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The Spiraling Opioid Epidemic in America

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US Opioid Epidemic Spiral in America

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The Spiraling Opioid Epidemic in America

Over the last 20 years, the ongoing U.S. opioid crisis has claimed tens of thousands of lives. In fact, opioid overdose deaths accounted for nearly 70% of all drug overdose deaths in 2018.

Although the damage of the opioid epidemic is well documented, what people might not know is that it has escalated in three distinct waves.

We pull the latest statistics from the UN World Drug Report 2020 to uncover the scope of the opioid crisis in the U.S., and how national drug-related death rates compare to other countries.

Three Waves of the Opioid Crisis

According to the CDC, the opioid epidemic can be traced back to the 1990s, when opioids started being over-prescribed for pain relief purposes.

  • 1990s – Wave 1
    Over-prescription of opioids for pain relief, including natural opioids, semi-synthetic opioids, and methadone. Addiction risks were widely downplayed.
  • 2010 – Wave 2
    Heroin-related overdose deaths on the rise.
  • 2013 – Wave 3
    Synthetic opioid-related deaths on the rise, particularly fentanyl and tramadol.

Here’s how that breaks down in terms of opioid-related overdose deaths over the years. Note that by the year 2018, 67% of overdose deaths involved synthetic opioids such as fentanyl.

YearAny opioidsHeroinPharmaceutical opioidsSynthetic opioids
19998,0501,9603,533730
20008,4071,8423,903782
20019,4961,7794,935957
200211,9202,0896,7741,295
200312,9402,0807,8391,400
200413,7561,8789,0761,664
200514,9182,00910,2341,742
200617,5452,08812,4232,707
200718,5162,39913,6762,213
200819,5823,04114,0432,306
200920,4223,27814,4312,946
201021,0893,03615,5203,007
201122,7844,39716,1112,666
201223,1665,92515,0722,628
201325,0528,25713,9373,105
201428,64710,57415,5595,544
201533,09112,98916,0289,580
201642,24915,46917,86019,413
201747,60015,48217,68928,466
201846,80214,99615,57531,335

Overdose deaths from synthetic opioids such as fentanyl and tramadol shot up by over 4,000% between 1999-2018. This can be attributed to two things: their relative potency, and the minute quantities of each that qualify as a lethal dose.

As per the medical and legal standard, opioids are often compared to morphine. To that end, heroin is 2-5x stronger—while fentanyl is 50-100x more potent. Put another way, roughly a dime-size or 10-12mg of heroin is considered a lethal dose, compared to only 1-2mg of fentanyl.

What’s worse, fentanyl is typically mixed with other types of drugs such as heroin or cocaine to increase their effects, which is how it ends up unintentionally ingested. Between 2008-2017, drug-use disorders as a whole claimed the most healthy lives due to poor health or early deaths—measured in disability-adjusted life years (DALYs)—followed in close second by opioid use disorders.

The Death Toll of U.S. Drug Overdoses

It’s undeniable that the opioid epidemic in America has caused significant harm to communities. But how does the U.S. drug crisis compare to the same issue in other countries?

The UN Drug Report further puts these numbers into perspective by comparing drug-related deaths per million population. Note that the source also compiled the total deaths across years for selected countries.

Country (Latest Year)Latest Years of EstimateTotal DeathsRate per 1M (Aged 15-64)
🇺🇸 U.S.201867,367314.5
🇦🇺 Australia2016-20173,240202.6
🇸🇻 El Salvador2018765184.5
🇨🇦 Canada 20184,460179.8
🇺🇾 Uruguay2016264119.4
🇮🇸 Iceland2012-201623105.2
🇸🇪 Sweden201757592.9
🇳🇿 New Zealand201626988.6
🇫🇮 Finland201728983.9
🇬🇧 UK20173,54783

With 314.5 deaths per million, the U.S. by far had the highest proportion of drug-related deaths per million people in 2018. It also had the highest overall number at 67.4K deaths.

Elephant in the Room?

Another drug rearing its head on the streets is carfentanil. Formerly developed as ‘elephant tranquilizer’, this synthetic opioid is similar in appearance to other illicit drugs such as heroin, making it indistinguishable when mixed in. However, there’s one big problem—carfentanil is 100x more potent than fentanyl itself.

In response to the continued crisis, an additional $35.7 billion was requested for counter-drug funding efforts in the FY2021 Budget. This amount is expected to go towards prevention and treatment efforts ($18.6 billion) and law enforcement efforts ($17.1 billion) both domestically and internationally.

But will these efforts properly combat the crisis, or are we already in the midst of a fourth wave of the opioid epidemic?

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Politics

How Much Do Americans Trust the Media?

Media trust among Americans has reached its lowest point since Trump won the 2016 presidential election.

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How Much Do Americans Trust the Media?

Media trust among Americans has reached its lowest point in six years.

Gallup began its survey on media trust in 1972, repeating it in 1974 and 1976. After a long period, the public opinion firm restarted the polls in 1997 and has asked Americans about their confidence level in the mass media—newspapers, TV, and radio—almost every year since then.

The above graphic illustrates Gallup’s latest poll results, conducted in September 2023.

Americans’ Trust in Mass Media, 1972-2023

Americans’ confidence in the mass media has sharply declined over the last few decades.

Trust in the mass media% Great deal/Fair amount% Not very much% None at all
197268246
197469218
197672224
1997533115
199855359
1999553411
2000513712
2001533314
2002543511
2003543511
2004443916
2005503712
2007473517
2008433521
2009453718
2010433621
2011443619
2012403921
2013443322
2014403624
2015403624
2016324127
2017412929
2018453024
2019413028
2020402733
2021362934
2022342838
2023322939

In 2016, the number of respondents trusting media outlets fell below the tally of those who didn’t trust the media at all. This is the first time that has happened in the poll’s history.

That year was marked by sharp criticism of the media from then-presidential candidate Donald Trump.

In 2017, the use of the term ‘fake news’ rose by 365% on social media, and the term was named the word of the year by dictionary publisher Collins.

The Lack of Faith in Institutions and Social Media

Although there’s no single reason to explain the decline of trust in the traditional media, some studies point to potential drivers.

According to Michael Schudson, a sociologist and historian of the news media and a professor at the Columbia Journalism School, in the 1970s, faith in institutions like the White House or Congress began to decline, consequently impacting confidence in the media.

“That may have been a necessary corrective to a sense of complacency that had been creeping in—among the public and the news media—that allowed perhaps too much trust: we accepted President Eisenhower’s lies about the U-2 spy plane, President Kennedy’s lies about the ‘missile gap,’ President Johnson’s lies about the war in Vietnam, President Nixon’s lies about Watergate,”
Michael Schudson – Columbia Journalism School

More recently, the internet and social media have significantly changed how people consume media. The rise of platforms such as X/Twitter and Facebook have also disrupted the traditional media status quo.

Partisans’ Trust in Mass Media

Historically, Democrats have expressed more confidence in the media than Republicans.

Democrats’ trust, however, has fallen 12 points over the past year to 58%, compared with 11% among Republicans and 29% among independents.

How-Much-Do-Americans-Trust-the-Media

According to Gallup, Republicans’ low confidence in the media has little room to worsen, but Democrat confidence could still deteriorate and bring the overall national reading down further.

The poll also shows that young Democrats have less confidence in the media than older Democrats, while Republicans are less varied in their views by age group.

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