Opioid crisis update: What's changed and where are we?

By Joe Hannan | Medically reviewed by Kristen Fuller, MD 
| Updated November 17, 2022    MDLinx

Key Takeaways

• Overdose deaths stemming from opioid addiction remain a leading cause of the death in the US.
  
• Clinicians find themselves awash with the third wave (as documented by the CDC) of opioid addiction, which is driven in large part by synthetic opioids such as fentanyl.
  
• Medication for opioid use disorder is an effective treatment modality, but access—as well as patient, public, and clinical attitudes—have a decisive impact on its utilization.
  

Opioid addiction has gone from a relic of bygone eras to an epidemic raging in American homes and communities. No spot on the US map is untouched by the addiction crisis, and it's common to know someone who has been struck by this tragedy.
But much has changed in the fight against opioid addiction. New diagnostic approaches and treatments, as well as shifting attitudes, are hopefully poised to lay this problem to rest.
How we got hereChart out the pattern of opioid overdose deaths in the US, beginning in 1999, and you get a hockey-stick graph.[1]
Between 1999 and 2020, an estimated 546,000 people died from opioid overdoses.
The CDC charts the rise of opioid addiction and its deadly wake in three distinct waves. Wave 1 began to crest in the 1990s with the wide distribution of prescription opioids. Wave 2 marked a shift toward fatal heroin overdoses beginning in 2010.
Clinicians find themselves struggling to stay afloat as Wave 3 pummels the US healthcare system. Driving this surge are synthetic opioids such as fentanyl. Increasingly, fentanyl and its synthetic analogs (acetylfentanyl, furanylfentanyl, and carfentanil) have made their way into combinations with heroin, cocaine, and counterfeit pills—all with deadly implications, including accidental overdose.
The CDC estimates that 187 people are dying each day from opioids.
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