Heard on Fox fentanyl leading cause of death in USA age 18-45.
There are two problems right now with overdoses. The government in its Infinite wisdoms has decided to schedule almost everything. Take a gander that schedules 2-5 from the DEA. things that used to be schedule 4 or 5 are now 2 and a lot of them are non-opioid. This plus the government treating chronic pain like a crime and not allowing people to get reasonable medications because of things like PDMPs and terrorizing primary care for writing them has left a ton of people in permanent untreated pain. They of course turn to street drugs. Or commit suicide
The second thing is in around 2011 the Joint commission which is the surveying body for hospital accreditation which if you don’t have the hospital doesn’t get paid made pain the “sixth vital sign”. So if patients complained about oain it didn’t matter what the chart said in terms of if the patient were seeking meds or not properly reporting pain based on exam…. It just went as a finding against the hospital. Naturally hospitals which are no longer run by medical personnel started stupid protocols that were heavy handed with pain meds. Additionally with Press-Gainey surveys becoming important in reimbursement (patient satisfaction) it allowed families and annoying patients to excoriate the hospital on satisfaction which lead non-clinical administrators to put pressure on clinicians to give the family whatever they wanted.
The trifecta is this storm was the OxyContin unethical behavior for marketing. Because of all of this WHICH RESULTED DEMONSTRABLY FROM GOVERNMENT STUPIDITY this is where we are today
The scary think is a lot of the drugs that can be procured from the street have designer drugs which don’t show up on tox screen. Bath salts were the rage a couple years ago. I have been seeing for a couple years with the overdose patients in the ICU combo drugs they didn’t know about. They were doing marijuana and it was laced with fentanyl. Or cocaine cut with heroin. Lots of garden variety parties a thinking they are getting there usual high and dying with a system full of drugs they didn’t know they were taking.
It is horrendous. Couple this with the sadness of lockdowns that were unnecessary and social distancing (we are social creatures after all) and it is pretty obvious why the street drug trade has exploded while at the same time more potent drugs that it takes just a whiff of to kill are working their way into the dark supply chain.
No sure what the answer is. The genie may be out of the barn on this one.