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The Numbers Behind America’s Opioid Epidemic



Opioid Epidemic overdose map

The Numbers Behind America’s Opioid Epidemic

Drug overdoses are the leading cause of death for Americans under the age of 50, who are now more likely to die from a drug overdose than from car accidents or firearms. The United States has the dubious distinction of having the highest percentage of drug-related deaths in the world.

While opioid abuse is a nationwide problem, there are specific areas that are being hit harder by this epidemic. Using the location data above, from NORC at the University of Chicago, we can see clusters of counties that have an extremely high rate of overdose deaths. Between 2012 and 2016, West Virginia, Kentucky, and Ohio saw a combined 18,000 deaths related to opioid abuse.

A sharp increase in prescribed opioid-based painkillers and the rise of illegal fentanyl – which is up to 50 times stronger than heroin – has unleashed the worst public health crisis in American history.

It’s a problem that can be tough to understand, but by delving into the data, some key observations emerge.

Doctors Prescribed a lot of Pain Killers

Beginning in the 1980s, prescription opioids like oxycodone and hydrocodone were heavily marketed as a treatment for pain, and at the time, the risk of addiction to these substances was downplayed. Opioid prescriptions nearly tripled between 1991 and 2011.

opioid sales

Sales of these powerful painkillers are beginning to drop, in part because the risk of addiction has now been widely publicized. Another decelerating factor is the crackdown on clinics and pharmacies that were over-dispensing painkillers, in some cases directly feeding the elicit drug market.

In 2015, nearly 100 million Americans were prescribed painkillers by their doctor. A recent survey showed one-third of people who abused prescription painkillers in the past year got pills directly from a physician.

Source of opioids

This abundance of pills impacts the community at large when excess pills are sold, stolen, or simply given to others. In fact, receiving painkillers from a friend or family member was the most common gateway to abusing opioids.

Fentanyl is Killing a lot of People

If doctors have been prescribing opioids for decades, what is causing this recent spike in overdoses? The answer, for the most part, is fentanyl.

This synthetic opioid presents a problem because it’s extremely potent – it only takes about 2 milligrams to overdose on the drug. Since much of the fentanyl on the market is sourced illegally, doses can and do exceed this amount on a regular basis.

As a result, overdose deaths related to opioids have skyrocketed in recent years:

Overdoses by opioid drug type

Overdoses are the tip of the Iceberg

The thousands of overdose deaths around the country are the most extreme symptom of the opioid epidemic, but the problem runs much deeper.

In 2017, there were over 11 million “opioid misusers” in the United States. To put that number in perspective, that’s equivalent to the entire population of Ohio. In fact, the problem is so widespread, that it’s suspected to be influencing workforce participation rates.

The health care burden of the crisis is also staggering. The cost of opioid abuse ranges from $10,000 to $20,000 in annual medical costs per patient.

The hard truth is that, unless bold action is taken, the opioid epidemic is projected to claim nearly 500,000 lives over the next decade.

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Visualized: The Biggest Ponzi Schemes in Modern History

Learn the stories behind some of the world’s biggest Ponzi schemes in this illustrative infographic timeline.



The Biggest Ponzi Schemes in Modern History

Some things simply sound too good to be true, but when money is involved, our judgement can become clouded.

This is often the case with Ponzi schemes, a type of financial fraud that lures investors by promising abnormally high returns. Money brought in by new members is used to pay the scheme’s founders, as well as its earlier investors.

The scheme is named after Charles Ponzi, an Italian who became infamous in the 1920s for claiming he could double his clients’ money within 90 days. Since then, numerous Ponzi schemes have been orchestrated around the globe.

To help you learn more about these sophisticated crimes, this infographic examines some of the biggest Ponzi schemes in modern history.

Ponzi Schemes in the 20th Century

The 1990s saw a number of large Ponzi schemes worth upwards of $500 million.

