Opioid Crisis

Information and statistics regarding opiate use, overdose, diversion, pain management, patient rights, street trafficking, heroin, fentanyl, and other aspects of the opioid overdose crisis.

Tighter Prescribing Regulations Drive Illegal Sales

"The US Drug Enforcement Administration introduced a schedule change for hydrocodone combination products in October 2014. During the period of our study, October 2013 to July 2016, the percentage of total drug sales represented by prescription opioids in the US doubled from 6.7% to 13.7%, which corresponds to a yearly increase of 4 percentage points in market share. It is not possible to determine the location of buyers from cryptomarket data. We cannot know, for example, if a drug shipped from a vendor in Europe was purchased by a US customer.

Likelihood That Young People with Diagnosed Mental Health Conditions Will be Put on Long Term Opioid Therapy

"Of the 1,000,453 opioid recipients (81.7%) with at least 6 months of follow-up, 51.1% were female, and the median age was 17 years (interquartile range, 16-18 years). Among these adolescents, the estimated cumulative incidence of LTOT [Long Term Opioid Therapy] after first opioid receipt was 1.1 (95% CI, 1.1-1.2) per 1000 recipients within 1 year, 3.0 (95% CI, 2.8-3.1) per 1000 recipients within 3 years, 8.2 (95% CI, 7.8-8.6) per 1000 recipients within 6 years, and 16.1 (95% CI, 14.2-18.0) per 1000 recipients within 10 years.

Likelihood That Young People with Diagnosed Mental Health Conditions Will be Put on Long Term Opioid Therapy

"In this nationwide study of commercially insured adolescents, LTOT [Long Term Opioid Therapy] was relatively uncommon. The estimated incidence of LTOT receipt was 3.0 per 1000 adolescents within 3 years of filling an initial opioid prescription. Although adolescents with a wide range of preexisting mental health conditions and treatments were modestly more likely than adolescents without those conditions or treatments to receive an initial opioid, the former had substantially higher rates of subsequent transitioning to LTOT.

The Burden of Opioid-Related Mortality in the United States

"Over the 15-year study period, 335,123 opioid-related deaths in the United States met our inclusion criteria, with an increase of 345% from 9489 in 2001 (33.3 deaths per million population) to 42,245 in 2016 (130.7 deaths per million population). By 2016, men accounted for 67.5% of all opioid-related deaths (n = 28,496), and the median (interquartile range) age at death was 40 (30-52) years.

Retail Price of Heroin in the US, Canada and the UK

According to the United Nations Office on Drugs and Crime:

In the United States in 2015 (the most recent year for which data are available), the retail price of black tar heroin ranged from $20 to $300 per gram; the retail price of South American heroin ranged from $25 to $400 per gram; and the retail price of southwest Asian heroin ranged from $120 to $300 per gram.

In Canada in 2014 (the most recent year for which data are available), the retail price of opium ranged from $43 to $55.90 per gram; and the retail price of heroin ranged from $154.80 to $300.90 per gram.

Wholesale Price of Heroin in the US and Around the World

According to the United Nations Office on Drugs and Crime:

In the United States in 2015 (the most recent year for which data are available), the wholesale price of black tar heroin ranged from $12,000 to $100,000 per kilogram; the wholesale price of South American heroin ranged from $10,000 to $100,000 per kilogram and the price of southwest Asian heroin ranged from $50,000 to $85,000 per kilogram.

In Mexico in 2015 (the most recent year for which data are available), the wholesale price of heroin was $35,000 per kilogram.

Changes in Synthetic Opioid Involvement in Overdose Deaths in the US and Involvement of Other Drugs in Combination

"Among the 42 249 opioid-related overdose deaths in 2016, 19,413 involved synthetic opioids, 17,087 involved prescription opioids, and 15,469 involved heroin. Synthetic opioid involvement in these deaths increased significantly from 3007 (14.3% of opioid-related deaths) in 2010 to 19,413 (45.9%) in 2016 (P for trend <.01). Significant increases in synthetic opioid involvement in overdose deaths involving prescription opioids, heroin, and all other illicit or psychotherapeutic drugs were found from 2010 through 2016 (Table).

Medicinal Cannabis as an Alternative to Prescription Opioid Medicines

"The use of MC [Medical Cannabis] as an alternative to POMs [Prescription Opioid Medications] for pain management warrants additional empirical attention as a potential harm reduction strategy. NASEM (2017) recommends more clinical trials to elucidate appropriate MC forms, routes of administration, and combination of products for treating pain, but access to MC products to fully evaluate these questions is challenging due to federal regulations.

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