has a 15-fold (1,500%) greater chance of becoming addicted. 976: 600:

one percent, ultimately influencing the prescribing habits of the medical professionals that attended these conferences. Consulting firm

575:. The initial promotion and marketing of OxyContin was an organized effort throughout 1996–2001, to dismiss the risk of opioid addiction. 14683: 13883: 9430: 7156: 3744: 2842:

The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicted is addressed less frequently.

2600:"public nuisance." This was the first jury verdict in the decades-long crisis. The retailers said they would appeal the jury's verdict. 14753: 14554: 11819: 11813: 11069: 9820: 9785: 9206:"Racial/ethnic residential segregation and the availability of opioid and substance use treatment facilities in US counties, 2009–2019" 8393: 7902: 7113: 6807: 6449: 6313: 4811: 3684: 3524: 3516: 2931: 2744: 2379:

reform in order to improve treatment, recovery, and prevention efforts while also strengthening the fight against synthetic drugs like

2336: 2329:

million to states and US territories in the fiscal year 2017 for the purpose of preventing and combatting opioid misuse and addiction.

2074: 1995:

in the US in 2016, opioids were involved in 42,249. In 2016, the five states with the highest rates of death due to drug overdose were

1009: 937:. The sellers also offered advice on how to evade screening by US authorities. According to Assistant US Attorney Matt Cronin in 2019: 784: 761: 100: 13044:. Casey, Libby, host. (October 17, 2017). "Talk to reporters and source behind our story on the drug industry's triumph over the DEA" 12798: 6317: 4747:

Ruan XI, Wyche MQ, Kaye AD (January 1, 2016). "Analyzing the relationship between nonmedical prescription-opioid use and heroin use".

4567:

Alexander GC, Kruszewski SP, Webster DW (November 2012). "Rethinking opioid prescribing to protect patient safety and public health".

3830:

Alexander GC, Kruszewski SP, Webster DW (November 2012). "Rethinking opioid prescribing to protect patient safety and public health".

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intensity of prescription pain reliever use as well as increases in clinically significant substance use disorders involving opioids.

12455: 11935: 10483: 7641: 1182:

prescription drugs in 2006. Teens used prescription drugs more than any illicit drug except cannabis, more than cocaine, heroin, and

14607: 14466:"Distribution of take-home opioid antagonist kits during a synthetic opioid epidemic in British Columbia, Canada: a modelling study" 9823:. The numbers are in the data table below the map, and by running your cursor over the map at the source. CSV data link below table. 9777: 8966: 5452: 3924: 2930:

individuals, the extent of coverage depends on which state they are in and if the state has opted into Medicaid expansion under the

13332:"Opioid Use Disorders: HHS Needs Measures to Assess the Effectiveness of Efforts to Expand Access to Medication-Assisted Treatment" 13048: 12561: 8525: 8307: 3770:"Prescription for Danger: A Report on the Troubling Trend of Prescription and Over-the-Counter Drug Abuse Among the Nation's Teens" 2503:(PDMP) enrollment laws: prescribers must enroll in their state's PDMP, an electronic database containing a record of all patients' 2181: 3576: 8995: 8353: 7906: 5215: 4313: 2279: 11715: 11435: 10039: 9636: 5880: 3051:

series indicate that a greater focus on improving the environments of those with opioid use disorders could also be beneficial.

1023:

Fentanyl has surpassed heroin as a killer in several locales: in all of 2014 the CDC identified 998 fatal fentanyl overdoses in

14947: 12951:"Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998-2012" 12916: 11024: 6867: 6281: 3258:, smugglers and distributors "profit primarily by putting drugs on the street and have become crucial to the Mexican cartels." 2472:

for use by patients with children under the age of six years old. Additionally, Indivior Solutions pled guilty to one-count of

2465:

used its political influence with the Trump administration to avoid criminal prosecution for over-dispensing opioids in Texas.

2368: 2347:

have declared a "state of emergency" to combat the opioid epidemic or undertaken other major efforts against it. In July 2017,

2272: 2256: 2102: 13604: 12195: 8471: 7986: 5254: 4792: 4244: 3440: 15247: 13915: 12706:"Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access" 9816: 8634: 6975:"Increasing Prescription Opioid and Heroin Overdose Mortality in the United States, 1999-2014: An Age-Period-Cohort Analysis" 6438: 4490: 3867:"A comparison between enriched and nonenriched enrollment randomized withdrawal trials of opioids for chronic noncancer pain" 3329: 2830:

In July 2019 the Washington Post and the Charleston (WV) Gazette-Mail gained a court order after a year-long battle with the

2143: 1128: 11913: 10510:"Analysis of drug test results before and after the US declaration of a national emergency concerning the COVID-19 outbreak" 9598: 9024:"African Americans now outpace whites in opioid-involved overdose deaths: a comparison of temporal trends from 1999 to 2018" 8818: 4800: 429: 417: 405: 14013: 13929: 12995:"The War on Drugs That Wasn't: Wasted Whiteness, "Dirty Doctors," and Race in Media Coverage of Prescription Opioid Misuse" 11008: 9659: 8270: 4949: 4106:"The Rural Opioid Initiative Consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis" 3279: 2857:

These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism. Popular treatments include

2811:

Hispanics increased 140%, and the data available on overdoses by Asians was not comprehensive enough to draw a conclusion.

2790:

prescriptions have doubled from 3,500 to 8,000 and more than 50,000 physicians were certified in 2017 to provide in-office

2732: 2212:

declaring the opioid crisis a "national emergency." In September 2019, he ordered U.S. mail carriers to block shipments of

787:

drug, indicating a high potential for non-medical use and addiction. After its 1995 approval by the FDA by Deputy Director

741:

Women are at a higher risk of overdosing on heroin than men. Overall, opioids are among the biggest killers of every race.

215: 11114: 3808: 2148:

In 2010, the US government began cracking down on pharmacists and doctors who were overprescribing opioid painkillers. An

908:, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin, with only 2 mg becoming a 7929:"ACMT and AACT Position Statement: Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders" 6063: 4668: 4207: 3541: 2417: 535: 12594: 12424: 10231:"A Cross-Sectional Survey Exploring Nursing Students' Knowledge and Attitudes Regarding Opioids and the Opioid Epidemic" 9805: 6480: 6442: 6115: 4826:"Fentanyl Law Enforcement Submissions and Increases in Synthetic Opioid–Involved Overdose Deaths — 27 States, 2013–2014" 1109:

disproportionately affecting white, middle-aged, and less-educated Americans, particularly those living in rural areas.

50:

U.S. yearly overdose deaths, and the drugs involved. Among the 108,000 deaths in 2022, the largest share was related to

13383: 13342: 10884:"Assessment of Filled Buprenorphine Prescriptions for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic" 9691:"Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines - United States, 2012" 8241:

United States House Select Committee on Strategic Competition between the United States and the Chinese Communist Party

7518: 7062: 3004:

Buprenorphine works as a partial opioid agonist. It is given in combination with Naloxone because Naloxone works as an

1069:

for $ 3,000 to $ 5,000, and then smuggled into the United States by mail or Mexican drug cartels to generate over $ 1.5

963:

United States House Select Committee on Strategic Competition between the United States and the Chinese Communist Party

441:

Opiates such as morphine have been used for pain relief in the United States since the 1800s, and were used during the

14582:"How vending machines help states battle the opioid crisis: 'You don't know when you're going to need these products'" 10093: 7188: 2516:

Pill mill laws: pain clinics are closely regulated and monitored to minimize the prescription of opioids non-medically

1943: 14355:"With a Little Help from My Friends: The Effects of Good Samaritan and Naloxone Access Laws on Opioid-Related Deaths" 13976: 10094:"A disturbing new phase of the opioid crisis: How rehab recruiters are luring recovering addicts into a deadly cycle" 9527:"Opioid-related overdose mortality in the era of fentanyl: Monitoring a shifting epidemic by person, place, and time" 2705:

prosecutions.) In 2017, legislators in at least 13 states introduced bills to enhance these laws or create new ones.

2032: 500: 14913: 14581: 12324: 12164: 7545: 4007: 3714: 11976: 11541: 9759: 5657: 3980: 3951: 3376: 2903: 2603:

On August 17, 2022, CVS, Walgreens and Walmart were forced to pay out $ 650.5 million to Lake and Trumbull County.

2469: 1213: 15462: 13298: 9748: 8930:"Addressing the Challenges of the Opioid Epidemic in Minority Health and Health Disparities Research in the U.S." 7928: 7755:"Can touch this: training to correct police officer beliefs about overdose from incidental contact with fentanyl" 6777: 6748:"'It's an overdose crisis': Mac Miller's death investigation highlights a dangerous trend in the opioid epidemic" 3365: 3255: 3204:

Public bathroom illuminated with blue lights to deter the use of drugs, supposedly making it harder to find veins

2892: 2831: 2500: 2019: 655: 525: 15031: 7458: 5278:"Opioid abuse in the U.S. is so bad it's lowering life expectancy. Why hasn't the epidemic hit other countries?" 286: 13840: 12355: 11503: 8557:"Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 2011–2016" 6092: 5416:"Missouri among five states selected to participate in project addressing maternal opioid use | opioids.mo.gov" 9737: 8173: 7962:"Trump UN ambassador vows 'full court press' to combat China's fentanyl 'abuses' in this state if elected gov" 6717: 5821: 15472: 11846:"The Complementarity of Health Information and Health IT for Reducing Opioid-Related Mortality and Morbidity" 11340: 6837: 6526: 5626: 1137: 1027:, which is the same number of deaths recorded in just the first five months of 2015. The US Attorney for the 14971:"A qualitative study of the perceived effects of blue lights in washrooms on people who use injection drugs" 11568: 9857: 8664:"Effect of race on opioid drug overdose deaths in the United States: an observational cross-sectional study" 8616: 8112:"China 'stands ready to work with US' to crack down on opioid dealers using postal service to smuggle drugs" 7424: 5423: 2125:

not decreased; however, filled prescriptions for all medications collectively have decreased considerably."

11875: 7692:"San Francisco activist warns city has become 'epicenter' of 'cartel-fueled' drug crisis as overdoses soar" 7257: 3334: 3036: 3024: 2759: 2311: 2205: 1241: 780: 14507:"No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone" 10939: 10614: 8720: 7213:, Alexander GC (February 2015). "Impact of abuse-deterrent OxyContin on prescription opioid utilization". 5796: 1248:, the number of opioid deaths increased 44 percent from 2016 to 2017, with 5,200 deaths in 2017. Governor 11371: 11027: 10714:"The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union" 7855: 7522: 7375: 5808: 3209:

unlikely to deter drugs users from injecting in public washrooms and may increase drug use-related harm.

1208:

Timeline of US overdose deaths involving stimulants (cocaine and psychostimulants), by opioid involvement

14232:"Assessing the impact of the Good Samaritan Law in the state of Connecticut: a system dynamics approach" 14051:

Stringfellow EJ, Lim TY, Humphreys K, DiGennaro C, Stafford C, Beaulieu E, et al. (June 24, 2022).

13373:"Opioid Addiction: Laws, Regulations, and Other Factors Can Affect Medication-Assisted Treatment Access" 10969: 3946: 3468:"Trends and Geographic Patterns in Drug and Synthetic Opioid Overdose Deaths - United States, 2013-2019" 1217:

communities majorly exceeding urban areas when it comes to the rate of opioid-involved overdose deaths.

66: 13910:. WHO Guidelines Approved by the Guidelines Review Committee. Geneva: World Health Organization. 2009. 12832:"Missouri Is the Only State in the US Where Doctors Have No Idea What Prescriptions People Are Getting" 11511: 10477:"Issue brief: reports of increases in opioid-related overdose and other concerns during COVID pandemic" 10345:"Innovative Approaches to Educating Future Clinicians about Opioids, Pain, Addiction and Health Policy" 9891:"The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013" 7572: 6897: 2402: 1229: 799: 691: 568: 373: 357: 55: 15060: 10772: 9464: 5153: 5034: 4972: 4606: 2979:

said to eliminate opiate withdrawal symptoms and cravings in many patients without inducing euphoria.

2199:

authorized millions of dollars in funding for opioid research and treatment, followed by CDC director

2157: 15216: 12886: 12831: 9314:"Nonmedical use of prescription drugs in adolescents and young adults: not just a Western phenomenon" 9079: 3157:

filled with free naloxone have been placed in high-density areas to prevents opioid overdose deaths.

2399: 2168: 1053:

Overdoses involving fentanyl have greatly contributed to the havoc caused by the opioid epidemic. In

433: 15286: 14053:"Reducing opioid use disorder and overdose deaths in the United States: A dynamic modeling analysis" 13687:"Medication-assisted treatment of opioid use disorder: review of the evidence and future directions" 12584:"An Overdose Death Is Not Murder: Why Drug-Induced Homicide Laws Are Counterproductive and Inhumane" 10182:"Survey Assessing Medical Student and Physician Knowledge and Attitudes Regarding the Opioid Crisis" 7290:

Cardia L, Calapai G, Quattrone D, Mondello C, Arcoraci V, Calapai F, et al. (October 1, 2018).

15309: 11096: 10123:

Ballreich J, Mansour O, Hu E, Chingcuanco F, Pollack HA, Dowdy DW, et al. (November 4, 2020).

9261: 7809:"Media Reports of Unintentional Opioid Exposure of Public Safety First Responders in North America" 6660: 3185: 3068: 2421: 2372: 2344: 2059: 946: 10882:

Nguyen TD, Gupta S, Ziedan E, Simon KI, Alexander GC, Saloner B, et al. (December 21, 2020).

7878: 7718: 3769: 15482: 14464:

Irvine MA, Buxton JA, Otterstatter M, Balshaw R, Gustafson R, Tyndall M, et al. (May 2018).

12507:(). "Symposium: From the Crime Scene to the Courtroom: The Future of Forensic Science Reform: ." 11848:. Max Planck Institute for Innovation & Competition Research Paper No. 21-14. Rochester, NY. 10230: 9862: 9792:. Click on a map year. The data table is below the map. Number of deaths for each state, and the 9364:

Whelshula M, Hill M, Galaitsi SE, Trump B, Mahoney E, Mersky A, et al. (September 1, 2021).

8853:

Whelshula M, Hill M, Galaitsi SE, Trump B, Mahoney E, Mersky A, et al. (September 1, 2021).

7546:"Drug overdose deaths top 100,000 annually for the first time, driven by fentanyl, CDC data show" 7118: 6934:"The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction" 5724: 4409: 3181: 2620: 454: 269: 244:; by 2012, the ratio had doubled to one in three. The most commonly prescribed opioids have been 198: 167: 163: 44: 15230:

National Academies of Sciences, Engineering, and Medicine (2019). Leshner AI, Mancher M (eds.).

13067:"The Prescription Opioid Epidemic: Social Media Responses to the Residents' Perspective Article" 8444: 7344: 7192: 4104:

Jenkins RA, Whitney BM, Nance RM, Allen TM, Cooper HL, Feinberg J, et al. (July 26, 2022).

3242:

As the number of opioid prescriptions rose, drug cartels began flooding the US with heroin from

2046:

overdoses, non-medical use, and dependence in the United States in 2013 was approximately $ 78.5

15367: 13800:"Trends in the use of buprenorphine by office-based physicians in the United States, 2003-2013" 13413:"The North American opioid epidemic: current challenges and a call for treatment as prevention" 9078:

Rushovich T, Arwady MA, Salisbury-Afshar E, Arunkumar P, Aks S, Prachand N (February 1, 2022).

8929: 6481:"In 2016, drug overdoses likely killed more Americans than the entire wars in Vietnam and Iraq" 5771: 2990: 2786:

encouraged to co-prescribe naloxone to those at risk of overdose. In 2017 alone, weekly filled

2429: 2322: 2228: 2149: 663: 504: 458: 309: 15300: 12066:"Indivior Solutions Pleads Guilty to Felony Charge as Part of DOJ's Largest Opioid Resolution" 11861: 11845: 10649:"Racial and Ethnic Disparities in Drug Overdose Deaths in the US During the COVID-19 Pandemic" 7181:

Findings from Purdue's Post-Marketing Epidemiology Studies of Reformulated OxyContin's Effects

7146: 6932:

Kolodny A, Courtwright DT, Hwang CS, Kreiner P, Eadie JL, Clark TW, et al. (March 2015).

6574: 5315:

Daubresse M, Chang HY, Yu Y, Viswanathan S, Shah ND, Stafford RS, et al. (October 2013).

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presented plans to reduce the addiction crisis, which it said was killing 91 people each day.

13875: 13265: 9287: 6950: 6933: 4536:"Number of prescriptions dispensed by community pharmacies tops one billion for first time". 4199: 4170:

Manchikanti L, Singh VM, Staats PS, Trescot AM, Prunskis J, Knezevic NN, et al. (2022).

4046:"The Rise of Illicit Fentanyls, Stimulants and the Fourth Wave of the Opioid Overdose Crisis" 3740: 3297: 3225:

on the streets. Dealers may hire people to go to pill mills to get painkiller prescriptions.

2879: 2751: 2596: 2513:

Opioid prescribing cap laws: opioid prescriptions cannot exceed designated doses or durations

757: 690:

In 2017, around 70,200 Americans died from drug overdose. 28,466 deaths were associated with

601: 155: 12949:

McGinty EE, Kennedy-Hendricks A, Baller J, Niederdeppe J, Gollust S, Barry CL (April 2016).

12036:"Walmart Was Almost Charged Criminally Over Opioids. Trump Appointees Killed the Indictment" 11805: 10940:"Poll: Many Utahns know people who seek treatment for opioid addiction, but barriers remain" 6197:"Federal Efforts to Combat the Opioid Crisis: A Status Update on CARA and Other Initiatives" 4404:. 9th World Congress of the World Institute of Pain (WIP), May 9-12, 2018. Dublin, Ireland. 3692: 3513: 2747:(CDC) was tasked with establishing and publishing a new guideline, and was heavily lobbied. 2321:

administers the Opioid State Targeted Response grants, a two-year program authorized by the

2223:

listed statistics which describe the extent of the problem. The House and Senate passed the

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more effective by eliminating obstacles to previously proven therapies for these disorders.

