Which countries have an opioid crisis?

Drug Epidemic: 5 Facts About The US Opioid Crisis

In addition, there are other harmful effects: If women take opioids during their pregnancy, their children are often born with a dependency. According to data from the US Department of Health, the Reuters agency counted 27,000 cases of this withdrawal syndrome in newborns in 2013 - more than five times as many as ten years earlier. There are also numerous new infections with hepatitis B and C as well as HIV. The rampant intoxicant problem leads to family crises, drug-related crime and is a burden on the USA's already fragile health system. The White House Economic Council (CEA) calculated that the opioid problem devoured more than half a trillion dollars in 2015 alone.

It hits the northeastern United States hardest, such as New England, Appalachia and the "Rust Belt", an industrial region between the Great Lakes and the east coast. Most of the addicts are white Americans, often middle-class. Addiction patients who started using heroin in the past decade were 90 percent white - according to research by Theodore Cicero and colleagues from 2014. It was different with earlier drug waves: For example, suffered from the crack epidemic of the 1980s especially black Americans.

The exact causes for this development are unclear. Andrew Kolodny comes up with a surprising explanation: "When a patient is black, the doctor often fears addiction, worries that the patient might sell the pills, or he takes the pain less seriously," said the addiction expert in an interview with the radio station NPR. "Blacks are prescribed fewer narcotics, so they are less dependent on the drug."

Paradoxically, it could be racist stereotypes, of all things, that keep non-white Americans from becoming dependent. In recent years, the epidemic has increasingly hit the black part of the population, as reported by the CDC health authority. The abuse of prescription pain killers like OxyContin remains a predominantly white phenomenon: In 2015, white citizens were twice as likely to die from an overdose of these drugs compared to black US citizens.

How do you try to contain the crisis?

Apparently, opioids can wreak havoc. Then why not just ban the substances completely from pharmacies and hospitals? The reason for this is that many patients still benefit enormously from the drugs. In palliative medicine, they can enable cancer patients to lead a more bearable life and prevent unnecessary suffering. Substances such as oxycodone are also useful for acute pain after an operation. So the problem is by no means that the drugs are in circulation at all, but that they are being prescribed inflationarily. In order to contain the crisis, health authorities are now trying to monitor the prescription of these drugs more closely - and to shut down the "pill-throwers" mentioned at the beginning.

Another approach focuses on responding quickly in the event of an acute overdose. The antidote naloxone is a real miracle cure in this regard: It inhibits the opioid receptors in the brain and can even remove already bound opioids from the receptors - and thus prevent impending death. In the meantime, many firefighters and police officers carry the antidote with them in order to save lives in an emergency. But naloxone alone will not stop the epidemic. The US emergency doctor Scott Weiner and colleagues examined how about 12,000 patients with opioid overdose fared in the twelve months after the emergency. The sad conclusion: More than six percent died on the day the naloxone was administered. One out of ten patients did not survive the following year.