CountryDate EndedName of Scheme and FounderValue (USD)
Belgium1991Moneytron, Jean-Pierre Van Rossem$860M
Romania1994Caritas, Ioan Stoica$1B - $5B
Russia1994MMM, Sergei Mavrodi$10B
U.S.1997Great Ministries International, Geral Payne$500M

In many cases, these schemes thrived by taking advantage of the unsuspecting public who often lacked any knowledge of investing. Caritas, for example, was a Ponzi scheme based in Romania that marketed itself as a “self-help game” for the poor.

The scheme was initially very successful, tricking millions of people into making deposits by offering the chance to earn an 800% return after three months. This was not sustainable, and Caritas was eventually unable to distribute further winnings.

Caritas operated for only two years, but its “success” was undeniable. In 1993, it was estimated that a third of the country’s money was circulating through the scheme.

Ponzi Schemes in the 21st Century

The American public has fallen victim to numerous multi-billion dollar Ponzi schemes since the beginning of the 21st century.

CountryDate EndedName of Scheme and FounderValue (USD)
U.S.2003Mutual Benefits Company, Joel Steinger$1B
U.S.2003Petters Group Worldwide, Tom Petters$4B
U.S.2008Madoff Investment Scandal, Bernie Madoff$65B
U.S.2012Stanford Financial Group, Allen Stanford$7B

Many of these schemes have made major headlines, but much less is said about the thousands of everyday Americans that were left in financial ruin.

For victims of the Madoff Investment Scandal, receiving any form of compensation has been a drawn-out process. In 2018, 10 years after the scheme was uncovered, a court-appointed trustee managed to recover $13 billion by liquidating Madoff’s firm and personal assets.

As NPR reported, investors may recover up to 60 to 70 percent of their initial investment only. For victims who had to delay retirement or drastically alter their lifestyles, this compensation likely provides little solace.

Do the Crime, Pay the Time

Running a Ponzi scheme is likely to land you in jail for a long time, at least in the U.S.

In 2009, for example, 71-year-old Bernie Madoff pled guilty to 11 federal felonies and was sentenced to 150 years in prison. That’s 135 years longer than the average U.S. murder conviction.

Outside of the U.S., it’s a much different story. Weaker regulation and enforcement, particularly in developing countries, means a number of schemes are ongoing today.

Sergei Mavrodi, known for running the Russian Ponzi scheme MMM, started a new organization named MMM Global after being released from prison in 2011. Although he died in March 2018, his self-described “social financial network” has established a base in several Southeast Asian and African countries.

If you or someone you know is worried about falling victim to a Ponzi scheme, this checklist from the U.S. Securities and Exchange Commission (SEC) may be a useful resource.

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The Top 100 Companies of the World: The U.S. vs Everyone Else

Where are the top 100 companies of the world located? We highlight the U.S. share of the top companies by market capitalization .



Top 100 Companies World vs US Shareable

The Top 100 Companies of the World: U.S. vs Everyone

When it comes to breaking down the top 100 companies of the world, the United States still commands the largest slice of the pie.

Throughout the 20th century and before globalization reached its current peaks, American companies made the country an economic powerhouse and the source of a majority of global market value.

But even as countries like China have made headway with multi-billion dollar companies of their own, and the market’s most important sectors have shifted, the U.S. has managed to stay on top.

How do the top 100 companies of the world stack up? This visualization pulls from PwC’s annual ranking of the world’s largest companies, using market capitalization data from May 2021.

Where are the World’s Largest Companies Located?

The world’s top 100 companies account for a massive $31.7 trillion in market cap, but that wealth is not distributed evenly.

Between companies, there’s a wide range of market caps. For example, the difference between the world’s largest company (Apple) and the 100th largest (Anheuser-Busch) is $1.9 trillion.

And between countries, that divide becomes even more stark. Of the 16 countries with companies making the top 100 ranking, the U.S. accounts for 65% of the total market cap value.