658:

stated that "overdose deaths, particularly from prescription drugs and heroin, have reached

14354: 14064: 13769:"New Medication Formulations Could Quickly Make a Difference for Treating Opioid Addiction" 12803: 10125:"Modeling Mitigation Strategies to Reduce Opioid-Related Morbidity and Mortality in the US" 9377: 8866: 8010:"Americans spent nearly $ 800M in 2 years on illegal fentanyl from China: 5 things to know" 6305: 4348: 3128: 3076: 2666: 2650: 2612: 2562: 2549: 2504: 2387: 2192: 2028: 1404: 1378: 719: 111: 92: 13222: 12447: 11281:"White House opioid commission to Trump: 'Declare a national emergency' on drug overdoses" 7633: 6059:

Watch 8-hour Deposition Of Richard Sackler As He Denies Family's Role in The Opioid Crisis

4692:""Every 'Never' I Ever Said Came True": Transitions from opioid pills to heroin injecting" 8: 15322: 15229: 15141: 13907:

Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence

13045: 11119: 10773:"Economic conditions, illicit drug use, and substance use disorders in the United States" 10559:"Nonfatal opioid overdoses at an urban emergency department during the COVID-19 pandemic" 9774: 8958: 7459:"Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures" 6633: 5530:"At height of crisis, Walgreens handled nearly one in five of the most addictive opioids" 5448: 5317:"Ambulatory diagnosis and treatment of nonmalignant pain in the United States, 2000-2010" 3916: 3290: 3247: 3044: 3040: 2616: 2611:

In February 2020, 21 US states turned down an $ 18 billion (US), 18-year offer from

2425: 2410: 2348: 2118: 2082: 1105: 1080:, an animal tranquilizer, is increasingly being detected in heroin and illicit fentanyl. 1047: 966: 187: 183: 14068: 12553: 12100:"Founder and Four Executives of Insys Therapeutics Convicted of Racketeering Conspiracy" 11172:"Obama paying tribute to Biden and bipartisanship, signs 21st Century Cures Act Tuesday" 10289: 9381: 9023: 8870: 4402:

Opioids for Chronic Non-Cancer Pain: A Systematic Review of Randomized Controlled Trials

4352: 4268:"CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022" 15273: 15261: 14997: 14970: 14895: 14883: 14870:

Loue S, Lurie P, Lloyd LS (1995). "Ethical issues raised by needle exchange programs".

14806: 14781: 14665: 14531: 14506: 14446: 14382: 14335: 14266: 14231: 14212: 14199: 14166: 14142: 14109: 14085: 14052: 13986: 13981: 13961: 13956: 13724: 13662: 13627: 13583: 13570: 13545: 13521: 13496: 13439: 13412: 13274: 13249: 13019: 12994: 12774: 12749: 12645: 12620: 11940: 11407: 10916: 10883: 10864: 10808: 10748: 10713: 10694: 10681: 10664: 10648: 10596: 10583: 10558: 10534: 10509: 10426: 10401: 10382: 10369: 10344: 10325: 10258: 10206: 10181: 10157: 10140: 10124: 9915: 9890: 9715: 9690: 9551: 9526: 9500: 9406: 9365: 9338: 9313: 9238: 9170: 9135: 8908: 8895: 8854: 8800: 8696: 8663: 8589: 8556: 7833: 7808: 7781: 7754: 7597: 7318: 7291: 7238: 7151: 6999: 6974: 6255: 6230: 6034: 6009: 5607: 5505: 5480: 5341: 5316: 5189: 5124: 5070: 5008: 4909: 4874: 4724: 4691: 4456: 4377: 4336: 4300: 4140: 4105: 4078: 4045: 3893: 3866: 3624: 3599: 3568: 3492: 3417: 3390: 3088: 3032: 2533: 2220: 1885: 796: 507:"public enemy number one". By 1973, there were 1.5 overdose deaths per 100,000 people. 442: 96: 15097: 14482: 14465: 13083: 13066: 9080:"Opioid-related overdose deaths by race and neighborhood economic hardship in Chicago" 8989: 8349: 8035:"Coronavirus chokes the drug trade — from Wuhan, through Mexico and onto U.S. streets" 7898: 7588: 7292:"Preclinical and Clinical Pharmacology of Hydrocodone for Chronic Pain: A Mini Review" 5872: 4267: 3467: 2681: 15380: 15265: 15253: 15243: 15203: 15002: 14887: 14852: 14811: 14725: 14721: 14657: 14615: 14536: 14487: 14450: 14438: 14430: 14386: 14374: 14327: 14319: 14271: 14253: 14216: 14204: 14186: 14182: 14147: 14129: 14090: 14021: 13921: 13911: 13821: 13716: 13708: 13667: 13649: 13575: 13526: 13444: 13279: 13195: 13096: 13088: 13024: 12972: 12779: 12727: 12650: 12227:"Teva Pharmaceuticals Agrees To $ 85 Million Settlement With Oklahoma In Opioid Case" 11945: 11857: 11403:"Tom Marino, Drug Czar Nominee, Withdraws in Latest Setback for Trump's Opioid Fight" 10921: 10903: 10868: 10856: 10800: 10792: 10753: 10735: 10698: 10686: 10668: 10600: 10588: 10539: 10431: 10386: 10374: 10329: 10317: 10309: 10262: 10250: 10211: 10193: 10162: 10144: 10063:"Americans more likely to die of opioid overdose than car crash, says council report" 10031: 10002:"U.S. House passes bill named for slain South Bend doctor to address opioid epidemic" 9920: 9720: 9702: 9628: 9556: 9542: 9504: 9492: 9484: 9480: 9411: 9393: 9343: 9243: 9225: 9175: 9157: 9107: 9099: 9051: 9043: 8912: 8900: 8882: 8804: 8792: 8784: 8701: 8683: 8630: 8594: 8576: 8572: 8278: 8039: 7838: 7786: 7602: 7481: 7323: 7230: 7004: 6955: 6356: 6348: 6260: 6161: 6039: 6010:"The promotion and marketing of oxycontin: commercial triumph, public health tragedy" 5966: 5925: 5599: 5510: 5346: 5285: 5193: 5181: 5173: 5116: 5062: 5054: 5012: 5000: 4992: 4988: 4941: 4914: 4896: 4855: 4847: 4772: 4764: 4729: 4711: 4584: 4549: 4486: 4448: 4440: 4436: 4382: 4364: 4305: 4287: 4191: 4183: 4145: 4127: 4083: 4065: 3898: 3847: 3660: 3652: 3629: 3422: 3139: 3072: 3005: 2843: 2642: 2592: 2406: 1017: 560: 14409:"Regional and temporal effects of naloxone access laws on opioid overdose mortality" 13587: 12131:"Insys Files For Chapter 11, Days After Landmark Opioid Settlement Of $ 225 Million" 11311:"Trump says opioid crisis is a national emergency, pledges more money and attention" 11115:"How Congress allied with drug company lobbyists to derail the DEA's war on opioids" 10899: 10812: 6288: 5246: 5128: 5074: 4875:"Overdose Deaths Involving Fentanyl and Fentanyl Analogs — New York City, 2000–2017" 4460: 3019:

Behavioral treatment is less effective without medical treatment during the initial

544:, has said that he never intended for the article to justify widespread opioid use. 15235: 15195: 14992: 14982: 14899: 14879: 14842: 14801: 14793: 14717: 14669: 14649: 14526: 14518: 14477: 14420: 14366: 14339: 14309: 14301: 14261: 14243: 14194: 14178: 14137: 14121: 14080: 14072: 13811: 13728: 13698: 13657: 13639: 13612: 13565: 13557: 13516: 13508: 13434: 13424: 13269: 13261: 13187: 13078: 13014: 13006: 12962: 12769: 12761: 12717: 12640: 12632: 12523:"My friend and I both took heroin. He overdosed. Why was I charged with his death?" 12294:"New trial asks whether big pharmacy chains bear any blame for the opioid epidemic" 11849: 11537: 11147:

Congress passes 21st Century Cures Act, boosting research and easing drug approvals

10911: 10895: 10846: 10788: 10784: 10743: 10725: 10676: 10660: 10647:

Han B, Einstein EB, Jones CM, Cotto J, Compton WM, Volkow ND (September 20, 2022).

10578: 10570: 10529: 10521: 10421: 10413: 10364: 10356: 10301: 10242: 10201: 10152: 10136: 9910: 9902: 9710: 9546: 9538: 9476: 9401: 9385: 9333: 9325: 9233: 9217: 9165: 9147: 9091: 9035: 8890: 8874: 8776: 8691: 8675: 8662:

Le AD, Li Y, Zhu A, Singh J, Xu JY, Srinivasan M, et al. (September 1, 2022).

8622: 8584: 8568: 7828: 7820: 7776: 7766: 7592: 7584: 7473: 7313: 7303: 7258:"Press Announcements – FDA requests removal of Opana ER for risks related to abuse" 7242: 7222: 6994: 6986: 6945: 6250: 6242: 6029: 6021: 5956: 5915: 5611: 5591: 5500: 5492: 5336: 5328: 5165: 5108: 5046: 4984: 4904: 4886: 4837: 4789: 4756: 4719: 4703: 4576: 4541: 4478: 4432: 4405: 4372: 4356: 4295: 4279: 4236: 4135: 4117: 4073: 4057: 3888: 3878: 3839: 3619: 3611: 3487: 3479: 3412: 3402: 3154: 2722:

at Columbia University, has suggested getting out more information about the risks:

2359:

concurred with his Commission's report and declared the country's opioid crisis a "

2268: 1690: 1237: 1233: 951: 926: 788: 779:

Oxycodone was first made available in the United States in 1939. In the 1970s, the

699:

like cocaine or psychostimulants with abuse potential (primarily methamphetamine).

14831:"Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015" 14797: 14684:"Cities Planning Supervised Drug Injection Sites Fear Justice Department Reaction" 14653: 14425: 14408: 14125: 12861:"Report: Prescription drug monitoring programs not shown to affect drug overdoses" 11716:"I looked for a state that's taken the opioid epidemic seriously. I found Vermont" 11007:. College of Physicians and Surgeons of Ontario. September 8, 2010. Archived from 9095: 8417:"Coroner: Franklin County fentanyl deaths hit 'unprecedented' rate of one per day" 6778:"Mexican cartel targeted by Biden administration in multiple fentanyl indictments" 5595: 15400: 15199: 14522: 14305: 13751: 13703: 13686: 13644: 13065:

Choo EK, Mazer-Amirshahi M, Juurlink D, Kobner S, Scott K, Lin M (January 2016).

13052: 12674: 12017: 11905: 11604: 11207: 11153: 11076: 11031: 10305: 9906: 9839: 9812: 9781: 9755: 9744: 9580: 9291: 8555:

Park JN, Rashidi E, Foti K, Zoorob M, Sherman S, Alexander GC (January 1, 2021).

8454: 8423: 8400: 8381: 8336: 8314: 8118: 8095: 8072: 8016: 7993: 7885: 7862: 7723: 7477: 7210: 6868:"Biden's top man on the opioid epidemic has created a 'toxic' office environment" 6629:"Mexican traffickers making New York a hub for lucrative — and deadly — fentanyl" 6581: 6562: 5828: 5778: 5565: 5398: 5370: 5332: 5169: 4807: 4796: 4707: 4613: 4203: 4061: 3987: 3721: 3713:

Rachel N. Lipari, Ph.D., Matthew Williams, Ph.D., and Struther L. Van Horn, M.A.

3520: 3372: 3143: 3120: 3080: 2959: 2646: 2188:

and authorizes millions of dollars in funding for opioid research and treatment.

2078: 2063: 1183: 1118: 934: 589: 128: 116: 80: 33: 15379:. They include, but are not limited to: the country's dysfunctional privatised 13905: 12479:"Johnson & Johnson Agrees to Settle Ohio Opioid Lawsuits for $ 20.4 Million" 9221: 6338: 5920: 5903: 5842:"Opioid epidemic shares chilling similarities with the past - Houston Chronicle" 2665:

The two counties had reached a similar settlement of US$ 20.4 million with

2364:

health information technologies and shares data through a centralized platform.

1065:. According to the DEA, one kilogram (2.2 lb) of fentanyl can be bought in 15439:. Hundreds of thousands of lives have been lost, each one of them a world." ( 15396: 15221: 14248: 13495:

Hansen HB, Siegel CE, Case BG, Bertollo DN, DiRocco D, Galanter M (July 2013).

13250:"Treatment and Prevention of Opioid Use Disorder: Challenges and Opportunities" 11974: 11569:"Opioid crisis: FDA's own staff demand agency halt approval of new painkillers" 9793: 9389: 9152: 8878: 8448:'Truly terrifying': Chinese suppliers flood US and Canada with deadly fentanyl" 7824: 7771: 6575:"STAT forecast: Opioids could kill nearly 500,000 Americans in the next decade" 6120: 5050: 4933: 4122: 3796: 3266: 3230: 3059: 3020: 2925:

Have been addicted to opioids for at least one year before beginning treatment.

2719: 2715: 2332: 2263: 2244: 2200: 1794: 1703: 1132: 1042: 821:

In June 2017, the FDA asked the manufacturer to remove its long-acting form of

622: 556: 548: 179: 142:

are a diverse class of strong, addictive, and inexpensive drugs, which include

13512: 13429: 13191: 13010: 12967: 12950: 12722: 12705: 10360: 10246: 9262:"The Opioid Crisis and the Black/African American Population: An Urgent Issue" 9205: 8679: 6808:"US announces sweeping action against Chinese fentanyl supply chain producers" 6057: 5496: 4660: 4171: 3741:"Rural America in Crisis: The Changing Opioid Overdose Epidemic | Blogs | CDC" 3656: 3615: 3537: 3389:

Guy GP, Zhang K, Bohm MK, Losby J, Lewis B, Young R, et al. (July 2017).

2873:, which are more effective when combined with a form of behavioral treatment. 15451: 15350: 15137:"Wave of addiction linked to fentanyl worsens as drugs, distribution, evolve" 14847: 14830: 14619: 14434: 14378: 14323: 14257: 14230:

Sabounchi NS, Heckmann R, D'Onofrio G, Walker J, Heimer R (January 6, 2022).

14190: 14133: 14025: 13712: 13653: 13561: 13092: 12621:"CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016" 12416: 11949: 10907: 10796: 10739: 10712:

Dom G, Samochowiec J, Evans-Lacko S, Wahlbeck K, Van Hal G, McDaid D (2016).

10672: 10313: 10197: 10148: 9706: 9488: 9397: 9229: 9161: 9103: 9047: 8886: 8788: 8687: 8580: 8282: 8066:"Deadly synthetic opioids coming to US via 'dark web' and the postal service" 7308: 6990: 6352: 6165: 6025: 5289: 5177: 5112: 5058: 4996: 4900: 4851: 4768: 4715: 4553: 4545: 4444: 4368: 4291: 4187: 4131: 4069: 3313: 3028: 2994: 2975: 2870: 2791: 2554: 2510:

PDMP query laws: prescribers must check the PDMP before prescribing an opioid

2360: 2185: 2004: 1996: 1992: 1898: 1651: 1547: 1122: 1092: 1054: 913: 826: 792: 610: 606: 596: 493: 304: 88: 26: 15294: 15183: 14987: 13372: 13331: 11530:"APhA Attends Swearing-In Ceremony of National Drug Control Policy Director" 10851: 10834: 10574: 10525: 9796:

rates of death for each state. Also, place cursor on map states to get data.

9134:

Banks DE, Duello A, Paschke ME, Grigsby SR, Winograd RP (January 13, 2023).

8780: 7634:"Suspected Nonfatal Drug-Related Overdoses Among Youth in the US: 2016–2019" 7054: 6246: 4580: 3843: 3647:

Hedegaard H (2018). "Drug overdose deaths in the United States, 1999-2017".

3391:"Vital Signs: Changes in Opioid Prescribing in the United States, 2006–2015" 15428: 15423:; and a general epistemological failure when it comes to ideas about what ' 15420: 15358: 15257: 15207: 15006: 14856: 14815: 14729: 14661: 14540: 14491: 14442: 14331: 14275: 14208: 14151: 14094: 14076: 13951: 13925: 13825: 13720: 13671: 13579: 13530: 13448: 13283: 13199: 13116:"76 billion opioid pills: Newly released federal data unmasks the epidemic" 13100: 13028: 12976: 12783: 12731: 12654: 12636: 11746:"Trump declares opioids a public health emergency but pledges no new money" 10925: 10860: 10804: 10757: 10730: 10690: 10592: 10543: 10435: 10417: 10378: 10321: 10254: 10215: 10166: 9924: 9724: 9560: 9496: 9415: 9347: 9247: 9179: 9111: 9055: 8904: 8796: 8705: 8598: 7842: 7790: 7606: 7485: 7327: 7234: 7008: 6959: 6360: 6264: 6043: 5970: 5603: 5514: 5350: 5185: 5120: 5066: 5004: 4945: 4918: 4891: 4873:

Colon-Berezin C, Nolan ML, Blachman-Forshay J, Paone D (January 18, 2019).

4859: 4842: 4825: 4776: 4733: 4588: 4386: 4309: 4283: 4195: 4149: 4087: 3902: 3851: 3664: 3633: 3483: 3426: 3407: 3222: 3084: 2586: 2545: 2450: 2392: 2356: 2240: 2209: 2196: 2177: 2008: 1807: 1781: 1768: 1716: 1245: 984: 983:

Fentanyl-laced heroin has become a big problem for major cities, including

863: 572: 541: 481: 470: 15375:

lamentable success was owed to a confluence of factors particular to the

15122: 14891: 12356:"CVS, Walgreens and Walmart Must Pay $ 650.5 Million in Ohio Opioids Case" 9525:

Althoff K, Leifheit K, Park JN, Chandran A, Sherman S (November 1, 2020).

8626: 8375:"Prince's Autopsy Result Highlights Dangers of Opioid Painkiller Fentanyl" 6595:"Canada's opioid crisis is burdening the health care system, report warns" 5943:

Leung PT, Macdonald EM, Stanbrook MB, Dhalla IA, Juurlink DN (June 2017).

5929: 4760: 4631:"Results from the 2012 NSDUH: Summary of National Findings, SAMHSA, CBHSQ" 4452: 3883: 3514:

Products - Vital Statistics Rapid Release - Provisional Drug Overdose Data

3269:, which has been linked to 80 percent of the fentanyl seized in New York. 2275:

in 2018. Carroll was subsequently approved by the Senate in January 2019.

1140:(NIH) reporting a rise in opioid morbidity and opioid related fatalities. 768:

million people in the US consume oxycodone in a non-medical way annually.

15432: 15416: 14969:

Crabtree A, Mercer G, Horan R, Grant S, Tan T, Buxton JA (October 2013).

14780:

Clarke K, Harris D, Zweifler JA, Lasher M, Mortimer RB, Hughes S (2016).

