400,000 deaths in the United States: Five things to know about fentanyl and the opiate crisis


Fentanyl ubiquitous, dead by hundreds of thousands and a potentially historic lawsuit against the pharmaceutical industry: the opiate drug crisis, which began in the 1990s, does not stop ravaging the United States.

A federal trial, the first of its kind, is scheduled to open Monday in the state of Ohio to determine the "culprits" of this disaster with the giants of the pharmaceutical industry in the dock. They are trying to pull out a last-minute deal with US states and local governments that want to make them pay for the ravages of the crisis, hoping to stop the lawsuit.

Here are five keys to understanding this file.

The editorial advises you

1. What is fentanyl?

Fentanyl is a synthetic opiate with euphoric abilities. In its legal form, it is a drug used as a sedative in the treatment of severe pain, especially for cancer patients. Deliverable only on prescription, it is considered 50 times more powerful than heroin, an illegal opiate, according to the National Institute on Drug Abuse.

But for several years he has been diverted from his medical use, manufactured and sold illegally in the form of counterfeit powder, spray or tablets, and has exploded the number of opioid deaths since 2013. Traffickers frequently mix it with other drugs. substances, such as heroin or cocaine, because of its greater profitability.

2. How many deaths?

The latest figures from the Centers for Disease Control (CDC) report more than 400,000 deaths by opioid overdoses in the United States between 1999 and 2018, and more than 130 deaths per day still today. In 2016, the singer Prince died from an overdose of Fentanyl.

In 2018, the number of fatal overdoses fell for the first time in twenty years in the United States, but deaths from fentanyl and other synthetic opiates continued to increase, with nearly 32,000 deaths, according to official figures. provisional.

3. Whose fault?

Many experts now recognize that the opioid crisis began with the over-prescription of pain medications such as OxyContin from the Purdue American laboratory, whereas until the mid-1990s, they were reserved for the most serious diseases. . Purdue and other labs like Johnson & Johnson or Teva, which has made similar drugs, as well as major US pharmacy chains, are accused of aggressively promoting these drugs and failing to respond to warning signals. about the abuses they were subjected to.

They face an avalanche of lawsuits from American states and local communities of all kinds, who want to recover the billions committed to stem the crisis. The main companies sued in court have recently made billions of dollars in claims for compensation in the hope of bringing the whole of the lawsuits against them to a close. But no agreement has yet been sealed.

The CDC estimates that the economic burden of the crisis is some $ 78.5 billion a year, including health care costs, lost productivity, and costs to the criminal justice system. A study published Tuesday by the American Society of Actuaries estimates even to 631 billion dollars the cost for the four years 2015-2018.

4. What are the authorities doing?

The Trump government made the opioid crisis a public health priority in October 2017, unlocking significant funds to fight the crisis, improve treatment and prevent drug addiction – a problem that does not date from opiates , and find non-addictive solutions to pain.

Beyond the repression of opiate trafficking, the National Institutes of Health (NIH) launched in April 2018 an initiative called HEAL to find medical and scientific solutions to the crisis, which was allocated for the fiscal year 2019 the record sum of $ 945 million.

Most US states have, through their prosecutors, been very aggressive in prosecuting the pharmaceutical industry.

5. Is Europe preserved?

The situation in Europe "is very different", summarizes the scientific director of the European Monitoring Center for Drugs and Drug Addiction (EMCDDA), Paul Griffiths, by putting forward several protective factors: prescriptions of painkillers better supervised, use of heroin less common among youth and easier access to heroin substitution treatments, less potent and less risky than fentanyl.

But the Old Continent is not spared. More than 8,200 drug-related deaths were reported in the European Union in 2017, of which "about 70%" are related to opiates, according to Paul Griffiths. The United Kingdom and Sweden experienced one-off spikes of fatal fentanyl-related overdoses in 2017. Seizures of fentanyl and its derivatives are also growing rapidly: some 15 kilograms were seized in 2017, compared to just one previous year, according to Paul Griffiths.

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