Location# of CompaniesMarket Capitalization (May 2021)
🇺🇸 United States59$20.55T
🇨🇳 China14$4.19T
🇸🇦 Saudi Arabia1$1.92T
🇨🇭 Switzerland3$0.82T
🇳🇱 Netherlands3$0.58T
🇯🇵 Japan3$0.56T
🇫🇷 France2$0.55T
🇩🇪 Germany3$0.46T
🇰🇷 South Korea1$0.43T
🇬🇧 United Kingdom3$0.43T
🇮🇳 India2$0.34T
🇮🇪 Ireland2$0.34T
🇦🇺 Australia1$0.16T
🇩🇰 Denmark1$0.16T
🇨🇦 Canada1$0.13T
🇧🇪 Belgium1$0.13T

Compared to the U.S., other once-prominent markets like Japan, France, and the UK have seen their share of the world’s top 100 companies falter over the years. In fact, all of Europe accounts for just $3.46 trillion or 11% of the total market cap value of the list.

A major reason for the U.S. dominance in market values is a shift in important industries and contributors. Of the world’s top 100 companies, 52% were based in either technology or consumer discretionary, and the current largest players like Apple, Alphabet, Tesla, and Walmart are all American-based.

The Top 100 Companies of the World: Competition From China

The biggest and most impressive competitor to the U.S. is China.

With 14 companies of its own in the world’s top 100, China accounted for $4.19 trillion or 13% of the top 100’s total market cap value. That includes two of the top 10 firms by market cap, Tencent and Alibaba.