14748: 14608:"Vending machines with lifesaving drug grow as opioid crisis rages in US" 12948: 11853: 8137:"Deadly Fentanyl Bought Online from China Being Shipped Through the Mail" 5961: 5944: 3166:

sites would be best utilized by people who could benefit most from them.

3116: 2036: 1586: 1352: 1169:

million women being diagnosed with an opioid use disorder compared to 0.9

996: 930: 909: 822: 723: 496: 485: 332:

by taking drugs obtained in a way other than by legitimate prescription.

249: 233: 159: 9972:"A doctor was killed for refusing to prescribe opioids, authorities say" 9833:"Heroin deaths surpass gun homicides for the first time, CDC data shows" 9077: 2164:

of heroin users found about 80 percent started with prescription drugs.

15440: 15388: 15338: 15177:. Baltimore, Maryland: Johns Hopkins Bloomberg School of Public Health. 14314: 13816: 13799: 12196:"From Ferris Bueller to opioid trial: A judge's wild ride into history" 11806:"Integrating & Expanding Prescription Drug Monitoring Program Data" 11440: 9939:"The true cost of opioid epidemic tops $ 500 billion, White House says" 8352:. Centers for Disease Control and Prevention (CDC). December 19, 2018. 8141: 7802: 7800: 7748: 7746: 4872: 4482: 4360: 3917:"U.S. Opioid Prescribing Rate Maps | Drug Overdose | CDC Injury Center" 2980: 2458: 2371:

on June 22, 2018, and was advanced on June 22, 2018. The bill includes

2252: 2248: 1677: 1664: 1326: 711: 707: 15303:. US Centers for Disease Control and Prevention (CDC). April 17, 2019. 14167:"Predictors of US states' adoption of naloxone access laws, 2001–2017" 12690:

Alan M Jette, Responding to the Opioid Epidemic in the United States,

9599:"Middletown, Ohio, a city under siege: 'Everyone I know is on heroin'" 9366:"Native populations and the opioid crisis: forging a path to recovery" 9329: 9039: 8855:"Native populations and the opioid crisis: forging a path to recovery" 7888:, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 6085:"McKinsey Settles for Nearly $ 600 Million Over Role in Opioid Crisis" 4337:"Epidemiology of the U.S. opioid crisis: the importance of the vector" 3200: 933:, an elephant tranquilizer that is so potent it has been considered a 15404: 15372: 15342: 13227: 12917:"AMA Report Shows National Progress Toward Reversing Opioid Epidemic" 12765: 11975:

Noor Zainab Hussain, Pushkala Aripaka, Nate Raymond (July 11, 2019).

11654:"In Annual Speech, Vermont Governor Shifts Focus to Drug Abuse Image" 10450:"COVID-19 may be worsening opioid crisis, but states can take action" 9629:"Doctors must help remedy opioid crisis in Canada, CMA meeting hears" 7226: 5364:"The opioid epidemic could turn into a pandemic if we're not careful" 3682: 3600:"Drug and Opioid-Involved Overdose Deaths – United States, 2013–2017" 3218: 2954: 2884: 2866: 2582: 2574: 2565:, which makes generic drugs, agreed to pay $ 85 million in May. 2558: 2487:

State government response to the opioid epidemic in the United States

2437: 1911: 1820: 1573: 1508: 905: 885: 753: 614: 474: 466: 325: 245: 151: 147: 14707: 14555:"Vending machines are the latest tool for fighting opioid overdoses" 14229: 11471:"FDA's Scott Gottlieb: Opioid addiction is FDA's biggest crisis now" 9738:

Timeline bar chart with 2016 number of deaths in the US from opioids

9660:"Gov. Tom Wolf declares 'state of emergency' in Pa. opioid epidemic" 8271:"The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years" 7797: 7743: 6556:"America's Addiction to Opioids: Heroin and Prescription Drug Abuse" 4507:"America's Addiction to Opioids: Heroin and Prescription Drug Abuse" 2772:

Support comprehensive treatment for pain and substance use disorders

771: 492:, finding that ten to fifteen percent were addicted to heroin. "The 15408: 15239: 14370: 11025:"First Do No Harm: Responding to Canada's Prescription Drug Crisis" 8526:"An animal tranquilizer is making street drugs even more dangerous" 8499:"An animal tranquilizer is increasingly showing up in street drugs" 3135: 3048: 2998: 2862: 2851: 2787: 2781:

Encourage safe storage and disposal of opioids and all medications.

2577:

court. The defendants are pharmacy chains and operators, including

2537: 2496:

new laws fell primarily into one of the following four categories:

2413: 2380: 2376: 2213: 2012: 1872: 1742: 1625: 1599: 1560: 1534: 1495: 1443: 1365: 1339: 1313: 1249: 1077: 889: 803: 734:

Between 4 and 6% of people who misuse prescription opioids turn to

703: 676: 659: 519: 480:

Heroin addiction began to make the news around 1970 when rock star

377: 241: 171: 51: 12854: 12852: 12261:"Pharmacy chains failed to prevent opioid misuse, U.S. jury hears" 11977:"Reckitt to pay $ 1.4 billion to end long-running Indivior probes" 11936:"Reckitt to Pay $ 1.4 Billion to End Long-Running Indivior Probes" 11436:"Ex-DEA agent: Opioid crisis fueled by drug industry and Congress" 11251:"President Trump Hosts an Opioid and Drug Abuse Listening Session" 8207:"US committee finds China is subsidizing American fentanyl crisis" 7665:"Teen overdose deaths have doubled in three years. Blame fentanyl" 7407:"Teen overdose deaths have doubled in three years. Blame fentanyl" 5528:

Abelson J, Williams A, Ba Tran A, Kornfield M (November 7, 2019).

4690:

Mars SG, Bourgois P, Karandinos G, Montero F, Ciccarone D (2014).

2152:

of this was that those addicted to prescription opiates turned to

559:

was worse, reaching almost 2 per 100,000. In 1982, Vice President

15412: 14050: 13064: 12748:

Chang HY, Murimi I, Faul M, Rutkow L, Alexander GC (April 2018).

12704:

Rutkow L, Turner L, Lucas E, Hwang C, Alexander GC (March 2015).

12551: 11980: 11623:"Maryland governor declares state of emergency for opioid crisis" 11598:"Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis" 11201:"Opioid Epidemic: Trump to Set Up Commission on Addiction Crisis" 10718:

International Journal of Environmental Research and Public Health

10711: 8330:"CDC Chief Frieden: How to end America's growing opioid epidemic" 8308:"Orlando man pleads guilty to selling heroin mixed with fentanyl" 8211: 6469:

Source lists US totals for 2015 and 2016 and statistics by state.

6437: 5415: 3598:

Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G (January 2018).

2578: 2462: 2433: 2424:

to resolve false marketing claims about the effectiveness of its

2096: 1924: 1859: 1612: 1456: 1391: 1300: 1274: 1061:

was found to be caused by street sales of fentanyl pills sold as

1058: 992: 988: 980:. Readily available fentanyl killed 70,000 people in 2021 alone. 814: 592:

about his family's role in the opioid crisis in the United States

552: 515: 489: 120: 14353:

Rees DI, Sabia JJ, Argys LM, Dave D, Latshaw J (February 2019).

12165:"Oklahoma wins case against drugmaker in historic opioid triall" 12011:"Trump Plans Crackdown on Fentanyl Shipments from China, Others" 11883: 10290:"An Opioid Education Program for Baccalaureate Nursing Students" 8089:"In China, Illegal Drugs Are Sold Online in an Unbridled Market" 5392:"Opioid Prescriptions Fall After 2010 Peak, C.D.C. Report Finds" 5035:"Commentary. Fentanyl-related death and the underreporting risk" 3864: 3569:"Understanding the Epidemic | Drug Overdose | CDC Injury Center" 3538:"Data Overview | CDC's Response to the Opioid Overdose Epidemic" 2085:

centers so those centers may bill the user's insurance company.

15436: 15384: 14463: 12849: 8234:"Investigation Findings: The CCP's Role in the Fentanyl Crisis" 6287:. Drug Enforcement Administration. October 2015. Archived from 5986:

Cocaine Politics: Drugs, Armies, and the CIA in Central America

5527: 3262: 3243: 3124: 2858: 2473: 2340: 2153: 2043: 1755: 1638: 1482: 1417: 1287: 955: 893: 735: 680: 672: 641: 632:'s National Survey on Drug Use and Health, in 2016 more than 11 450: 324:

clinician. Among pharmacies, the most prolific distributor was

313: 143: 139: 124: 12448:"$ 260 million deal averts 1st federal trial on opioid crisis" 11928: 8174:"Report: China continues to subsidize deadly fentanyl exports" 7514: 7457:

Agnich LE, Stogner JM, Miller BL, Marcum CD (September 2013).

7289: 6931: 6661:"White House: True cost of opioid epidemic tops $ 500 billion" 3261:

Illicit fentanyl is commonly made in Mexico and trafficked by

2641:

The United States' three largest pharmaceutical distributors,

219:

Overdose death rates involving opioids, by type, United States

15424: 14165:

Bohler RM, Hodgkin D, Kreiner PW, Green TC (August 1, 2021).

12325:"CVS, Walgreens and Walmart Fueled Opioid Crisis, Jury Finds" 10122: 8819:"Native American Overdose Deaths Surge Since Opioid Epidemic" 8394:"Documents highlight Prince's struggle with opioid addiction" 7573:"The burden of opioid-related mortality in the united states" 5942: 5822:

WGBH educational foundation. Interview with Dr. Robert DuPont

4689: 4169: 2916: 2035:. It has also left thousands of children suddenly in need of 1833: 1521: 1430: 1066: 1062: 446: 178:

risks of addiction and overdose, and long-term use can cause

13625: 12799:"Painkiller politics: Effort to curb prescribing under fire" 12387:"States Reject Opioid Makers' $ 18 Billion Settlement Offer" 11372:"In Heroin Crisis, White Families Seek Gentler War on Drugs" 11221:"It's time to 'Trump' opioid addiction in the United States" 11045:"UK: Task Force offers ideas for opioid addiction solutions" 10474: 6443:"Provisional Counts of Drug Overdose Deaths, as of 8/6/2017" 5580: 5216:"How the Opioid Epidemic Became a Uniquely American Problem" 4237:"Understanding the Opioid Overdose Epidemic | Opioids | CDC" 3325:

United States drug overdose death rates and totals over time

2766:

2561:, agreed to a fine of $ 270 million in March 2019, and 2243:

appointed a commission on the epidemic, chaired by Governor

1236:, overdose deaths quadrupled in the 15 years since 2000. In 648:

million had an addiction to prescription opioids or heroin.

625:, were nevertheless able to file for bankruptcy afterwards. 15435:

is supposed to look like. prepared a consumer market for

15399:

that impedes evidence-based medication-assisted treatment;

12554:"Health in Justice | Drug Induced Homicide | United States" 12033: 11475: 10399: 9943: 9524: 7719:"What if San Francisco never pulls out of its 'doom loop'?" 6154:"(S+) Opioid-Krise in den USA: Eine Nation auf Drogen (S+)" 5314: 3797:"Weighing the Risks and Benefits of Chronic Opioid Therapy" 2282:

announced their "Opioid Strategy" consisting of five aims:

2161: 2000: 1846: 1729: 1469: 1232:, overdose deaths went from 149 in 2012 to 588 in 2016. In 1024: 718:

In 2023, the Biden administration announced a crackdown on

15188:

Journal of Psychosocial Nursing and Mental Health Services

14779: 13177: 12058: 9431:"The Opioid Epidemic Is This Generation's Pandemic Crisis" 9363: 9021: 8852: 7987:"Online Sales of Illegal Opioids from China Surge in U.S." 7024:"Overshadowed by the Opioid Crisis: A Comeback by Cocaine" 5988:. Berkeley, CA: University of California Press. p. 2. 5481:"A Review of the Opioid Epidemic: What Do We Do About It?" 4566: 3829: 3683:

Assistant Secretary of Public Affairs (December 4, 2017).

2922:

Be actively addicted to opioids at the time of intake, and

2669:

and its subsidiary Ethicon, Inc. earlier in October 2019.

2654:(Cleveland) and Summit County (Akron) brought the suit in 2225:

Ensuring Patient Access and Effective Drug Enforcement Act

2023:

Drug overdose deaths in the US per 100,000 people by state

929:

reporters found multiple sellers in China willing to ship

869: 15167: 14940:"Retailers experiment with blue lights to deter drug use" 14291: 14164: 13797: 13626:

Russolillo A, Moniruzzaman A, Somers JM (July 31, 2018).

11685:"Lawmakers react to governor's opioid state of emergency" 9269:

Substance Abuse and Mental Health Services Administration

9133: 8178: 8146: 7856:"Why fentanyl is deadlier than heroin, in a single photo" 7456: 5772:"American Carnage: The New Landscape of Opioid Addiction" 4934:"Trends in Heroin Use in the United States: 2002 to 2013" 3725:

Substance Abuse and Mental Health Services Administration

3265:. North America's dominant trafficking group is Mexico's 2915:

Have a diagnosable opioid use disorder, according to the

2847: 2846:

can lead to a number of consequences like contraction of

2606: 2352: 2319:

Substance Abuse and Mental Health Services Administration

1252:

declared a state of emergency in response to the crisis.

1240:, 967 people died of an opiate overdose in 2016, and the 630:

Substance Abuse and Mental Health Services Administration

564: 110:

The problem is significantly worse in rural areas, where

15301:"CDC Guideline for Prescribing Opioids for Chronic Pain" 14968: 13501:

The Journal of Behavioral Health Services & Research

13494: 12074:

United States Postal Service Office of Inspector General

9574:"Patient brokering exacerbates opioid crisis in Florida" 9022:

Furr-Holden D, Milam AJ, Wang L, Sadler R (March 2021).

7085:"What Science tells us About Opioid Abuse and Addiction" 4103: 3865:

Furlan A, Chaparro LE, Irvin E, Mailis-Gagnon A (2011).

683:. The epidemic cost the United States an estimated $ 504 636:

million Americans misused prescription opioids, nearly 1

461:

banned the sale, importation, or manufacture of heroin.

15431:

chemicals are safe and which are dangerous, and what a

15392: 15376: 14505:

Jones JD, Campbell A, Metz VE, Comer SD (August 2017).

12417:"Opioid crisis: US drug giants reach $ 26bn settlement" 11095:. US Surgeon General. 2016. p. 413. Archived from 11070:

Summary of the Comprehensive Addiction and Recovery Act

10557:

Ochalak TA, Cumpston PL, Wils BK (September 18, 2020).

10342: 6565:, National Institute on Drug Abuse (NIDA), May 14, 2014 3597: 2755:

and lower cost following prescription drug crackdowns.

2662:

the aggregate total the companies will be able to pay.

726:

led White House efforts to combat the opioid epidemic.

563:

and his aides began pushing for the involvement of the

308:

as a "uniquely American problem." The structure of the

15363:

Dreamland: The True Tale of America's Opiate Epidemic

15125:, Congressional Research Service report, March 3, 2016 14504: 13798:

Turner L, Kruszewski SP, Alexander GC (January 2015).

12703: 10881: 10770: 7255: 7147:"In Guilty Plea, OxyContin Maker to Pay $ 600 Million" 6107: 3794: 2195:

began to deal with the crisis, and in 2016, President

2160:

but cheaper opioid, as a substitute. A 2017 survey in

406:

Part 1: The Narcotic Farm and the Promise of Salvation

14749:"Determination of Need for Syringe Services Programs" 14639: 13546:"Improving Rural Access to Opioid Treatment Programs" 13247: 12747: 12006: 12004: 12002: 10771:

Carpenter CS, McClellan CB, Rees DI (March 1, 2017).

10646: 10343:

Aronowitz SV, Compton P, Schmidt HD (February 2021).

8959:"Products - Data Briefs - Number 457 - December 2022" 8554: 7055:"Heroin: Effects, Addictions & Treatment Options" 5478: 3981:"Why opioid overdose deaths seem to happen in spurts" 3316:, world's highest per capita rate of opiate addiction 2778:

Co-prescribe naloxone to patients at risk of overdose

2656:

US Federal District Court (Northern District of Ohio)

2432:, and to resolve charges over their scheme to direct 418:

Part 2: Synanon and the Tunnel Back to the Human Race

15371:, vol. 41, no. 7 (April 4, 2019), pp. 23–26. " 15355:

American Overdose: The Opioid Tragedy in Three Acts

15184:"The Opioid Epidemic: What Does It Mean for Nurses?" 15168:

Alexander GC, Frattaroli S, Gielen AC, eds. (2017).

14829:

Rudd RA, Seth P, David F, Scholl L (December 2016).

13954:(2019). "Opioids: The Good, the Bad, and the Ugly". 13410: 10228: 10179: 6406:"Drug Deaths in America Are Rising Faster Than Ever" 5451:. Centers for Disease Control and Prevention (CDC). 3094: 1257:

Table: Opioid prescriptions per 100 persons in 2012.

