The U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration recently released the 2023 National Drug Use and Health Survey, highlighting an escalating drug abuse crisis in America. The report reveals that nearly 9 million Americans are misusing opioids, and approximately 61.8 million individuals aged 12 and over are using marijuana.
Experts note that despite comprising less than 5% of the global population, the U.S. consumes 80% of the world’s opioids. The absence of permanent scheduling for fentanyl and delays in regulatory measures have exacerbated the issues of drug misuse and drug-related crises, posing significant challenges to public health.
The surge in overdose-related deaths is alarming. In contrast to the upscale stores surrounding Union Square in San Francisco, just a few blocks away, the Tenderloin district presents a starkly different reality: a large homeless population grappling with opioid addiction and other substance use issues. This area has gained notoriety as one of the most dangerous neighborhoods in the city.
The trend of rising drug abuse has persisted over the past few decades. Research from the Council on Foreign Relations indicates that more than 1 million people have died from overdoses in the U.S. since 2000, with a significant portion attributed to opioids. Data from the Centers for Disease Control and Prevention (CDC) shows that the rampant use of fentanyl-based opioids is a primary cause of overdose deaths, with around 81,000 fatalities recorded in 2023 alone.
As reported by The Wall Street Journal, “The U.S. has struggled to stem the rapid rise in overdose deaths.” Statistics reveal that in 1990, just 8,400 deaths were attributed to overdoses; from 1999 to 2017, 400,000 people lost their lives to opioid-related overdoses. In 2023, overdose deaths surpassed 100,000 for the third consecutive year, reaching approximately double those seen in 2015.
Dr. Magdalena Cerdá, director of the Opioid Epidemiology and Policy Center at NYU Langone Health, stated, “The U.S. is facing a monumental crisis in drug abuse,” noting that the situation has intensified significantly compared to previous years. Furthermore, Princeton University professors Anne Case and Nobel laureate Angus Deaton remarked in their book, “Deaths of Despair and the Future of Capitalism,” that “opioids have become a kind of anesthetic for the masses.”
The escalating drug crisis burdens individuals, families, and communities while straining healthcare systems and exacerbating broader social issues. Axios reports that substance abuse often coexists with mental health issues; the recent SAMHSA report indicates that in 2023, around 58.7 million adults in the U.S. reported experiencing mental illness, with many affected by the consequences of overdoses.
Another study published in the Journal of the American Medical Association Psychiatry highlights that between 2011 and 2021, overdose deaths led to 320,000 children losing a parent, potentially resulting in lifelong trauma and impacting future addiction behaviors among this vulnerable group. Millions of children are also living with parents who struggle with substance abuse or addiction, raising significant concerns about their well-being.
In April 2016, Congress passed the Ensuring Patient Access and Effective Drug Enforcement Act, which notably limited the Drug Enforcement Administration’s ability to regulate large pharmaceutical companies. Reports indicate that political action committees representing the pharmaceutical industry contributed over $1.5 million to 23 lawmakers involved in creating various versions of this bill. Between 2014 and 2016, the pharmaceutical industry spent around $102 million lobbying Congress for this and other related legislation. A prior report by The Guardian noted that major pharmaceutical companies invested nearly $2.5 billion in lobbying and funding U.S. congressional members from 2007 to 2017, aiming to influence legislation on drug costs and approval processes.
Stanford University psychiatry professor Keith Humphreys and Carnegie Mellon University public policy professor Jonathan Caulkins argue that many large pharmaceutical companies have long supported organized campaigns to downplay the dangers of opioids, misleading countless individuals into substance misuse, thus intensifying the current addiction crisis in America.
CNN reports that the U.S. initiated a national strategy to prevent overdoses two years ago; however, statistics show that the drug abuse crisis remains unchecked. CDC Chief Medical Officer Debra Houry emphasized that many families are still losing loved ones to overdoses. Former Assistant Secretary for Health at HHS, Dr. K. Michael C. P. O’Keeffe, pointed out that donations from opioid manufacturers to politicians continue to shape policy decisions, describing the crisis as indicative of “a systemic regulatory failure.”
Media reports also highlight that in the pursuit of higher market profits, pharmaceutical companies and related entities have aggressively pushed for drug legalization, encouraging increased drug use and over-prescription by physicians. The New York Times noted that pharmaceutical representatives wield significant influence within the U.S. healthcare system, often incentivizing doctors to prescribe medications, which in turn leads to widespread substance misuse and addiction. Various interest groups further complicate the situation by lobbying against substantive solutions to the drug crisis.
An article in The Atlantic revealed that advertisements recommending sharing fentanyl and other opioids popped up in San Francisco, while the Drug Policy Alliance praised fentanyl distributors as harm reduction advocates, suggesting that local governments refrain from interfering. Many experts have also spoken out against the stigmatization of drug users.
The Atlantic article argues that the issues of drug abuse and addiction in the U.S. stem from a convergence of political systems, economic interests, lobbying practices, and social culture, highlighting the deep-seated governance challenges in America. It calls for significant reforms across public policy, law enforcement, the legal system, and social culture to alter the underlying environment fostering substance misuse and drug proliferation.