 CompanyCountrySectorMarket Cap (May 2021)
#1AppleUnited StatesTechnology$2,051B
#2Saudi AramcoSaudi ArabiaEnergy$1,920B
#3MicrosoftUnited StatesTechnology$1,778B
#4AmazonUnited StatesConsumer Discretionary$1,558B
#5AlphabetUnited StatesTechnology$1,393B
#6FacebookUnited StatesTechnology$839B
#8TeslaUnited StatesConsumer Discretionary$641B
#9AlibabaChinaConsumer Discretionary$615B
#10Berkshire HathwayUnited StatesFinancials$588B
#12VisaUnited StatesIndustrials$468B
#13JPMorgan ChaseUnited StatesFinancials$465B
#14Johnson & JohnsonUnited StatesHealth Care$433B
#15Samsung ElectronicsSouth KoreaTechnology$431B
#16Kweichow MoutaiChinaConsumer Staples$385B
#17WalmartUnited StatesConsumer Discretionary$383B
#18MastercardUnited StatesIndustrials$354B
#19UnitedHealth GroupUnited StatesHealth Care$352B
#20LVMH Moët HennessyFranceConsumer Discretionary$337B
#21Walt Disney CoUnited StatesConsumer Discretionary$335B
#22Bank of AmericaUnited StatesFinancials$334B
#23Procter & GambleUnited StatesConsumer Staples$333B
#24NvidiaUnited StatesTechnology$331B
#25Home DepotUnited StatesConsumer Discretionary$329B
#26Nestle SASwitzerlandConsumer Staples$322B
#28Paypal HoldingsUnited StatesIndustrials$284B
#29Roche HoldingsSwitzerlandHealth Care$283B
#30Intel United StatesTechnology$261B
#31ASML Holding NVNetherlandsTechnology$255B
#32Toyota MotorJapanConsumer Discretionary$254B
#33ComcastUnited StatesTelecommunication$248B
#34Verizon CommunicationsUnited StatesTelecommunication$241B
#35Exxon MobilUnited StatesEnergy$236B
#36NetflixUnited StatesConsumer Discretionary$231B
#37AdobeUnited StatesTechnology$228B
#38Coca-Cola Co United StatesConsumer Staples$227B
#40Ping AnChinaFinancials$219B
#41Cisco SystemsUnited StatesTelecommunication$218B
#42AT&TUnited StatesFinancials$216B
#43L'OréalFranceConsumer Discretionary$215B
#44China Construction BankChinaFinancials$213B
#45Abbott LabsUnited StatesHealth Care$212B
#46Novartis AGSwitzerlandHealth Care$212B
#47NikeUnited StatesConsumer Discretionary$209B
#48Oracle United StatesTechnology$202B
#49PfizerUnited StatesHealth Care$202B
#50ChevronUnited StatesOil & Gas$202B
#51China Merchants BankChinaFinancials$196B
#52PepsiCoUnited StatesConsumer Staples$195B
#53Salesforce.comUnited StatesTechnology$195B
#54Merck & CoUnited StatesHealth Care$195B
#55AbbVieUnited StatesHealth Care$191B
#56BroadcomUnited StatesTechnology$189B
#57Prosus NVNetherlandsTechnology$181B
#58Reliance IndustriesIndiaEnergy$180B
#59Thermo Fisher ScientificUnited StatesHealth Care$180B
#60Eli Lilly & CoUnited StatesHealth Care$179B
#61Agricultural Bank of ChinaChinaFinancials$178B
#62Softbank GroupJapanTelecommunication$176B
#63Accenture IrelandIndustrials$176B
#64Texas InstrumentsUnited StatesTechnology$174B
#65McDonaldsUnited StatesConsumer Discretionary$167B
#66Volkswagen AGGermanyConsumer Discretionary$165B
#67BHP GroupAustraliaBasic Materials$163B
#68Wells Fargo & CoUnited StatesFinancials$162B
#69Tata Consultancy ServicesIndiaTechnology$161B
#70DanaherUnited StatesHealth Care$160B
#71Novo NordiskDenmarkHealth Care$160B
#72Medtronic IrelandHealth Care$159B
#73Wuliangye YibinChinaConsumer Staples$159B
#74Costco WholesaleUnited StatesConsumer Discretionary$156B
#75T-Mobile USUnited StatesTelecommunication$156B
#76CitigroupUnited StatesFinancials$152B
#77HoneywellUnited StatesIndustrials$151B
#78QualcommUnited StatesTechnology$151B
#79SAP SEGermanyTechnology$151B
#80BoeingUnited StatesIndustrials$149B
#81Royal Dutch Shell NetherlandsOil & Gas$148B
#82NextEra EnergyUnited StatesUtilities$148B
#83United Parcel ServiceUnited StatesIndustrials$148B
#84Union PACUnited StatesIndustrials$148B
#85Unilever United KingdomConsumer Staples$147B
#86AIA ChinaFinancials$147B
#87LindeUnited KingdomBasic Materials$146B
#88AmgenUnited StatesHealth Care$144B
#89Bristol Myers SquibbUnited StatesHealth Care$141B
#90Siemens AGGermanyIndustrials$140B
#91Bank of ChinaChinaFinancials$139B
#92Philip MorrisUnited StatesConsumer Staples$138B
#93Lowe's CompaniesUnited StatesConsumer Discretionary$136B
#94Charter CommunicationsUnited StatesTelecommunication$135B
#95China MobileChinaTelecommunication$134B
#96Sony GroupJapanConsumer Discretionary$132B
#97AstrazenecaUnited KingdomHealth Care$131B
#98Royal Bank of CanadaCanadaFinancials$131B
#99StarbucksUnited StatesConsumer Discretionary$129B
#100Anheuser-BuschBelgiumConsumer Staples$128B

Impressively, China’s rise in market value isn’t limited to well-known tech and consumer companies. The country’s second biggest contributing industry to the top 100 firms was finance, once also the most valuable sector in the U.S. (currently 4th behind tech, consumer discretionary, and health care).

Other notable countries on the list include Saudi Arabia and its state-owned oil and gas giant Saudi Aramco, which is the third largest company in the world. Despite only having one company in the top 100, Saudi Arabia had the third-largest share of the top 100’s total market cap value.

As Europe continues to lose ground year-over-year and the rest of Asia struggles to keep up, the top 100 companies might become increasingly concentrated in just the U.S. and China. The question is, will the imbalance of global market value start to even out, or become even bigger?

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