1104:

In 2015, Anne Case and Angus Deaton's theory of the

14828: 13152:. Washington DC: Nash Holdings Inc. June 16, 2019. 12618: 12347: 11906:"SUPPORT for Patients and Communities Act (H.R. 6)" 11614: 11047:. Delhidailynews.com. June 11, 2014. Archived from 10556: 8474:. National Institute of Drug Abuse. April 6, 2017. 7208: 5904:"Addiction rare in patients treated with narcotics" 4823: 15308: 14352: 13745:"My View: New approach needed for opioid epidemic" 13543: 13146:"Five takeaways from the DEA's pain pill database" 13113: 11999: 11776:"President Trump delivers speech on opioid crisis" 10975:. Government Publishing Office. October 12, 2010. 10970:"Secure and Responsible Drug Disposal Act of 2010" 10835:"The Opioid Epidemic During the COVID-19 Pandemic" 10288:Hines CB, Cody SL, Eyer JC, Coupe L (April 2021). 10287: 6375:"Drug overdoses now kill more Americans than guns" 5695:"The devastating effect of opioids on our society" 5559:Opioid Crisis: What People Don't Know About Heroin 4824:Gladden RM, Martinez P, Seth P (August 26, 2016). 3795:Lebmke A, HUMPHREYS K, NEWMARK J (June 15, 2016). 3309:List of deaths from drug overdose and intoxication 3286:China and the opioid epidemic in the United States 876:China and the opioid epidemic in the United States 9889:Florence CS, Zhou C, Luo F, Xu L (October 2016). 9888: 9790:National Center for Injury Prevention and Control 7543: 7114:Now a counselor, she went from stoned to straight 6228: 3441:"What led to the opioid crisis and how to fix it" 3388: 2395:signed the package into law on October 28, 2018. 1117:In the US, addiction and overdoses affect mostly 531:Addiction Rare in Patients Treated with Narcotics 15449: 15234:. Washington, DC: The National Academies Press. 14406: 13248:McCarty D, Priest KC, Korthuis PT (April 2018). 12992: 12034:Jesse Eisinger, James Bandler (March 25, 2020). 11034:, Canadian Centre on Substance Abuse, March 2013 10475:American Medical Association (August 14, 2020). 10229:Meadows C, Martin D, LeBaron V (March 3, 2021). 8766: 8721:"The Opioid Epidemic: A Geography in Two Phases" 8718: 7345:"The Effects of Hydrocodone Use - DrugAbuse.com" 5479:Shipton EA, Shipton EE, Shipton AJ (June 2018). 5387: 5385: 5383: 4422: 4002: 4000: 2573:On October 4, 2021, a landmark trial began in a 2184:, which expands opioid addiction treatment with 2039:after their parents have died from an overdose. 715:occurring on the streets of America every day." 72:Total drug overdose deaths in the United States. 15128: 14107: 14014:"Conference Seeks Ways To Reduce Heroin Deaths" 12694:, Volume 98, Issue 3, March 2018, Pages 147–148 11169: 11112: 11082: 10845:(16). American Medical Association: 1615–1617. 10569:(16). American Medical Association: 1673–1674. 10520:(16). American Medical Association: 1674–1677. 10507: 9590: 9311: 9203: 7752: 6003: 6001: 5999: 5997: 5995: 5945:"A 1980 Letter on the Risk of Opioid Addiction" 5873:"Opioid crisis: The letter that started it all" 5725:"Opioids: From 'wonder drug' to abuse epidemic" 2708: 2355:'s biggest crisis". In October 2017, President 2027:The high death rate by overdose, the spread of 473:, which were widely used at rock concerts like 193: 15232:Medications for Opioid Use Disorder Save Lives 14869: 13114:Hingham S, Horwitz S, Rich S (June 16, 2019). 12445: 11504:"Trump to nominate Jim Carroll for 'drug czar" 11501: 10452:. American Medical Association. May 28, 2020. 8618:Deaths of Despair and the Future of Capitalism 6622: 6620: 6282:"2015 National Drug Threat Assessment Summary" 6229:Dowell D, Noonan RK, Houry D (December 2017). 6224: 6222: 5689: 5687: 3507: 3304:List of countries by prevalence of opiates use 3160: 2479: 2140:Anti-fentanyl legislation in the United States 2097:Treatment and effects during COVID-19 pandemic 912:. As of 2023, one dose costs $ 8 for users in 202:3 waves of opioid overdose deaths. US timeline 16:Ongoing overuse of opioid medication in the US 15123:"Heroin Production in Mexico and U.S. Policy" 13977:"Confessions of an American Opium-Prescriber" 12619:Dowell D, Haegerich TM, Chou R (April 2016). 11560: 11341:"Trump to tap Rep. Tom Marino as 'drug czar'" 10508:Wainwright JJ, Mikre M (September 18, 2020). 10180:Chouinard S, Prasad A, Brown R (March 2018). 9596: 9204:DiNardi M, Swann WL, Kim SY (December 2022). 7716: 6838:"U.S. Presses China to Stop Flow of Fentanyl" 6587: 5983: 5649: 5443: 5441: 5380: 4746: 4477:(in Hindi). World Health Organization. 1986. 3997: 3772:. US Office of National Drug Control Policy. 3361: 3359: 3357: 3355: 3353: 2042:A 2016 study showed the cost of prescription 15278:: CS1 maint: multiple names: authors list ( 15171:The Opioid Epidemic: From Evidence to Impact 14863: 14407:Cataife G, Dong J, Davis CS (July 3, 2021). 13740: 13738: 13411:Vashishtha D, Mittal ML, Werb D (May 2017). 12863:. Santa Rosa's Press Gazette. Archived from 12668:Missouri is final state to pass PDMP program 12158: 12156: 11170:Eilperin J, Johnson CY (December 13, 2016). 9657: 8661: 6972: 6433: 6431: 6231:"Underlying Factors in Drug Overdose Deaths" 5992: 5794: 5308: 5032: 4931: 4602: 4600: 4598: 4560: 4410:10.26226/morressier.5ab3c87fa874c60026558b9a 4334: 571:in drug interdiction efforts, the so-called 484:died from an overdose. During and after the 15387:to accumulate doctors willing to prescribe 15341:, "A Blizzard of Prescriptions" (review of 14931: 14835:MMWR. Morbidity and Mortality Weekly Report 13544:Johnson Q, Mund B, Joudrey PJ (June 2018). 13296: 12162: 10406:MMWR. Morbidity and Mortality Weekly Report 9770: 9768: 9695:MMWR. Morbidity and Mortality Weekly Report 9307: 9305: 9303: 9301: 8924: 8922: 8325: 8323: 7753:del Pozo B, Sightes E (November 24, 2021). 6617: 6341:MMWR. Morbidity and Mortality Weekly Report 6298: 6219: 5766: 5764: 5762: 5760: 5758: 5756: 5754: 5752: 5750: 5684: 5094: 4879:MMWR. Morbidity and Mortality Weekly Report 4830:MMWR. Morbidity and Mortality Weekly Report 3604:MMWR. Morbidity and Mortality Weekly Report 3472:MMWR. Morbidity and Mortality Weekly Report 3395:MMWR. Morbidity and Mortality Weekly Report 3320:Response to the Opioid Crisis in New Jersey 3175: 977:Journal of the American Medical Association 430:Part 3: Searching for Meaning in Kensington 15407:class that takes marching orders from the 15214: 15030:. Kentucky Law Enforcement. Archived from 14754:Centers for Disease Control and Prevention 13761: 12823: 12593:. November 2017. p. 2. Archived from 12446:Smith JC, Mulvihill G (October 21, 2019). 11814:Centers for Disease Control and Prevention 11113:Higham S, Bernstein L (October 15, 2017). 11002:"Tackling the Opioid Public Health Crisis" 10832: 9821:Centers for Disease Control and Prevention 9786:Centers for Disease Control and Prevention 9462: 8614: 7934:. American College of Medical Toxicology. 7903:Centers for Disease Control and Prevention 6524: 6450:Centers for Disease Control and Prevention 6314:Centers for Disease Control and Prevention 5901: 5438: 5247:"Why opioids are such an American problem" 5151: 4970: 4812:Centers for Disease Control and Prevention 4790:Understanding the Opioid Overdose Epidemic 4341:Annals of the New York Academy of Sciences 3715:"Why Do Adults Misuse Prescription Drugs?" 3525:Centers for Disease Control and Prevention 3350: 2745:Centers for Disease Control and Prevention 2337:Centers for Disease Control and Prevention 2208:'s biggest crisis", followed by President 2075:Patient Protection and Affordable Care Act 1010:Centers for Disease Control and Prevention 762:US Department of Health and Human Services 101:Centers for Disease Control and Prevention 15295:https://doi.org/10.1016/j.pmn.2019.05.004 15134: 14996: 14986: 14872:The Journal of Law, Medicine & Ethics 14846: 14805: 14530: 14481: 14424: 14313: 14265: 14247: 14198: 14141: 14084: 13815: 13735: 13702: 13661: 13643: 13569: 13550:The Journal of Law, Medicine & Ethics 13520: 13438: 13428: 13273: 13082: 13018: 12993:Netherland J, Hansen HB (December 2016). 12966: 12773: 12721: 12644: 12153: 11079:, American Society of Addiction Medicine. 10915: 10850: 10747: 10729: 10680: 10582: 10533: 10425: 10400:O'Donnell, Gladden RA, Mattson C (2020). 10368: 10205: 10156: 9914: 9846:, December 8, 2016, Retrieved May 8, 2017 9799: 9731: 9714: 9550: 9422: 9405: 9337: 9312:Martins SS, Ghandour LA (February 2017). 9237: 9169: 9151: 8894: 8695: 8588: 8032: 7959: 7832: 7780: 7770: 7596: 7317: 7307: 6998: 6949: 6428: 6254: 6033: 5960: 5936: 5919: 5895: 5504: 5474: 5472: 5470: 5340: 4908: 4890: 4841: 4723: 4595: 4376: 4299: 4139: 4121: 4110:Addiction Science & Clinical Practice 4077: 4043: 3892: 3882: 3646: 3623: 3491: 3445:Harvard T.C. Chan School of Public Health 3416: 3406: 15081: 15021:"Signs of a Pill Mill in Your Community" 14937: 14287: 14285: 14108:Lyden J, Binswanger IA (April 1, 2019). 14011: 13266:10.1146/annurev-publhealth-040617-013526 12476: 12224: 11433: 10833:Haley DF, Saitz R (September 18, 2020). 9969: 9765: 9428: 9298: 8919: 8523: 8440: 8438: 8436: 8320: 8171: 7507: 7376:"A Quiet Drug Problem Among the Elderly" 7052: 6973:Huang X, Keyes KM, Li G (January 2018). 6951:10.1146/annurev-publhealth-031914-122957 6151: 5747: 5718: 5716: 5357: 5275: 5097:"The Opioid Crisis in Black Communities" 4607:"America's opioid epidemic is worsening" 3199: 3115: 2182:Comprehensive Addiction and Recovery Act 2133: 2018: 1942: 1203: 1091: 945: 896:tip) is a lethal amount for most people. 879: 770: 671:the epidemic over the next 10 years. In 577: 285: 268: 214: 197: 15317:s investigation of the opioid epidemic" 14676: 14605: 13974: 13870: 13868: 13866: 13684: 13460: 13458: 13406: 13404: 13367: 13365: 13363: 13326: 13324: 13243: 13241: 13239: 13237: 13235: 13156:from the original on September 20, 2020 12858: 12743: 12741: 12552:Northeastern University School of Law. 12353: 12322: 12288: 12286: 12254: 12252: 11682: 11566: 11465: 11463: 11303: 11273: 11127:from the original on September 18, 2021 10642: 10640: 9982:from the original on September 29, 2018 9658:Meyer K, Sholtis B (January 10, 2018). 9458: 9456: 9359: 9357: 9275: 9199: 9197: 9195: 9193: 9191: 9189: 9129: 9127: 9125: 9123: 9121: 9084:Journal of Ethnicity in Substance Abuse 9073: 9071: 9069: 9067: 9065: 9017: 9015: 9013: 8987: 8953: 8951: 8848: 8846: 8844: 8762: 8760: 8758: 8756: 8610: 8608: 8496: 8368: 8204: 7662: 7631: 7544:Deidre McPhillips (November 17, 2021). 7452: 7450: 7404: 7339: 7337: 7285: 7283: 6537:from the original on September 12, 2016 6320:from the original on September 23, 2022 6191: 6189: 6187: 6077: 6007: 5637:from the original on September 30, 2020 5426:from the original on September 26, 2019 5213: 4231: 4229: 4227: 4225: 4099: 4097: 3465: 3014: 2672: 2636: 2627: 2440:who were likely to prescribe Suboxone. 2310:In July 2017, a 400-page report by the 2280:Department of Health and Human Services 2073:The opioid epidemic, combined with the 1244:expected over 1,500 deaths in 2017. In 870:2010s to present (increase in fentanyl) 15450: 14914:"Understanding Drug Use and Addiction" 14775: 14773: 14743: 14741: 14739: 14579: 13599: 13597: 13476:from the original on November 15, 2018 13309:from the original on November 15, 2018 13217: 13215: 13213: 13211: 13209: 13173: 13171: 12988: 12986: 12944: 12942: 12564:from the original on November 27, 2019 12533:from the original on November 27, 2019 12520: 12485:. New York NY: Dow Jones and Company. 12397:from the original on February 15, 2020 12384: 12366:from the original on September 3, 2022 12335:from the original on February 19, 2022 12271:from the original on November 10, 2021 12258: 11651: 11620: 11518:from the original on October 18, 2019. 11369: 11321:from the original on November 24, 2020 11231:from the original on September 3, 2023 10060: 9855: 9815:. Pick year from menu below map. From 9281: 8749:– via Economic Research Service. 8719:McGranahan DA, Parker T (April 2021). 8472:"Addressing America's Fentanyl Crisis" 8289:from the original on September 4, 2017 8134: 7953: 7806: 7552:from the original on February 11, 2022 7525:from the original on November 15, 2023 7435:from the original on November 22, 2018 7177: 6728:from the original on February 23, 2023 6626: 6605:from the original on November 10, 2017 6525:Nolan D, Amico C (February 23, 2016). 6520: 6518: 6516: 6514: 6512: 6510: 6508: 6506: 6276: 6274: 6066:from the original on December 11, 2021 5867: 5865: 5863: 5815: 5701:from the original on September 3, 2023 5672:from the original on September 5, 2018 5467: 5296:from the original on December 28, 2017 5257:from the original on December 28, 2017 5147: 5145: 5039:Journal of Forensic and Legal Medicine 4783: 4316:from the original on December 23, 2022 4265: 4210:from the original on September 3, 2023 4165: 4163: 4161: 4159: 4039: 4037: 4035: 4033: 4031: 4029: 4008:"Can America solve its opioid crisis?" 3976: 3974: 3776:from the original on February 24, 2019 3764: 3762: 3747:from the original on November 15, 2021 3735: 3733: 3678: 3676: 3674: 3579:from the original on November 23, 2020 3544:from the original on November 15, 2021 3153:Beginning in Spring 2023 in Illinois, 2607:States reject distributors' settlement 2273:Office of National Drug Control Policy 2257:Office of National Drug Control Policy 1212:In the United States, those living in 15468:Health disasters in the United States 15181: 14282: 13993:from the original on December 3, 2019 13886:from the original on November 1, 2018 13838: 13389:from the original on January 12, 2019 12927:from the original on November 7, 2018 12897:from the original on November 7, 2018 12829: 12489:from the original on October 13, 2020 12458:from the original on October 26, 2019 12304:from the original on October 31, 2021 12193: 12175:from the original on February 7, 2021 12163:Howard J, Drash W (August 26, 2019). 