Why is the Northeast Hit Hardest by Opiate Deaths?
It is no mystery that the United States is struggling with a drug addiction crisis. In October of 2017, the opioid epidemic alone (just one facet of America's addiction problem) was declared a Public Health Emergency.
Drug addiction has spread across the United States. There is not a single state that hasn’t felt the effects of the epidemic. However, not all states have been affected equally when it comes to drug overdoses. The eastern states struggle with overdoses to a much larger extent than the western ones.
Why is that? Why would the geographic location be a determining factor in overdose numbers?
Drug Overdoses
According to the Centers for Disease Control and Prevention, “70,237 drug overdose deaths occurred in the United States in 2017. The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). Opioids—mainly synthetic opioids—are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).”
And according to a recent news release in U.S. News, the northeastern U.S. experiences more drug overdoses per capita than any other region in the country. And that is primarily because opiate drugs are more prevalent there. The area most affected begins in Minnesota, runs east and then northeast, canvasing states like Wisconsin, Illinois, Indiana, Ohio, West Virginia, Virginia, Pennsylvania, New York, New Hampshire, Vermont, Connecticut, Maine, and others.
One of the primary factors that contribute to more overdoses in this region is the higher concentration of fentanyl, an extremely potent opiate. In this region of the U.S., fentanyl overdoses claim anywhere from 12 to 22 lives, every year, for every 100,000 population. That means, in each state, about 12 to 22 persons for every 100,000 people in that state die every year from just one drug. If a state (like Ohio, for example) has about 11 million people in it, that means about 2,000 Ohioans will die from fentanyl overdoses alone in just one year.
Swing the lenses to a different side of the country such as the Southwest, and the problem looks quite different. In New Mexico, Arizona, Nevada, Utah, and Colorado, the fentanyl overdose death rate is only about 1.5 per 100,000 people. A marked difference from the Northeast.
“We tend to think all the U.S. is the same, and clearly it is not. There are differences across the country in terms of the drugs that are contributing to overdose deaths…”
A Combination of Factors
Dr. Holly Hedegaard, an NCHS epidemiologist, commented for U.S. News on the vast disparity of the drug problem region to region. “We tend to think all the U.S. is the same, and clearly it is not. There are differences across the country in terms of the drugs that are contributing to overdose deaths. It's important to recognize those [regional] differences, particularly when we're thinking about effective prevention programs. What might work in one region won't necessarily work somewhere else.”
Dr. Hedegaard and her research team analyzed overdose deaths for 2017, comparing the type of drugs that caused such deaths. According to the research, most drug overdose deaths west of the Mississippi were attributed to methamphetamine. Most overdoses east of the Mississippi were attributed to opiates. And while all drugs have the potential for causing a death, opioids cause far more deaths per year than methamphetamine does. (This paper from the National Institute on Drug Abuse offers excellent insight into different types of overdoses).
Fentanyl was the leading cause of death in the U.S., and fentanyl abuse is heavily focused in the Northeast. Fentanyl alone was responsible for about two out of every five overdose deaths in 2017, with the majority of those deaths being in just a few states.
One might ask, if fentanyl is so lethal, why are people using it? The truth is, they don’t often know they are using it. According to Pat Aussem, the director of clinical content and development at the Center on Addiction in New York City, “This report highlights the inroads fentanyl has made, particularly east of the Mississippi, contributing to overdose deaths as people using substances either seek or unwittingly consume it in heroin, counterfeit pills or cocaine.”
Addiction can affect anyone. No one is immune to the threat of this problem. But different types of drugs affect the body differently. People who fall prey to addiction in the western U.S. are more likely to use the drugs that are most available to them. And it just so happens that those drugs are not usually as lethal as the drugs that are available in the eastern U.S.
What does that tell us?
Addressing the Drug Problem
It tells us that addressing the drug problem is not only a life or death matter, but it is a matter of addressing both supply and demand. We have to support our law enforcement organizations that are working hard to bust drug trafficking cartels. We need to support groups that get drugs off the streets in all states.
But just as important, we have to create a society where people don’t want to use drugs. We need to educate the populace about the risks of drugs, and that includes all drugs. People need to know the truth about drugs, about the harmful nature of all drugs, including meth, opiates, marijuana, alcohol, cocaine, hallucinogenics, designer drugs, etc.
And last but not least, we have to help those who are currently addicted to drugs. That means helping addicts get into and through residential drug treatment programs. Addiction is not something that goes away on its own. Addicts cannot tackle such a vicious and potentially lethal problem on their own. Addiction requires professional help, on a residential level, and preferably of a long-term nature to treat it effectively.
In closing, it’s worth pausing for a moment to point out that all forms of drug addiction have risk. All types of addiction should be treated with proper care. We can learn a lot from examining geographic factors in drug overdoses. But that doesn’t change the fact that each state and its residents need to focus attention on helping those who suffer from addiction. Again quoting Pat Aussem, “While understanding geographic differences is important, we can't lose sight that our country has an addiction problem. Access to evidence-based, affordable care is essential. We must also catch the problem further upstream, screening people, including our youth, to protect against addiction and loss of life.”
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378105/
- https://www.cdc.gov/drugoverdose/data/statedeaths.html
- https://www.usnews.com/news/health-news/articles/2019-10-25/one-region-is-being-hit-hardest-by-us-opioid-crisis
- https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
®