11916:from the original on November 7, 2018 11786:from the original on October 26, 2017 11756:from the original on October 26, 2017 11713: 11695:from the original on January 11, 2018 11415:from the original on October 11, 2018 11400: 11351:from the original on October 14, 2017 11261:from the original on November 9, 2017 10994: 10932: 10456:from the original on October 11, 2020 10073:from the original on January 14, 2019 10042:from the original on January 14, 2019 9951:from the original on December 4, 2017 9870:from the original on February 4, 2018 9817:National Center for Health Statistics 9639:from the original on November 7, 2017 8536:from the original on January 12, 2023 8505:from the original on January 12, 2023 8478:from the original on January 11, 2018 8433: 8356:from the original on January 30, 2018 8342: 7968:from the original on January 15, 2023 7941:from the original on January 13, 2022 7570: 7386:from the original on November 1, 2018 7355:from the original on October 30, 2017 7268:from the original on November 4, 2017 7191:. Scottsdale, Arizona. Archived from 7159:from the original on October 27, 2017 7144: 7065:from the original on October 19, 2016 7021: 6927: 6925: 6923: 6715: 6667:from the original on December 1, 2017 6478: 6459:from the original on December 9, 2017 6439:National Center for Health Statistics 6128:from the original on January 22, 2018 6113: 5795:Murphy MF, Steele RH (May 27, 1971). 5722: 5713: 5655: 5624: 5618: 5455:from the original on October 26, 2018 5101:Journal of Law, Medicine & Ethics 4952:from the original on October 17, 2022 4661:"Underlying Cause of Death 1999-2018" 4641:from the original on January 26, 2021 4399: 3563: 3561: 3559: 3330:United States sanctions against China 3195: 2733:prescription drug monitoring programs 2679: 2416:, agreed to pay $ 1.4 billion to the 2144:United States sanctions against China 273:Three waves of opioid overdose deaths 15478:Opioid epidemic in the United States 15458:2010s disasters in the United States 15116: 13950: 13863: 13466:"eCFR — Code of Federal Regulations" 13455: 13401: 13360: 13348:from the original on January 9, 2019 13321: 13232: 13122:. Washington DC: Nash Holdings Inc. 12754:Pharmacoepidemiology and Drug Safety 12738: 12283: 12249: 12237:from the original on August 26, 2019 12206:from the original on August 26, 2019 12128: 11843: 11483:from the original on August 29, 2020 11460: 11448:from the original on August 31, 2020 10637: 10269:from the original on August 17, 2022 9826: 9670:from the original on August 18, 2018 9453: 9354: 9186: 9118: 9062: 9010: 8948: 8841: 8825:. Associated Press. March 15, 2018. 8753: 8605: 8350:"Opioid Data Analysis and Resources" 8268: 8153:from the original on October 1, 2020 7717:Hammond G, Kinder T (May 18, 2023). 7689: 7447: 7373: 7334: 7280: 7249: 7215:Pharmacoepidemiology and Drug Safety 6687:"Overdose Crisis Mac Miller's Death" 6641:from the original on August 18, 2018 6491:from the original on August 11, 2017 6403: 6385:from the original on August 11, 2017 6306:"Opioid Data Analysis and Resources" 6184: 6172:from the original on August 11, 2023 5540:from the original on August 27, 2021 5244: 5158:International Journal of Drug Policy 4696:International Journal of Drug Policy 4222: 4094: 3248:transnational criminal organizations 2501:Prescription Drug Monitoring Program 2077:, has led to a situation called the 617:, increasing their earning to US$ 35 514:Modern prescription opiates such as 14770: 14736: 14110:"The United States opioid epidemic" 13594: 13380:US Government Accountability Office 13339:US Government Accountability Office 13206: 13168: 12983: 12939: 12811:from the original on August 5, 2017 12796: 12509:Georgia State University Law Review 12046:from the original on March 25, 2020 11579:from the original on March 22, 2019 11502:POLITICO Staff (February 9, 2018). 11291:from the original on August 8, 2020 10982:from the original on April 27, 2017 10104:from the original on March 18, 2019 9858:"The Children of the Opioid Crisis" 9609:from the original on August 2, 2017 8829:from the original on March 15, 2018 8643:from the original on April 29, 2023 8615:Case A, Deaton A (March 17, 2020). 8250:from the original on April 16, 2024 8186:from the original on April 16, 2024 8047:from the original on April 26, 2020 7909:from the original on August 5, 2017 7698:from the original on March 27, 2023 7671:from the original on March 29, 2023 7644:from the original on March 15, 2023 7613:from the original on March 15, 2023 7495:from the original on April 27, 2019 6878:from the original on March 13, 2024 6848:from the original on March 13, 2024 6818:from the original on March 13, 2024 6788:from the original on March 13, 2024 6549: 6503: 6397: 6271: 5949:The New England Journal of Medicine 5908:The New England Journal of Medicine 5860: 5142: 4964: 4671:from the original on April 19, 2020 4156: 4026: 4014:from the original on March 20, 2023 3971: 3927:from the original on April 23, 2020 3759: 3730: 3685:"What is the U.S. Opioid Epidemic?" 3671: 2904:US Government Accountability Office 2820:Academic Life in Emergency Medicine 2686:Georgia State University Law Review 1004:opioids; urgent action is critical. 403:Treating America's Opioid Addiction 372:U.S. yearly deaths involving other 13: 15160: 14884:10.1111/j.1748-720X.1995.tb01383.x 14236:Health Research Policy and Systems 13804:The American Journal on Addictions 13126:from the original on July 25, 2020 12427:from the original on July 30, 2021 11987:from the original on March 4, 2020 11956:from the original on July 11, 2019 11726:from the original on June 25, 2018 11664:from the original on June 26, 2018 11544:. February 4, 2019. Archived from 11182:from the original on June 15, 2017 10950:from the original on July 10, 2017 10665:10.1001/jamanetworkopen.2022.32314 10141:10.1001/jamanetworkopen.2020.23677 10012:from the original on June 20, 2018 9597:de La Bruyere E (August 2, 2017). 8936:from the original on July 17, 2019 7519:US Drug Enforcement Administration 7091:. January 27, 2016. Archived from 6920: 6758:from the original on July 24, 2020 6697:from the original on July 24, 2020 6416:from the original on June 28, 2023 6332: 6203:. October 25, 2017. Archived from 6091:. February 3, 2021. Archived from 5844:. November 7, 2017. Archived from 5735:from the original on April 9, 2019 5152:Keyes KM, Cerdá M (June 1, 2022). 3959:from the original on June 12, 2019 3947:"Drug Facts: Prescription Opioids" 3811:from the original on June 25, 2021 3801:American Family Physicians Journal 3556: 2568: 2522: 2128: 2081:, where a drug user moves between 1190: 499:panicked," wrote political editor 453:was made an illegal drug with the 14: 15494: 15411:of said corporations; entrenched 15215:Montgomery P (October 30, 2017). 15059:. October 3, 2016. Archived from 14032:from the original on July 6, 2022 13932:from the original on May 30, 2020 13851:from the original on July 9, 2021 13775:. August 22, 2017. Archived from 13084:10.1016/j.annemergmed.2015.05.005 12393:. 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October 15, 2021. 2960:slowly taper off the drug 2335:, former director of the 2169:Controlled Substances Act 2158:significantly more potent 1938: 1029:Northern District of Ohio 729: 654:In a 2015 report, the US 434:Science History Institute 423: 411: 396: 391: 297: 14848:10.15585/mmwr.mm655051e1 14114:Seminars in Perinatology 13750:August 19, 2017, at the 13562:10.1177/1073110518782951 12129:Romo V (June 10, 2019). 11514:: Capitol News Company. 9838:January 8, 2019, at the 8384:, ABC News, June 2, 2016 8123:South China Morning Post 8077:Becker's Hospital Review 8021:Becker's Hospital Review 7905:(CDC). 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A Reporter at Large. 5397:April 29, 2019, at the 4581:10.1001/jama.2012.14282 3844:10.1001/jama.2012.14282 2911:potential patients to: 2621:AmerisourceBergen Corp. 2534:Insys Therapeutics Inc. 2011:(37.9 per 100,000) and 1112: 764:estimates that about 11 455:Anti-Heroin Act of 1924 15463:2010s health disasters 15368:London Review of Books 15349:, Head of Zeus, 2019; 15217:"Faces of an Epidemic" 15098:"America's Pill Mills" 14975:Harm Reduction Journal 14077:10.1126/sciadv.abm8147 13417:Harm Reduction Journal 13223:Opioid Abuse~treatment 12637:10.1001/jama.2016.1464 11603:July 16, 2017, at the 11075:July 19, 2017, at the 11030:March 2, 2019, at the 10888:JAMA Internal Medicine 10731:10.3390/ijerph13010122 10418:10.15585/mmwr.mm6935a1 9140:Harm Reduction Journal 8117:July 31, 2018, at the 8094:July 31, 2018, at the 8071:July 31, 2018, at the 8015:July 31, 2018, at the 7992:July 31, 2018, at the 7189:NASCSA 2012 Conference 7131:Patrick Radden Keefe, 6601:. September 14, 2017. 6584:, STAT, June 27, 2017, 6561:June 14, 2017, at the 5770:Caldwell, Christoper. 5627:"Frontline Pharmacies" 4892:10.15585/mmwr.mm6802a3 4843:10.15585/mmwr.mm6533a2 4511:archives.drugabuse.gov 4284:10.15585/mmwr.rr7103a1 3720:June 11, 2020, at the 3484:10.15585/mmwr.mm7006a4 3408:10.15585/mmwr.mm6626a4 3205: 3142:, meaning it binds to 3132: 2991:Buprenorphine/naloxone 2902:In December 2015, the 2818:collaborated with the 2728: 2455: 2411:pharmaceutical company 2398:In July 2019, English 2393:President Donald Trump 2323:21st Century Cures Act 2255:to be director of the 2229:21st Century Cures Act 2150:unintended consequence 2024: 2016: 1209: 1176: 1159: 1097: 1038: 1006: 958: 944: 897: 776: 664:substance use disorder 602:McKinsey & Company 593: 561:George H. W. Bush 310:U.S. healthcare system 290: 274: 226:a letter to the editor 220: 203: 32:Number of yearly U.S. 15365:, Bloomsbury, 2016), 13882:. November 28, 2013. 11347:. September 1, 2017. 11227:. February 27, 2017. 10944:The Salt Lake Tribune 10621:. February 25, 2022. 9947:. November 20, 2017. 8965:. December 21, 2022. 8627:10.1515/9780691199955 8428:The Columbus Dispatch 8399:May 17, 2017, at the 8313:May 25, 2017, at the 7861:June 4, 2017, at the 6874:. February 16, 2024. 6844:. November 15, 2023. 6663:. November 20, 2017. 6294:on February 20, 2017. 5584:Postgraduate Medicine 5564:May 19, 2018, at the 4806:July 6, 2023, at the 4795:July 9, 2022, at the 4761:10.5055/jom.2016.0315 3986:May 19, 2017, at the 3743:. November 28, 2017. 3203: 3119: 2880:Webb v. United States 2752:University of Florida 2724: 2667:Johnson & Johnson 2550:Johnson & Johnson 2446: 2138:Further information: 2134:US federal government 2058:Two employees of the 2029:communicable diseases 2022: 1946: 1207: 1173:million men in 2015. 1095: 1033: 1001: 949: 939: 883: 774: 587: 289: 272: 218: 201: 93:medical prescriptions 15473:McKesson Corporation 15037:on December 21, 2016 14841:(50–51): 1445–1452. 12955:Psychiatric Services 12807:. Associated Press. 12804:The Washington Times 12600:on November 13, 2019 12591:Drug Policy Alliance 12024:, September 10, 2019 11854:10.2139/ssrn.3176809 11782:. October 26, 2017. 11752:. October 26, 2017. 11548:on September 8, 2020 11102:on October 19, 2017. 10489:on September 2, 2020 9775:Drug Overdose Deaths 9749:Overdose Death Rates 7869:, September 29, 2016 7759:Health & Justice 7638:publications.aap.org 6381:. December 9, 2016. 6095:on February 18, 2021 5962:10.1056/NEJMc1700150 4517:on February 11, 2021 3366:Overdose Death Rates 3129:Lake Ozark, Missouri 3079:), which was led by 3077:Drug Policy Alliance 3075:(later known as the 3041:twelve-step programs 3015:Behavioral treatment 2946:for the addictions. 2750:A 2018 study by the 2673:Homicide by overdose 2651:McKesson Corporation 2637:Cleveland Settlement 2628:July 2021 settlement 2613:McKesson Corporation 2563:Teva Pharmaceuticals 2505:controlled substance 2325:which provided $ 485 2231:, which includes $ 1 2193:Obama administration 2180:signed into law the 2007:(39.0 per 100,000), 2003:(39.1 per 100,000), 1999:(52.0 per 100,000), 1379:District of Columbia 720:Mexican drug cartels 551:followed widespread 501:Christopher Caldwell 79:There is an ongoing 15323:The Washington Post 15142:The Washington Post 15082:Quinones S (2015). 15063:on December 1, 2017 15028:Kentucky Government 14511:Addictive Behaviors 14294:Addictive Behaviors 14069:2022SciA....8M8147S 13779:on January 11, 2018 13685:Connery HS (2015). 13046:Periscopetv website 13042:The Washington Post 12527:The Washington Post 12483:Wall Street Journal 11886:on November 7, 2018 11627:The Washington Post 11609:Scientific American 11317:. 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Economist. 2023. 3884:10.1155/2011/465281 3610:(5152): 1419–1427. 3466:Mattson CL (2021). 3291:Diseases of despair 3089:good samaritan laws 3045:Narcotics Anonymous 2932:Affordable Care Act 2805:The Washington Post 2617:Cardinal Health Inc 2278:In April 2017, the 2119:opioid use disorder 2083:drug rehabilitation 2015:(33.5 per 100,000). 1259: 1119:non-Hispanic Whites 1048:Southern California 758:recreational opioid 184:physical dependence 83:(also known as the 14018:The New York Times 13989:. pp. 53–56. 13987:Center for Inquiry 13982:Skeptical Inquirer 13962:Center for Inquiry 13957:Skeptical Inquirer 13817:10.1111/ajad.12174 12360:The New York Times 12329:The New York Times 11941:The New York Times 11658:The New York Times 11408:The New York Times 11376:The New York Times 11257:. March 29, 2017. 10006:South Bend Tribune 9585:South Bend Tribune 8988:Kariisa M (2022). 8275:The New York Times 8243:. April 16, 2024. 8125:, January 25, 2018 8100:The New York Times 8023:, January 25, 2018 8000:, January 24, 2018 7998:The New York Times 7663:DE VISÉ D (2023). 7413:on March 26, 2023. 7405:de Visé D (2023). 7380:The New York Times 7152:The New York Times 7135:, Doubleday, 2021. 7028:The New York Times 6842:The New York Times 6784:. April 14, 2023. 6410:The New York Times 6089:The New York Times 6062:, August 4, 2021, 5403:The New York Times 5377:, February 9, 2017 4475:Cancer pain relief 4361:10.1111/nyas.14209 3994:, February 8, 2017 3923:. March 12, 2020. 3575:. March 19, 2020. 3447:. February 9, 2022 3206: 3196:Use of blue lights 3133: 2351:was cited as the " 2221:US Surgeon General 2025: 2017: 1255: 1210: 1098: 967:Chinese government 959: 898: 797:controlled release 777: 594: 443:American Civil War 291: 275: 221: 204: 15381:healthcare system 15249:978-0-309-48648-4 15182:Leahy LG (2017). 13964:. pp. 19–21. 13917:978-92-4-154754-3 13615:on June 30, 2017. 12423:. 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July 17, 2012. 7198:on June 14, 2013. 7178:Coplan P (2012). 6782:Colorado Newsline 6241:(23): 2295–2296. 5955:(22): 2194–2195. 5625:Hicks RD (2011). 4492:978-4-307-77043-9 4266:Dowell D (2022). 3695:on April 19, 2020 3140:opioid antagonist 3073:Lindesmith Center 3067:Institute at the 3006:opioid antagonist 2844:Opioid dependence 2643:AmerisourceBergen 2407:Reckitt Benckiser 2103:COVID-19 pandemic 1990: 1989: 1936: 1935: 1106:deaths of despair 1008:According to the 961:According to the 692:synthetic opioids 687:billion in 2015. 628:According to the 585: 439: 438: 374:synthetic opioids 358:synthetic opioids 56:synthetic opioids 15490: 15335: 15333: 15331: 15319: 15316: 15304: 15290: 15289: 15283: 15277: 15269: 15226: 15211: 15178: 15176: 15154: 15153: 15151: 15149: 15132: 15126: 15120: 15114: 15113: 15111: 15109: 15094: 15088: 15087: 15079: 15073: 15072: 15070: 15068: 15053: 15047: 15046: 15044: 15042: 15036: 15025: 15017: 15011: 15010: 15000: 14990: 14966: 14960: 14959: 14957: 14955: 14950:on June 24, 2018 14946:. Archived from 14935: 14929: 14928: 14926: 14924: 14910: 14904: 14903: 14867: 14861: 14860: 14850: 14826: 14820: 14819: 14809: 14777: 14768: 14767: 14765: 14763: 14758:. April 26, 2018 14745: 14734: 14733: 14705: 14699: 14698: 14696: 14694: 14680: 14674: 14673: 14637: 14631: 14630: 14628: 14626: 14603: 14597: 14596: 14594: 14592: 14577: 14571: 14570: 14568: 14566: 14551: 14545: 14544: 14534: 14502: 14496: 14495: 14485: 14476:(5): e218–e225. 14461: 14455: 14454: 14428: 14404: 14398: 14397: 14395: 14393: 14350: 14344: 14343: 14317: 14289: 14280: 14279: 14269: 14251: 14227: 14221: 14220: 14202: 14162: 14156: 14155: 14145: 14105: 14099: 14098: 14088: 14063:(25): eabm8147. 14057:Science Advances 14048: 14042: 14041: 14039: 14037: 14009: 14003: 14002: 14000: 13998: 13972: 13966: 13965: 13948: 13942: 13941: 13939: 13937: 13902: 13896: 13895: 13893: 13891: 13872: 13861: 13860: 13858: 13856: 13836: 13830: 13829: 13819: 13795: 13789: 13788: 13786: 13784: 13765: 13759: 13756:Portland Tribune 13742: 13733: 13732: 13706: 13682: 13676: 13675: 13665: 13647: 13623: 13617: 13616: 13601: 13592: 13591: 13573: 13541: 13535: 13534: 13524: 13492: 13486: 13485: 13483: 13481: 13462: 13453: 13452: 13442: 13432: 13408: 13399: 13398: 13396: 13394: 13388: 13377: 13369: 13358: 13357: 13355: 13353: 13347: 13336: 13328: 13319: 13318: 13316: 13314: 13294: 13288: 13287: 13277: 13245: 13230: 13219: 13204: 13203: 13175: 13166: 13165: 13163: 13161: 13142: 13136: 13135: 13133: 13131: 13111: 13105: 13104: 13086: 13062: 13056: 13039: 13033: 13032: 13022: 12990: 12981: 12980: 12970: 12946: 12937: 12936: 12934: 12932: 12923:. May 31, 2018. 12921:www.ama-assn.org 12913: 12907: 12906: 12904: 12902: 12891:www.ama-assn.org 12883: 12877: 12876: 12874: 12872: 12867:on June 20, 2018 12856: 12847: 12846: 12844: 12842: 12827: 12821: 12820: 12818: 12816: 12794: 12788: 12787: 12777: 12766:10.1002/pds.4404 12745: 12736: 12735: 12725: 12701: 12695: 12692:Physical Therapy 12688: 12682: 12681:; April 13, 2017 12665: 12659: 12658: 12648: 12616: 12610: 12609: 12607: 12605: 12599: 12588: 12580: 12574: 12573: 12571: 12569: 12549: 12543: 12542: 12540: 12538: 12518: 12512: 12505: 12499: 12498: 12496: 12494: 12474: 12468: 12467: 12465: 12463: 12452:Associated Press 12443: 12437: 12436: 12434: 12432: 12413: 12407: 12406: 12404: 12402: 12382: 12376: 12375: 12373: 12371: 12351: 12345: 12344: 12342: 12340: 12320: 12314: 12313: 12311: 12309: 12290: 12281: 12280: 12278: 12276: 12256: 12247: 12246: 12244: 12242: 12222: 12216: 12215: 12213: 12211: 12191: 12185: 12184: 12182: 12180: 12160: 12151: 12150: 12148: 12146: 12126: 12120: 12119: 12117: 12115: 12096: 12090: 12089: 12083: 12081: 12062: 12056: 12055: 12053: 12051: 12031: 12025: 12008: 11997: 11996: 11994: 11992: 11972: 11966: 11965: 11963: 11961: 11932: 11926: 11925: 11923: 11921: 11902: 11896: 11895: 11893: 11891: 11882:. Archived from 11872: 11866: 11865: 11841: 11835: 11834: 11832: 11830: 11824: 11810: 11802: 11796: 11795: 11793: 11791: 11772: 11766: 11765: 11763: 11761: 11742: 11736: 11735: 11733: 11731: 11711: 11705: 11704: 11702: 11700: 11680: 11674: 11673: 11671: 11669: 11649: 11643: 11642: 11640: 11638: 11618: 11612: 11595: 11589: 11588: 11586: 11584: 11564: 11558: 11557: 11555: 11553: 11538:Washington, D.C. 11526: 11520: 11519: 11499: 11493: 11492: 11490: 11488: 11467: 11458: 11457: 11455: 11453: 11431: 11425: 11424: 11422: 11420: 11398: 11392: 11391: 11389: 11387: 11367: 11361: 11360: 11358: 11356: 11337: 11331: 11330: 11328: 11326: 11307: 11301: 11300: 11298: 11296: 11277: 11271: 11270: 11268: 11266: 11247: 11241: 11240: 11238: 11236: 11217: 11211: 11198: 11192: 11191: 11189: 11187: 11167: 11161: 11143: 11137: 11136: 11134: 11132: 11110: 11104: 11103: 11101: 11094: 11086: 11080: 11067: 11061: 11060: 11058: 11056: 11041: 11035: 11022: 11016: 11015: 11014:on June 7, 2016. 11013: 11006: 10998: 10992: 10991: 10989: 10987: 10981: 10974: 10966: 10960: 10959: 10957: 10955: 10936: 10930: 10929: 10919: 10879: 10873: 10872: 10854: 10830: 10824: 10823: 10821: 10819: 10768: 10762: 10761: 10751: 10733: 10709: 10703: 10702: 10684: 10644: 10635: 10634: 10632: 10630: 10611: 10605: 10604: 10586: 10554: 10548: 10547: 10537: 10505: 10499: 10498: 10496: 10494: 10488: 10482:. Archived from 10481: 10472: 10466: 10465: 10463: 10461: 10446: 10440: 10439: 10429: 10397: 10391: 10390: 10372: 10340: 10334: 10333: 10285: 10279: 10278: 10276: 10274: 10226: 10220: 10219: 10209: 10177: 10171: 10170: 10160: 10135:(11): e2023677. 10120: 10114: 10113: 10111: 10109: 10089: 10083: 10082: 10080: 10078: 10058: 10052: 10051: 10049: 10047: 10028: 10022: 10021: 10019: 10017: 9998: 9992: 9991: 9989: 9987: 9967: 9961: 9960: 9958: 9956: 9935: 9929: 9928: 9918: 9886: 9880: 9879: 9877: 9875: 9853: 9847: 9830: 9824: 9803: 9797: 9772: 9763: 9747:. Originally at 9735: 9729: 9728: 9718: 9686: 9680: 9679: 9677: 9675: 9655: 9649: 9648: 9646: 9644: 9625: 9619: 9618: 9616: 9614: 9594: 9588: 9571: 9565: 9564: 9554: 9522: 9516: 9515: 9513: 9511: 9460: 9451: 9450: 9448: 9446: 9426: 9420: 9419: 9409: 9361: 9352: 9351: 9341: 9318:World Psychiatry 9309: 9296: 9295: 9279: 9273: 9272: 9266: 9258: 9252: 9251: 9241: 9201: 9184: 9183: 9173: 9155: 9131: 9116: 9115: 9075: 9060: 9059: 9019: 9008: 9007: 9005: 9003: 8985: 8979: 8978: 8976: 8974: 8955: 8946: 8945: 8943: 8941: 8932:April 10, 2018. 8926: 8917: 8916: 8898: 8850: 8839: 8838: 8836: 8834: 8815: 8809: 8808: 8764: 8751: 8750: 8748: 8746: 8740: 8725: 8716: 8710: 8709: 8699: 8659: 8653: 8652: 8650: 8648: 8612: 8603: 8602: 8592: 8552: 8546: 8545: 8543: 8541: 8521: 8515: 8514: 8512: 8510: 8494: 8488: 8487: 8485: 8483: 8468: 8462: 8461:, April 5, 2016, 8447: 8442: 8431: 8430:, March 16, 2017 8414: 8408: 8407:, April 17, 2017 8391: 8385: 8372: 8366: 8365: 8363: 8361: 8346: 8340: 8327: 8318: 8305: 8299: 8298: 8296: 8294: 8266: 8260: 8259: 8257: 8255: 8249: 8238: 8230: 8224: 8223: 8221: 8219: 8202: 8196: 8195: 8193: 8191: 8169: 8163: 8162: 8160: 8158: 8132: 8126: 8109: 8103: 8086: 8080: 8063: 8057: 8056: 8054: 8052: 8030: 8024: 8007: 8001: 7984: 7978: 7977: 7975: 7973: 7957: 7951: 7950: 7948: 7946: 7940: 7933: 7925: 7919: 7918: 7916: 7914: 7895: 7889: 7876: 7870: 7853: 7847: 7846: 7836: 7804: 7795: 7794: 7784: 7774: 7750: 7741: 7740: 7738: 7736: 7714: 7708: 7707: 7705: 7703: 7687: 7681: 7680: 7678: 7676: 7660: 7654: 7653: 7651: 7649: 7629: 7623: 7622: 7620: 7618: 7600: 7568: 7562: 7561: 7559: 7557: 7541: 7535: 7534: 7532: 7530: 7511: 7505: 7504: 7502: 7500: 7494: 7463: 7454: 7445: 7444: 7442: 7440: 7421: 7415: 7414: 7402: 7396: 7395: 7393: 7391: 7371: 7365: 7364: 7362: 7360: 7341: 7332: 7331: 7321: 7311: 7287: 7278: 7277: 7275: 7273: 7253: 7247: 7246: 7227:10.1002/pds.3723 7206: 7200: 7199: 7197: 7186: 7175: 7169: 7168: 7166: 7164: 7142: 7136: 7129: 7123: 7111: 7105: 7104: 7102: 7100: 7081: 7075: 7074: 7072: 7070: 7050: 7044: 7043: 7041: 7039: 7019: 7013: 7012: 7002: 6970: 6964: 6963: 6953: 6929: 6918: 6917: 6915: 6913: 6904:. June 1, 2017. 6894: 6888: 6887: 6885: 6883: 6864: 6858: 6857: 6855: 6853: 6834: 6828: 6827: 6825: 6823: 6804: 6798: 6797: 6795: 6793: 6774: 6768: 6767: 6765: 6763: 6744: 6738: 6737: 6735: 6733: 6713: 6707: 6706: 6704: 6702: 6683: 6677: 6676: 6674: 6672: 6657: 6651: 6650: 6648: 6646: 6624: 6615: 6614: 6612: 6610: 6591: 6585: 6572: 6566: 6553: 6547: 6546: 6544: 6542: 6522: 6501: 6500: 6498: 6496: 6476: 6470: 6468: 6466: 6464: 6458: 6447: 6435: 6426: 6425: 6423: 6421: 6401: 6395: 6394: 6392: 6390: 6371: 6365: 6364: 6336: 6330: 6329: 6327: 6325: 6316:. June 1, 2022. 6302: 6296: 6295: 6293: 6286: 6278: 6269: 6268: 6258: 6226: 6217: 6216: 6214: 6212: 6193: 6182: 6181: 6179: 6177: 6149: 6143: 6142:Indepth-analysis 6141: 6135: 6133: 6111: 6105: 6104: 6102: 6100: 6081: 6075: 6074: 6073: 6071: 6054: 6048: 6047: 6037: 6005: 5990: 5989: 5981: 5975: 5974: 5964: 5940: 5934: 5933: 5923: 5899: 5893: 5892: 5890: 5888: 5879:. June 3, 2017. 5869: 5858: 5857: 5855: 5853: 5838: 5832: 5819: 5813: 5812: 5806: 5804: 5792: 5786: 5768: 5745: 5744: 5742: 5740: 5720: 5711: 5710: 5708: 5706: 5691: 5682: 5681: 5679: 5677: 5656:Rinde M (2018). 5653: 5647: 5646: 5644: 5642: 5622: 5616: 5615: 5578: 5572: 5556: 5550: 5549: 5547: 5545: 5525: 5519: 5518: 5508: 5485:Pain and Therapy 5476: 5465: 5464: 5462: 5460: 5445: 5436: 5435: 5433: 5431: 5412: 5406: 5389: 5378: 5361: 5355: 5354: 5344: 5312: 5306: 5305: 5303: 5301: 5273: 5267: 5266: 5264: 5262: 5242: 5236: 5235: 5233: 5231: 5211: 5205: 5204: 5202: 5200: 5149: 5140: 5139: 5137: 5135: 5092: 5086: 5085: 5083: 5081: 5030: 5024: 5023: 5021: 5019: 4968: 4962: 4961: 4959: 4957: 4938:The CBHSQ Report 4929: 4923: 4922: 4912: 4894: 4870: 4864: 4863: 4845: 4821: 4815: 4787: 4781: 4780: 4744: 4738: 4737: 4727: 4687: 4681: 4680: 4678: 4676: 4657: 4651: 4650: 4648: 4646: 4627: 4621: 4604: 4593: 4592: 4564: 4558: 4557: 4533: 4527: 4526: 4524: 4522: 4503: 4497: 4496: 4471: 4465: 4464: 4420: 4414: 4413: 4397: 4391: 4390: 4380: 4332: 4326: 4325: 4323: 4321: 4303: 4263: 4257: 4256: 4254: 4252: 4233: 4220: 4219: 4217: 4215: 4167: 4154: 4153: 4143: 4125: 4101: 4092: 4091: 4081: 4041: 4024: 4023: 4021: 4019: 4004: 3995: 3978: 3969: 3968: 3966: 3964: 3943: 3937: 3936: 3934: 3932: 3913: 3907: 3906: 3896: 3886: 3862: 3856: 3855: 3827: 3821: 3820: 3818: 3816: 3792: 3786: 3785: 3783: 3781: 3766: 3757: 3756: 3754: 3752: 3737: 3728: 3711: 3705: 3704: 3702: 3700: 3691:. Archived from 3680: 3669: 3668: 3644: 3638: 3637: 3627: 3595: 3589: 3588: 3586: 3584: 3565: 3554: 3553: 3551: 3549: 3534: 3528: 3511: 3505: 3504: 3502: 3500: 3495: 3463: 3457: 3456: 3454: 3452: 3437: 3431: 3430: 3420: 3410: 3386: 3380: 3363: 3336:Wilful Blindness 3180:The CDC defines 3155:vending machines 3144:opioid receptors 3123:dispensing free 2701: 2699: 2697: 2426:opioid addiction 2349:opioid addiction 2328: 2234: 2054: 2049: 1984: 1978: 1972: 1966: 1960: 1954: 1948: 1947: 1260: 1258: 1254: 1238:British Columbia 1234:Middletown, Ohio 1172: 1168: 1129:Native Americans 1072: 950:Annual fentanyl 923: 812: 789:Curtis Wright IV 767: 686: 647: 639: 635: 620: 586: 428: 427: 416: 415: 401: 400: 389: 388: 376:, predominately 369: 353: 341: 228:featured in the 188:opioid addiction 69: 58:(73,838 deaths). 47: 29: 15498: 15497: 15493: 15492: 15491: 15489: 15488: 15487: 15448: 15447: 15446: 15401:corporate greed 15357:, Faber, 2018; 15329: 15327: 15326:. July 20, 2019 15314: 15307: 15299: 15284: 15271: 15270: 15250: 15174: 15163: 15161:Further reading 15158: 15157: 15147: 15145: 15133: 15129: 15121: 15117: 15107: 15105: 15096: 15095: 15091: 15080: 15076: 15066: 15064: 15055: 15054: 15050: 15040: 15038: 15034: 15023: 15019: 15018: 15014: 14967: 14963: 14953: 14951: 14936: 14932: 14922: 14920: 14912: 14911: 14907: 14868: 14864: 14827: 14823: 14778: 14771: 14761: 14759: 14747: 14746: 14737: 14706: 14702: 14692: 14690: 14682: 14681: 14677: 14642:Substance Abuse 14638: 14634: 14624: 14622: 14604: 14600: 14590: 14588: 14578: 14574: 14564: 14562: 14553: 14552: 14548: 14503: 14499: 14462: 14458: 14413:Substance Abuse 14405: 14401: 14391: 14389: 14351: 14347: 14290: 14283: 14228: 14224: 14163: 14159: 14106: 14102: 14049: 14045: 14035: 14033: 14010: 14006: 13996: 13994: 13973: 13969: 13949: 13945: 13935: 13933: 13918: 13904: 13903: 13899: 13889: 13887: 13874: 13873: 13864: 13854: 13852: 13841:"Buprenorphine" 13837: 13833: 13796: 13792: 13782: 13780: 13767: 13766: 13762: 13758:, July 25, 2017 13752:Wayback Machine 13743: 13736: 13683: 13679: 13638:(7): e1002625. 13624: 13620: 13603: 13602: 13595: 13542: 13538: 13493: 13489: 13479: 13477: 13464: 13463: 13456: 13409: 13402: 13392: 13390: 13386: 13375: 13371: 13370: 13361: 13351: 13349: 13345: 13334: 13330: 13329: 13322: 13312: 13310: 13295: 13291: 13246: 13233: 13220: 13207: 13176: 13169: 13159: 13157: 13150:Washington Post 13144: 13143: 13139: 13129: 13127: 13120:Washington Post 13112: 13108: 13063: 13059: 13053:Wayback Machine 13040: 13036: 12991: 12984: 12947: 12940: 12930: 12928: 12915: 12914: 12910: 12900: 12898: 12885: 12884: 12880: 12870: 12868: 12857: 12850: 12840: 12838: 12828: 12824: 12814: 12812: 12795: 12791: 12746: 12739: 12702: 12698: 12689: 12685: 12675:Wayback Machine 12666: 12662: 12631:(15): 1624–45. 12617: 12613: 12603: 12601: 12597: 12586: 12582: 12581: 12577: 12567: 12565: 12550: 12546: 12536: 12534: 12525:. Perspective. 12519: 12515: 12506: 12502: 12492: 12490: 12475: 12471: 12461: 12459: 12454:. New York NY. 12444: 12440: 12430: 12428: 12415: 12414: 12410: 12400: 12398: 12383: 12379: 12369: 12367: 12352: 12348: 12338: 12336: 12321: 12317: 12307: 12305: 12292: 12291: 12284: 12274: 12272: 12257: 12250: 12240: 12238: 12223: 12219: 12209: 12207: 12192: 12188: 12178: 12176: 12161: 12154: 12144: 12142: 12127: 12123: 12113: 12111: 12106:. May 2, 2019. 12098: 12097: 12093: 12079: 12077: 12076:. July 24, 2020 12064: 12063: 12059: 12049: 12047: 12032: 12028: 12018:Wayback Machine 12009: 12000: 11990: 11988: 11973: 11969: 11959: 11957: 11934: 11933: 11929: 11919: 11917: 11904: 11903: 11899: 11889: 11887: 11876:"#OpioidCrisis" 11874: 11873: 11869: 11842: 11838: 11828: 11826: 11822: 11808: 11804: 11803: 11799: 11789: 11787: 11774: 11773: 11769: 11759: 11757: 11750:Chicago Tribune 11744: 11743: 11739: 11729: 11727: 11712: 11708: 11698: 11696: 11689:Herald Standard 11681: 11677: 11667: 11665: 11650: 11646: 11636: 11634: 11619: 11615: 11611:, July 13, 2017 11605:Wayback Machine 11596: 11592: 11582: 11580: 11565: 11561: 11551: 11549: 11528: 11527: 11523: 11500: 11496: 11486: 11484: 11469: 11468: 11461: 11451: 11449: 11432: 11428: 11418: 11416: 11399: 11395: 11385: 11383: 11368: 11364: 11354: 11352: 11339: 11338: 11334: 11324: 11322: 11309: 11308: 11304: 11294: 11292: 11279: 11278: 11274: 11264: 11262: 11249: 11248: 11244: 11234: 11232: 11219: 11218: 11214: 11208:Wayback Machine 11199: 11195: 11185: 11183: 11168: 11164: 11154:Wayback Machine 11144: 11140: 11130: 11128: 11111: 11107: 11099: 11092: 11088: 11087: 11083: 11077:Wayback Machine 11068: 11064: 11054: 11052: 11051:on June 6, 2017 11043: 11042: 11038: 11032:Wayback Machine 11023: 11019: 11011: 11004: 11000: 10999: 10995: 10985: 10983: 10979: 10972: 10968: 10967: 10963: 10953: 10951: 10938: 10937: 10933: 10880: 10876: 10831: 10827: 10817: 10815: 10769: 10765: 10710: 10706: 10659:(9): –2232314. 10645: 10638: 10628: 10626: 10613: 10612: 10608: 10555: 10551: 10506: 10502: 10492: 10490: 10486: 10479: 10473: 10469: 10459: 10457: 10448: 10447: 10443: 10398: 10394: 10341: 10337: 10286: 10282: 10272: 10270: 10227: 10223: 10178: 10174: 10121: 10117: 10107: 10105: 10090: 10086: 10076: 10074: 10059: 10055: 10045: 10043: 10030: 10029: 10025: 10015: 10013: 10000: 9999: 9995: 9985: 9983: 9968: 9964: 9954: 9952: 9937: 9936: 9932: 9887: 9883: 9873: 9871: 9854: 9850: 9840:Wayback Machine 9831: 9827: 9813:Wayback Machine 9804: 9800: 9782:Wayback Machine 9773: 9766: 9756:Wayback Machine 9745:Wayback Machine 9736: 9732: 9687: 9683: 9673: 9671: 9656: 9652: 9642: 9640: 9627: 9626: 9622: 9612: 9610: 9595: 9591: 9587:, April 2, 2017 9581:Wayback Machine 9572: 9568: 9523: 9519: 9509: 9507: 9461: 9454: 9444: 9442: 9427: 9423: 9362: 9355: 9310: 9299: 9280: 9276: 9264: 9260: 9259: 9255: 9202: 9187: 9132: 9119: 9076: 9063: 9020: 9011: 9001: 8999: 8986: 8982: 8972: 8970: 8957: 8956: 8949: 8939: 8937: 8928: 8927: 8920: 8851: 8842: 8832: 8830: 8817: 8816: 8812: 8765: 8754: 8744: 8742: 8738: 8723: 8717: 8713: 8660: 8656: 8646: 8644: 8637: 8613: 8606: 8553: 8549: 8539: 8537: 8522: 8518: 8508: 8506: 8495: 8491: 8481: 8479: 8470: 8469: 8465: 8455:Wayback Machine 8445: 8443: 8434: 8424:Wayback Machine 8415: 8411: 8401:Wayback Machine 8392: 8388: 8382:Wayback Machine 8373: 8369: 8359: 8357: 8348: 8347: 8343: 8337:Wayback Machine 8328: 8321: 8315:Wayback Machine 8306: 8302: 8292: 8290: 8267: 8263: 8253: 8251: 8247: 8236: 8232: 8231: 8227: 8217: 8215: 8203: 8199: 8189: 8187: 8170: 8166: 8156: 8154: 8133: 8129: 8119:Wayback Machine 8110: 8106: 8102:, June 21, 2015 8096:Wayback Machine 8087: 8083: 8073:Wayback Machine 8064: 8060: 8050: 8048: 8031: 8027: 8017:Wayback Machine 8008: 8004: 7994:Wayback Machine 7985: 7981: 7971: 7969: 7958: 7954: 7944: 7942: 7938: 7931: 7927: 7926: 7922: 7912: 7910: 7897: 7896: 7892: 7886:Wayback Machine 7877: 7873: 7863:Wayback Machine 7854: 7850: 7805: 7798: 7751: 7744: 7734: 7732: 7724:Financial Times 7715: 7711: 7701: 7699: 7688: 7684: 7674: 7672: 7661: 7657: 7647: 7645: 7630: 7626: 7616: 7614: 7569: 7565: 7555: 7553: 7542: 7538: 7528: 7526: 7513: 7512: 7508: 7498: 7496: 7492: 7461: 7455: 7448: 7438: 7436: 7423: 7422: 7418: 7403: 7399: 7389: 7387: 7372: 7368: 7358: 7356: 7343: 7342: 7335: 7288: 7281: 7271: 7269: 7254: 7250: 7207: 7203: 7195: 7184: 7176: 7172: 7162: 7160: 7143: 7139: 7130: 7126: 7112: 7108: 7098: 7096: 7083: 7082: 7078: 7068: 7066: 7051: 7047: 7037: 7035: 7020: 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2064:Jackie Walorski 2052: 2047: 1993:overdose deaths 1986: 1985: 21.1–52.0 1982: 1980: 1979: 18.6–21.0 1976: 1974: 1973: 16.1–18.5 1970: 1968: 1967: 13.6–16.0 1964: 1962: 1961: 11.1–13.5 1958: 1956: 1952: 1941: 1256: 1202: 1193: 1191:Economic status 1184:methamphetamine 1179: 1170: 1166: 1162: 1115: 1090: 1070: 935:chemical weapon 921: 878: 872: 860: 835: 810: 765: 751: 732: 684: 645: 637: 633: 618: 590:Richard Sackler 578: 503:, and declared 457:, in which the 425: 413: 398: 387: 380: 370: 361: 354: 345: 342: 300: 284: 267: 258: 213: 196: 137: 129:methamphetamine 97:illegal sources 81:opioid epidemic 77: 76: 75: 74: 73: 70: 61: 60: 59: 48: 39: 38: 37: 34:opioid overdose 30: 17: 12: 11: 5: 15496: 15486: 15485: 15483:Sackler family 15480: 15475: 15470: 15465: 15460: 15445: 15444: 15443:, p. 23.) 15397:drug addiction 15336: 15305: 15297: 15291: 15248: 15240:10.17226/25310 15227: 15222:The New Yorker 15212: 15179: 15164: 15162: 15159: 15156: 15155: 15127: 15115: 15104:. July 1, 2016 15089: 15074: 15048: 15012: 14961: 14930: 14905: 14862: 14821: 14792:(5): 398–407. 14769: 14735: 14700: 14675: 14632: 14598: 14572: 14561:. May 15, 2023 14546: 14497: 14456: 14419:(3): 329–338. 14399: 14371:10.1086/700703 14345: 14281: 14222: 14157: 14120:(3): 123–131. 14100: 14043: 14004: 13967: 13943: 13916: 13897: 13862: 13831: 13790: 13760: 13734: 13677: 13618: 13593: 13556:(2): 437–439. 13536: 13487: 13454: 13400: 13359: 13320: 13303:www.samhsa.gov 13289: 13260:(1): 525–541. 13231: 13205: 13167: 13137: 13106: 13057: 13034: 13005:(4): 664–686. 12982: 12938: 12908: 12878: 12848: 12822: 12789: 12760:(4): 422–429. 12737: 12710:Health Affairs 12696: 12683: 12660: 12611: 12575: 12544: 12513: 12500: 12469: 12438: 12408: 12377: 12346: 12315: 12282: 12248: 12217: 12186: 12152: 12121: 12091: 12057: 12026: 12022:Bloomberg News 11998: 11967: 11927: 11897: 11867: 11836: 11797: 11767: 11737: 11706: 11675: 11644: 11613: 11590: 11559: 11534:Pharmacist.com 11521: 11494: 11459: 11426: 11393: 11362: 11332: 11302: 11272: 11242: 11212: 11193: 11162: 11145:Mike DeBonis, 11138: 11105: 11081: 11062: 11036: 11017: 10993: 10961: 10931: 10894:(4): 562–565. 10874: 10825: 10763: 10704: 10636: 10606: 10549: 10500: 10467: 10441: 10392: 10335: 10280: 10241:(4): 539–548. 10221: 10172: 10115: 10084: 10053: 10032:"Injury Facts" 10023: 9993: 9962: 9930: 9881: 9848: 9825: 9798: 9764: 9730: 9681: 9650: 9620: 9589: 9566: 9517: 9452: 9421: 9376:(3): 334–340. 9353: 9324:(1): 102–104. 9297: 9274: 9253: 9185: 9117: 9061: 9034:(3): 677–683. 9009: 8980: 8947: 8918: 8865:(3): 334–340. 8840: 8810: 8775:(5): 421–422. 8752: 8711: 8674:(3): –66–e68. 8654: 8635: 8604: 8547: 8516: 8489: 8463: 8432: 8409: 8386: 8367: 8341: 8319: 8300: 8261: 8225: 8197: 8164: 8127: 8104: 8081: 8058: 8025: 8002: 7979: 7952: 7920: 7890: 7871: 7848: 7819:(2): 112–115. 7796: 7742: 7709: 7682: 7655: 7624: 7583:(2): e180217. 7563: 7536: 7506: 7446: 7416: 7397: 7366: 7333: 7279: 7248: 7221:(2): 197–204. 7201: 7170: 7137: 7133:Empire of Pain 7124: 7106: 7076: 7045: 7014: 6985:(1): 131–136. 6965: 6919: 6889: 6859: 6829: 6799: 6769: 6739: 6708: 6678: 6652: 6616: 6586: 6567: 6548: 6502: 6471: 6427: 6408:. The Upshot. 6396: 6366: 6331: 6297: 6270: 6218: 6183: 6144: 6121:The New Yorker 6106: 6076: 6049: 5991: 5976: 5935: 5894: 5859: 5833: 5814: 5787: 5746: 5712: 5683: 5648: 5617: 5573: 5551: 5520: 5466: 5437: 5420:opioids.mo.gov 5407: 5405:, July 6, 2017 5379: 5356: 5307: 5268: 5237: 5206: 5141: 5107:(2): 404–421. 5087: 5025: 4963: 4924: 4865: 4816: 4782: 4739: 4702:(2): 257–266. 4682: 4665:wonder.cdc.gov 4652: 4635:www.samhsa.gov 4622: 4594: 4575:(18): 1865–6. 4559: 4528: 4498: 4491: 4466: 4431:(2): 201–208. 4415: 4392: 4347:(1): 130–143. 4327: 4258: 4221: 4176:Pain Physician 4155: 4093: 4056:(4): 344–350. 4025: 3996: 3970: 3938: 3908: 3857: 3838:(18): 1865–6. 3822: 3787: 3758: 3729: 3706: 3670: 3639: 3590: 3555: 3529: 3506: 3458: 3432: 3381: 3348: 3347: 3345: 3342: 3341: 3340: 3332: 3327: 3322: 3317: 3311: 3306: 3301: 3294: 3288: 3283: 3274: 3271: 3267:Sinaloa Cartel 3239: 3236: 3214: 3211: 3197: 3194: 3177: 3174: 3162: 3159: 3113: 3110: 3096: 3093: 3083:, financed by 3060:Harm reduction 3056: 3055:Harm reduction 3053: 3021:detoxification 3016: 3013: 2972: 2969: 2951: 2948: 2927: 2926: 2923: 2920: 2839: 2836: 2827: 2824: 2799: 2796: 2783: 2782: 2779: 2776: 2773: 2770: 2767: 2720:epidemiologist 2716:Silvia Martins 2710: 2707: 2678:unintentional. 2674: 2671: 2638: 2635: 2629: 2626: 2608: 2605: 2570: 2567: 2538:fentanyl spray 2529: 2526: 2524: 2521: 2518: 2517: 2514: 2511: 2508: 2491: 2483: 2481: 2478: 2461:revealed that 2403:consumer goods 2333:Thomas Frieden 2304: 2303: 2299: 2295: 2292: 2288: 2264:Scott Gottlieb 2245:Chris Christie 2201:Thomas Frieden 2135: 2132: 2130: 2127: 2098: 2095: 1991:Of the 64,070 1988: 1987: 1981: 1975: 1969: 1963: 1957: 1951: 1940: 1937: 1934: 1933: 1930: 1927: 1921: 1920: 1917: 1914: 1908: 1907: 1904: 1901: 1895: 1894: 1891: 1888: 1882: 1881: 1878: 1875: 1869: 1868: 1865: 1862: 1856: 1855: 1852: 1849: 1843: 1842: 1839: 1836: 1830: 1829: 1826: 1823: 1817: 1816: 1813: 1810: 1804: 1803: 1800: 1797: 1795:South Carolina 1791: 1790: 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1198: 1192: 1189: 1178: 1175: 1161: 1158: 1133:Alaska Natives 1114: 1111: 1101:demographics. 1089: 1086: 871: 868: 859: 856: 834: 831: 750: 747: 731: 728: 623:Sackler family 549:crack epidemic 437: 436: 421: 420: 409: 408: 394: 393: 392:External audio 386: 383: 382: 381: 371: 364: 362: 355: 348: 346: 343: 336: 299: 296: 283: 280: 266: 263: 257: 254: 212: 209: 195: 192: 136: 133: 71: 64: 63: 62: 49: 42: 41: 40: 31: 24: 23: 22: 21: 20: 15: 9: 6: 4: 3: 2: 15495: 15484: 15481: 15479: 15476: 15474: 15471: 15469: 15466: 15464: 15461: 15459: 15456: 15455: 15453: 15442: 15438: 15434: 15430: 15427:' are, which 15426: 15422: 15418: 15414: 15410: 15406: 15402: 15398: 15394: 15390: 15386: 15382: 15378: 15374: 15370: 15369: 15364: 15360: 15356: 15352: 15351:Chris McGreal 15348: 15344: 15340: 15337: 15325: 15324: 15318: 15313: 15306: 15302: 15298: 15296: 15292: 15288: 15281: 15275: 15267: 15263: 15259: 15255: 15251: 15245: 15241: 15237: 15233: 15228: 15224: 15223: 15218: 15213: 15209: 15205: 15201: 15197: 15193: 15189: 15185: 15180: 15173: 15172: 15166: 15165: 15144: 15143: 15138: 15131: 15124: 15119: 15103: 15102:DrugAbuse.com 15099: 15093: 15085: 15078: 15062: 15058: 15052: 15033: 15029: 15022: 15016: 15008: 15004: 14999: 14994: 14989: 14984: 14980: 14976: 14972: 14965: 14949: 14945: 14941: 14934: 14919: 14915: 14909: 14901: 14897: 14893: 14889: 14885: 14881: 14877: 14873: 14866: 14858: 14854: 14849: 14844: 14840: 14836: 14832: 14825: 14817: 14813: 14808: 14803: 14799: 14795: 14791: 14787: 14783: 14776: 14774: 14757: 14755: 14750: 14744: 14742: 14740: 14731: 14727: 14723: 14719: 14715: 14711: 14704: 14689: 14685: 14679: 14671: 14667: 14663: 14659: 14655: 14651: 14648:(1): 95–101. 14647: 14643: 14636: 14621: 14617: 14613: 14609: 14602: 14587: 14583: 14576: 14560: 14556: 14550: 14542: 14538: 14533: 14528: 14524: 14520: 14516: 14512: 14508: 14501: 14493: 14489: 14484: 14479: 14475: 14471: 14467: 14460: 14452: 14448: 14444: 14440: 14436: 14432: 14427: 14422: 14418: 14414: 14410: 14403: 14388: 14384: 14380: 14376: 14372: 14368: 14364: 14360: 14356: 14349: 14341: 14337: 14333: 14329: 14325: 14321: 14316: 14311: 14307: 14303: 14299: 14295: 14288: 14286: 14277: 14273: 14268: 14263: 14259: 14255: 14250: 14245: 14241: 14237: 14233: 14226: 14218: 14214: 14210: 14206: 14201: 14196: 14192: 14188: 14184: 14180: 14176: 14172: 14168: 14161: 14153: 14149: 14144: 14139: 14135: 14131: 14127: 14123: 14119: 14115: 14111: 14104: 14096: 14092: 14087: 14082: 14078: 14074: 14070: 14066: 14062: 14058: 14054: 14047: 14031: 14027: 14023: 14019: 14015: 14008: 13992: 13988: 13984: 13983: 13978: 13971: 13963: 13959: 13958: 13953: 13947: 13931: 13927: 13923: 13919: 13913: 13909: 13908: 13901: 13885: 13881: 13880:drugabuse.com 13877: 13871: 13869: 13867: 13850: 13846: 13842: 13835: 13827: 13823: 13818: 13813: 13809: 13805: 13801: 13794: 13778: 13774: 13770: 13764: 13757: 13753: 13749: 13746: 13741: 13739: 13730: 13726: 13722: 13718: 13714: 13710: 13705: 13700: 13696: 13692: 13688: 13681: 13673: 13669: 13664: 13659: 13655: 13651: 13646: 13641: 13637: 13633: 13632:PLOS Medicine 13629: 13622: 13614: 13610: 13606: 13600: 13598: 13589: 13585: 13581: 13577: 13572: 13567: 13563: 13559: 13555: 13551: 13547: 13540: 13532: 13528: 13523: 13518: 13514: 13510: 13507:(3): 367–77. 13506: 13502: 13498: 13491: 13475: 13471: 13467: 13461: 13459: 13450: 13446: 13441: 13436: 13431: 13426: 13422: 13418: 13414: 13407: 13405: 13385: 13381: 13374: 13368: 13366: 13364: 13344: 13340: 13333: 13327: 13325: 13308: 13304: 13300: 13293: 13285: 13281: 13276: 13271: 13267: 13263: 13259: 13255: 13251: 13244: 13242: 13240: 13238: 13236: 13229: 13225: 13224: 13218: 13216: 13214: 13212: 13210: 13201: 13197: 13193: 13189: 13186:(2): 155–66. 13185: 13181: 13174: 13172: 13155: 13151: 13147: 13141: 13125: 13121: 13117: 13110: 13102: 13098: 13094: 13090: 13085: 13080: 13076: 13072: 13068: 13061: 13054: 13050: 13047: 13043: 13038: 13030: 13026: 13021: 13016: 13012: 13008: 13004: 13000: 12996: 12989: 12987: 12978: 12974: 12969: 12964: 12961:(4): 405–11. 12960: 12956: 12952: 12945: 12943: 12926: 12922: 12918: 12912: 12896: 12892: 12888: 12882: 12866: 12862: 12855: 12853: 12837: 12833: 12830:Ghorayshi A. 12826: 12810: 12806: 12805: 12800: 12793: 12785: 12781: 12776: 12771: 12767: 12763: 12759: 12755: 12751: 12744: 12742: 12733: 12729: 12724: 12719: 12716:(3): 484–92. 12715: 12711: 12707: 12700: 12693: 12687: 12680: 12676: 12672: 12669: 12664: 12656: 12652: 12647: 12642: 12638: 12634: 12630: 12626: 12622: 12615: 12596: 12592: 12585: 12579: 12563: 12559: 12555: 12548: 12532: 12528: 12524: 12517: 12510: 12504: 12488: 12484: 12480: 12473: 12457: 12453: 12449: 12442: 12426: 12422: 12418: 12412: 12396: 12392: 12391:Bloomberg.com 12388: 12381: 12365: 12361: 12357: 12350: 12334: 12330: 12326: 12319: 12303: 12299: 12295: 12289: 12287: 12270: 12266: 12262: 12255: 12253: 12236: 12232: 12228: 12221: 12205: 12201: 12197: 12190: 12174: 12170: 12166: 12159: 12157: 12140: 12136: 12132: 12125: 12109: 12105: 12101: 12095: 12088: 12075: 12071: 12067: 12061: 12045: 12041: 12037: 12030: 12023: 12019: 12015: 12012: 12007: 12005: 12003: 11986: 11982: 11978: 11971: 11955: 11951: 11947: 11943: 11942: 11937: 11931: 11915: 11911: 11907: 11901: 11885: 11881: 11880:#opioidcrisis 11877: 11871: 11863: 11859: 11855: 11851: 11847: 11840: 11821: 11817: 11815: 11807: 11801: 11785: 11781: 11777: 11771: 11755: 11751: 11747: 11741: 11725: 11721: 11717: 11710: 11694: 11690: 11686: 11679: 11663: 11659: 11655: 11648: 11632: 11628: 11624: 11617: 11610: 11606: 11602: 11599: 11594: 11578: 11574: 11570: 11563: 11547: 11543: 11539: 11535: 11531: 11525: 11517: 11513: 11509: 11505: 11498: 11482: 11478: 11477: 11472: 11466: 11464: 11447: 11443: 11442: 11437: 11430: 11414: 11410: 11409: 11404: 11397: 11381: 11377: 11373: 11366: 11350: 11346: 11342: 11336: 11320: 11316: 11312: 11306: 11290: 11286: 11282: 11276: 11260: 11256: 11252: 11246: 11230: 11226: 11222: 11216: 11209: 11205: 11202: 11197: 11181: 11177: 11173: 11166: 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USA Today. 10068: 10064: 10057: 10041: 10037: 10033: 10027: 10016:September 29, 10011: 10007: 10003: 9997: 9986:September 29, 9981: 9977: 9973: 9966: 9950: 9946: 9945: 9940: 9934: 9926: 9922: 9917: 9912: 9908: 9904: 9901:(10): 901–6. 9900: 9896: 9892: 9885: 9869: 9865: 9864: 9859: 9852: 9845: 9841: 9837: 9834: 9829: 9822: 9818: 9814: 9810: 9807: 9802: 9795: 9791: 9787: 9783: 9779: 9776: 9771: 9769: 9761: 9757: 9753: 9750: 9746: 9742: 9739: 9734: 9726: 9722: 9717: 9712: 9708: 9704: 9701:(26): 563–8. 9700: 9696: 9692: 9685: 9669: 9665: 9661: 9654: 9638: 9634: 9630: 9624: 9608: 9604: 9600: 9593: 9586: 9582: 9578: 9575: 9570: 9562: 9558: 9553: 9548: 9544: 9540: 9536: 9532: 9528: 9521: 9506: 9502: 9498: 9494: 9490: 9486: 9482: 9478: 9474: 9470: 9466: 9459: 9457: 9440: 9436: 9432: 9425: 9417: 9413: 9408: 9403: 9399: 9395: 9391: 9387: 9383: 9379: 9375: 9371: 9367: 9360: 9358: 9349: 9345: 9340: 9335: 9331: 9327: 9323: 9319: 9315: 9308: 9306: 9304: 9302: 9293: 9289: 9285: 9278: 9271:. April 2020. 9270: 9263: 9257: 9249: 9245: 9240: 9235: 9231: 9227: 9223: 9219: 9215: 9211: 9207: 9200: 9198: 9196: 9194: 9192: 9190: 9181: 9177: 9172: 9167: 9163: 9159: 9154: 9149: 9145: 9141: 9137: 9130: 9128: 9126: 9124: 9122: 9113: 9109: 9105: 9101: 9097: 9093: 9089: 9085: 9081: 9074: 9072: 9070: 9068: 9066: 9057: 9053: 9049: 9045: 9041: 9037: 9033: 9029: 9025: 9018: 9016: 9014: 8997: 8993: 8992: 8984: 8968: 8964: 8960: 8954: 8952: 8935: 8931: 8925: 8923: 8914: 8910: 8906: 8902: 8897: 8892: 8888: 8884: 8880: 8876: 8872: 8868: 8864: 8860: 8856: 8849: 8847: 8845: 8828: 8824: 8820: 8814: 8806: 8802: 8798: 8794: 8790: 8786: 8782: 8778: 8774: 8770: 8763: 8761: 8759: 8757: 8737: 8733: 8729: 8722: 8715: 8707: 8703: 8698: 8693: 8689: 8685: 8681: 8677: 8673: 8669: 8665: 8658: 8642: 8638: 8632: 8628: 8624: 8620: 8619: 8611: 8609: 8600: 8596: 8591: 8586: 8582: 8578: 8574: 8570: 8566: 8562: 8558: 8551: 8535: 8531: 8527: 8520: 8504: 8500: 8493: 8477: 8473: 8467: 8460: 8456: 8452: 8449: 8441: 8439: 8437: 8429: 8425: 8421: 8418: 8413: 8406: 8405:Seattle Times 8402: 8398: 8395: 8390: 8383: 8379: 8376: 8371: 8355: 8351: 8345: 8338: 8334: 8331: 8326: 8324: 8316: 8312: 8309: 8304: 8288: 8284: 8280: 8276: 8272: 8265: 8246: 8242: 8235: 8229: 8214: 8213: 8208: 8201: 8185: 8181: 8180: 8175: 8168: 8152: 8148: 8144: 8143: 8138: 8131: 8124: 8120: 8116: 8113: 8108: 8101: 8097: 8093: 8090: 8085: 8078: 8074: 8070: 8067: 8062: 8046: 8042: 8041: 8036: 8029: 8022: 8018: 8014: 8011: 8006: 7999: 7995: 7991: 7988: 7983: 7967: 7963: 7956: 7937: 7930: 7924: 7908: 7904: 7900: 7894: 7887: 7883: 7880: 7875: 7868: 7864: 7860: 7857: 7852: 7844: 7840: 7835: 7830: 7826: 7822: 7818: 7814: 7810: 7803: 7801: 7792: 7788: 7783: 7778: 7773: 7768: 7764: 7760: 7756: 7749: 7747: 7730: 7726: 7725: 7720: 7713: 7697: 7693: 7686: 7670: 7666: 7659: 7643: 7639: 7635: 7628: 7612: 7608: 7604: 7599: 7594: 7590: 7586: 7582: 7578: 7574: 7567: 7551: 7547: 7540: 7524: 7520: 7516: 7510: 7491: 7487: 7483: 7479: 7475: 7472:(9): 2445–9. 7471: 7467: 7460: 7453: 7451: 7434: 7430: 7426: 7420: 7412: 7408: 7401: 7385: 7381: 7377: 7370: 7354: 7350: 7349:drugabuse.com 7346: 7340: 7338: 7329: 7325: 7320: 7315: 7310: 7305: 7301: 7297: 7293: 7286: 7284: 7267: 7263: 7259: 7252: 7244: 7240: 7236: 7232: 7228: 7224: 7220: 7216: 7212: 7205: 7194: 7190: 7183: 7182: 7174: 7158: 7154: 7153: 7148: 7141: 7134: 7128: 7121: 7120: 7115: 7110: 7094: 7090: 7086: 7080: 7064: 7060: 7056: 7049: 7033: 7029: 7025: 7018: 7010: 7006: 7001: 6996: 6992: 6988: 6984: 6980: 6976: 6969: 6961: 6957: 6952: 6947: 6943: 6939: 6935: 6928: 6926: 6924: 6907: 6903: 6899: 6893: 6877: 6873: 6869: 6863: 6847: 6843: 6839: 6833: 6817: 6813: 6809: 6803: 6787: 6783: 6779: 6773: 6757: 6753: 6749: 6743: 6727: 6723: 6719: 6712: 6696: 6692: 6688: 6682: 6666: 6662: 6656: 6640: 6636: 6635: 6630: 6623: 6621: 6604: 6600: 6599:Globalnews.ca 6596: 6590: 6583: 6579: 6576: 6571: 6564: 6560: 6557: 6552: 6536: 6532: 6528: 6521: 6519: 6517: 6515: 6513: 6511: 6509: 6507: 6490: 6487:. Vox Media. 6486: 6482: 6475: 6455: 6451: 6444: 6440: 6434: 6432: 6415: 6411: 6407: 6400: 6384: 6380: 6376: 6370: 6362: 6358: 6354: 6350: 6346: 6342: 6335: 6324:September 24, 6319: 6315: 6311: 6307: 6301: 6290: 6283: 6277: 6275: 6266: 6262: 6257: 6252: 6248: 6244: 6240: 6236: 6232: 6225: 6223: 6206: 6202: 6198: 6192: 6190: 6188: 6171: 6167: 6163: 6160:(in German). 6159: 6155: 6148: 6140: 6127: 6123: 6122: 6117: 6110: 6094: 6090: 6086: 6080: 6065: 6061: 6060: 6053: 6045: 6041: 6036: 6031: 6027: 6023: 6019: 6015: 6011: 6004: 6002: 6000: 5998: 5996: 5987: 5980: 5972: 5968: 5963: 5958: 5954: 5950: 5946: 5939: 5931: 5927: 5922: 5917: 5913: 5909: 5905: 5898: 5882: 5878: 5874: 5868: 5866: 5864: 5847: 5843: 5837: 5830: 5826: 5823: 5818: 5810: 5798: 5791: 5784: 5780: 5776: 5773: 5767: 5765: 5763: 5761: 5759: 5757: 5755: 5753: 5751: 5734: 5730: 5726: 5719: 5717: 5700: 5696: 5690: 5688: 5671: 5667: 5663: 5662:Distillations 5659: 5652: 5636: 5632: 5628: 5621: 5613: 5609: 5605: 5601: 5597: 5593: 5589: 5585: 5577: 5571: 5570:Rolling Stone 5567: 5563: 5560: 5555: 5539: 5535: 5531: 5524: 5516: 5512: 5507: 5502: 5498: 5494: 5490: 5486: 5482: 5475: 5473: 5471: 5454: 5450: 5444: 5442: 5430:September 26, 5425: 5421: 5417: 5411: 5404: 5400: 5396: 5393: 5388: 5386: 5384: 5376: 5372: 5368: 5365: 5360: 5352: 5348: 5343: 5338: 5334: 5330: 5327:(10): 870–8. 5326: 5322: 5318: 5311: 5295: 5291: 5287: 5283: 5279: 5272: 5256: 5252: 5248: 5241: 5225: 5221: 5220:Rolling Stone 5217: 5210: 5195: 5191: 5187: 5183: 5179: 5175: 5171: 5167: 5163: 5159: 5155: 5148: 5146: 5130: 5126: 5122: 5118: 5114: 5110: 5106: 5102: 5098: 5091: 5076: 5072: 5068: 5064: 5060: 5056: 5052: 5048: 5044: 5040: 5036: 5029: 5014: 5010: 5006: 5002: 4998: 4994: 4990: 4986: 4982: 4978: 4974: 4967: 4951: 4947: 4943: 4939: 4935: 4928: 4920: 4916: 4911: 4906: 4902: 4898: 4893: 4888: 4884: 4880: 4876: 4869: 4861: 4857: 4853: 4849: 4844: 4839: 4835: 4831: 4827: 4820: 4813: 4809: 4805: 4802: 4798: 4794: 4791: 4786: 4778: 4774: 4770: 4766: 4762: 4758: 4754: 4750: 4743: 4735: 4731: 4726: 4721: 4717: 4713: 4709: 4705: 4701: 4697: 4693: 4686: 4670: 4666: 4662: 4656: 4640: 4636: 4632: 4626: 4619: 4618:The Economist 4615: 4611: 4608: 4603: 4601: 4599: 4590: 4586: 4582: 4578: 4574: 4570: 4563: 4555: 4551: 4547: 4543: 4539: 4532: 4516: 4512: 4508: 4502: 4494: 4488: 4484: 4480: 4476: 4470: 4462: 4458: 4454: 4450: 4446: 4442: 4438: 4434: 4430: 4426: 4419: 4411: 4407: 4403: 4396: 4388: 4384: 4379: 4374: 4370: 4366: 4362: 4358: 4354: 4350: 4346: 4342: 4338: 4331: 4315: 4311: 4307: 4302: 4297: 4293: 4289: 4285: 4281: 4277: 4273: 4269: 4262: 4246: 4242: 4238: 4232: 4230: 4228: 4226: 4209: 4205: 4201: 4197: 4193: 4189: 4185: 4182:(2): 97–124. 4181: 4177: 4173: 4166: 4164: 4162: 4160: 4151: 4147: 4142: 4137: 4133: 4129: 4124: 4119: 4115: 4111: 4107: 4100: 4098: 4089: 4085: 4080: 4075: 4071: 4067: 4063: 4059: 4055: 4051: 4047: 4040: 4038: 4036: 4034: 4032: 4030: 4013: 4009: 4003: 4001: 3993: 3989: 3985: 3982: 3977: 3975: 3958: 3955:. June 2019. 3954: 3953: 3948: 3942: 3926: 3922: 3918: 3912: 3904: 3900: 3895: 3890: 3885: 3880: 3877:(5): 337–51. 3876: 3872: 3868: 3861: 3853: 3849: 3845: 3841: 3837: 3833: 3826: 3810: 3806: 3802: 3798: 3791: 3775: 3771: 3765: 3763: 3746: 3742: 3736: 3734: 3726: 3723: 3719: 3716: 3710: 3694: 3690: 3686: 3679: 3677: 3675: 3666: 3662: 3658: 3654: 3650: 3643: 3635: 3631: 3626: 3621: 3617: 3613: 3609: 3605: 3601: 3594: 3578: 3574: 3570: 3564: 3562: 3560: 3543: 3539: 3533: 3526: 3522: 3518: 3515: 3510: 3494: 3489: 3485: 3481: 3477: 3473: 3469: 3462: 3446: 3442: 3436: 3428: 3424: 3419: 3414: 3409: 3404: 3400: 3396: 3392: 3385: 3378: 3374: 3370: 3367: 3362: 3360: 3358: 3356: 3354: 3349: 3339: 3337: 3333: 3331: 3328: 3326: 3323: 3321: 3318: 3315: 3314:Opium in Iran 3312: 3310: 3307: 3305: 3302: 3300: 3299: 3295: 3292: 3289: 3287: 3284: 3282: 3281: 3277: 3276: 3270: 3268: 3264: 3259: 3257: 3251: 3249: 3245: 3235: 3232: 3226: 3224: 3223:black markets 3220: 3210: 3202: 3193: 3189: 3187: 3183: 3173: 3170: 3167: 3158: 3156: 3151: 3147: 3145: 3141: 3137: 3130: 3126: 3122: 3118: 3109: 3105: 3101: 3092: 3090: 3086: 3082: 3078: 3074: 3070: 3064: 3061: 3052: 3050: 3046: 3042: 3038: 3034: 3030: 3026: 3022: 3012: 3009: 3007: 3002: 3000: 2996: 2995:buprenorphine 2992: 2988: 2984: 2982: 2977: 2976:Buprenorphine 2971:Buprenorphine 2968: 2964: 2961: 2956: 2947: 2943: 2939: 2935: 2933: 2924: 2921: 2918: 2914: 2913: 2912: 2908: 2905: 2900: 2896: 2894: 2888: 2886: 2882: 2881: 2874: 2872: 2871:buprenorphine 2868: 2864: 2860: 2855: 2853: 2849: 2845: 2835: 2833: 2823: 2821: 2817: 2812: 2808: 2806: 2795: 2793: 2792:buprenorphine 2789: 2780: 2777: 2774: 2771: 2768: 2765: 2764: 2763: 2761: 2756: 2753: 2748: 2746: 2740: 2736: 2734: 2727: 2723: 2721: 2717: 2706: 2702: 2691: 2687: 2683: 2670: 2668: 2663: 2659: 2657: 2652: 2648: 2644: 2634: 2625: 2622: 2618: 2614: 2604: 2601: 2598: 2594: 2590: 2588: 2584: 2580: 2576: 2566: 2564: 2560: 2556: 2555:Purdue Pharma 2551: 2547: 2541: 2539: 2535: 2515: 2512: 2509: 2507:prescriptions 2506: 2502: 2499: 2498: 2497: 2493: 2488: 2477: 2476:information. 2475: 2471: 2466: 2464: 2460: 2454: 2452: 2445: 2441: 2439: 2435: 2431: 2427: 2423: 2419: 2415: 2412: 2408: 2404: 2401: 2400:multinational 2396: 2394: 2389: 2384: 2382: 2378: 2374: 2370: 2365: 2362: 2361:public health 2358: 2354: 2350: 2346: 2342: 2338: 2334: 2330: 2324: 2320: 2315: 2313: 2308: 2300: 2296: 2293: 2289: 2285: 2284: 2283: 2281: 2276: 2274: 2270: 2269:James Carroll 2265: 2260: 2258: 2254: 2250: 2246: 2242: 2237: 2230: 2226: 2222: 2219:In 2016, the 2217: 2215: 2211: 2207: 2202: 2198: 2194: 2191:In 2011, the 2189: 2187: 2186:buprenorphine 2183: 2179: 2173: 2170: 2167:In 2010, the 2165: 2163: 2159: 2155: 2151: 2145: 2141: 2126: 2122: 2120: 2114: 2110: 2106: 2104: 2094: 2090: 2086: 2084: 2080: 2076: 2071: 2067: 2065: 2061: 2056: 2045: 2040: 2038: 2034: 2033:gun homicides 2030: 2021: 2014: 2010: 2006: 2005:New Hampshire 2002: 1998: 1997:West Virginia 1994: 1950: 1949: 1945: 1931: 1928: 1926: 1923: 1922: 1918: 1915: 1913: 1910: 1909: 1905: 1902: 1900: 1899:West Virginia 1897: 1896: 1892: 1889: 1887: 1884: 1883: 1879: 1876: 1874: 1871: 1870: 1866: 1863: 1861: 1858: 1857: 1853: 1850: 1848: 1845: 1844: 1840: 1837: 1835: 1832: 1831: 1827: 1824: 1822: 1819: 1818: 1814: 1811: 1809: 1806: 1805: 1801: 1798: 1796: 1793: 1792: 1788: 1785: 1783: 1780: 1779: 1775: 1772: 1770: 1767: 1766: 1762: 1759: 1757: 1754: 1753: 1749: 1746: 1744: 1741: 1740: 1736: 1733: 1731: 1728: 1727: 1723: 1720: 1718: 1715: 1714: 1710: 1707: 1705: 1702: 1701: 1697: 1694: 1692: 1689: 1688: 1684: 1681: 1679: 1676: 1675: 1671: 1668: 1666: 1663: 1662: 1658: 1655: 1653: 1652:New Hampshire 1650: 1649: 1645: 1642: 1640: 1637: 1636: 1632: 1629: 1627: 1624: 1623: 1619: 1616: 1614: 1611: 1610: 1606: 1603: 1601: 1598: 1597: 1593: 1590: 1588: 1585: 1584: 1580: 1577: 1575: 1572: 1571: 1567: 1564: 1562: 1559: 1558: 1554: 1551: 1549: 1548:Massachusetts 1546: 1545: 1541: 1538: 1536: 1533: 1532: 1528: 1525: 1523: 1520: 1519: 1515: 1512: 1510: 1507: 1506: 1502: 1499: 1497: 1494: 1493: 1489: 1486: 1484: 1481: 1480: 1476: 1473: 1471: 1468: 1467: 1463: 1460: 1458: 1455: 1454: 1450: 1447: 1445: 1442: 1441: 1437: 1434: 1432: 1429: 1428: 1424: 1421: 1419: 1416: 1415: 1411: 1408: 1406: 1403: 1402: 1398: 1395: 1393: 1390: 1389: 1385: 1382: 1380: 1377: 1376: 1372: 1369: 1367: 1364: 1363: 1359: 1356: 1354: 1351: 1350: 1346: 1343: 1341: 1338: 1337: 1333: 1330: 1328: 1325: 1324: 1320: 1317: 1315: 1312: 1311: 1307: 1304: 1302: 1299: 1298: 1294: 1291: 1289: 1286: 1285: 1281: 1278: 1276: 1273: 1272: 1268: 1265: 1262: 1261: 1253: 1251: 1247: 1243: 1239: 1235: 1231: 1226: 1222: 1218: 1215: 1206: 1197: 1188: 1185: 1174: 1157: 1153: 1149: 1145: 1141: 1139: 1134: 1130: 1126: 1124: 1123:working class 1120: 1110: 1107: 1102: 1094: 1085: 1081: 1079: 1074: 1068: 1064: 1060: 1056: 1055:New Hampshire 1051: 1049: 1045: 1044: 1037: 1032: 1030: 1026: 1021: 1019: 1013: 1011: 1005: 1000: 998: 994: 990: 986: 981: 979: 978: 971: 968: 964: 957: 953: 948: 943: 938: 936: 932: 928: 917: 915: 914:San Francisco 911: 907: 902: 895: 891: 887: 882: 877: 867: 865: 855: 851: 847: 843: 839: 830: 828: 827:public health 824: 819: 816: 807: 805: 801: 798: 794: 793:Purdue Pharma 790: 786: 782: 773: 769: 763: 759: 755: 746: 742: 739: 737: 727: 725: 721: 716: 713: 709: 705: 700: 696: 693: 688: 682: 678: 674: 668: 665: 661: 657: 652: 649: 643: 640:million used 631: 626: 624: 616: 612: 611:West Virginia 608: 607:New Hampshire 603: 598: 597:Purdue Pharma 591: 576: 574: 570: 566: 562: 558: 554: 550: 545: 543: 538: 537: 532: 528: 527: 521: 517: 512: 508: 506: 502: 498: 495: 491: 487: 483: 478: 476: 472: 468: 462: 460: 456: 452: 448: 444: 435: 431: 422: 419: 410: 407: 404: 395: 390: 379: 375: 368: 363: 359: 352: 347: 340: 335: 334: 333: 329: 327: 321: 317: 315: 311: 307: 306: 305:Rolling Stone 295: 288: 279: 271: 262: 253: 251: 247: 243: 237: 235: 231: 227: 217: 208: 200: 191: 189: 185: 181: 175: 173: 169: 165: 161: 157: 153: 149: 145: 141: 132: 130: 126: 122: 118: 113: 112:socioeconomic 108: 104: 102: 98: 94: 90: 89:United States 86: 85:opioid crisis 82: 68: 57: 53: 46: 35: 28: 19: 15429:psychoactive 15421:hopelessness 15366: 15362: 15359:Sam Quinones 15354: 15346: 15328:. 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