The US consumes more than 80% of the global opioid pill production even though it has less than 5% of the world’s population. Over the past 20 years, one federal institution after another lined up behind the drug manufacturers’ false claims of an epidemic of untreated pain in the US. They seem not to have asked why no other country was apparently suffering from such an epidemic or plying opioids to its patients at every opportunity.

From 2013 to 2014, Maine saw the third-highest increase in any state, 27 percent ... Twenty years ago, just 34 people died from drug overdoses ... Only four years ago, there were 176 overdose deaths, less than half the 2016 total ... The death toll reached 378 in 2016, driven almost entirely by opioids – prescription painkillers, heroin and now fentanyl, a powerful synthetic. More than one victim per day. More than car accidents. Or suicide. Or breast cancer.

Dentists have become a significant source of opioid prescribing — especially for younger patients undergoing wisdom teeth extractions. They prescribe about 8 percent of the opioids in this country, ... but are the top prescribers of these drugs to adolescents, accounting for 31 percent of all opioids given to patients aged 10 to 19 years old. That’s particularly concerning because that age group is among the most likely to abuse drugs and develop addictions.

There were increases in just about every major cause of death between 2014 and 2015, and the death-rate increases centered on whites and black men — they remained flat for Latinos and for black women ... drugs stand out as a particularly devastating part of the problem: In fact, one key to the racial divide may also come from numbers released yesterday, these from the CDC: For the first time ever, more people died from heroin overdoses than from gun homicides in 2015.

Much of the current opioid predicament stems from the explosion of prescription painkiller use in the late 1990s and early 2000s. Widespread painkiller use led to many Americans developing dependencies on the drugs. When various authorities at the state and federal levels began issuing tighter restrictions on painkillers in the late 2000s, much of that demand shifted over to the illicit market, feeding the heroin boom of the past several years.

while the disappearance of high-paying jobs for those with little education is a large part of the overall story of a shrinking middle class, it can’t wholly account for the uptick of mortality identified in the Case and Deaton study ... the groups that have been affected most viciously by these market trends in the U.S., African Americans and Latinos, have not suffered the dramatic increases in death by suicide or substance abuse that whites have.

While New Mexico has more than 30 needle exchange programs, neighboring Colorado, where syringe exchanges were illegal until 2010, has only seven. In Appalachia, another region hit hard by substance abuse, there are just a handful ... In 2007, New Mexico adopted the nation’s first “Good Samaritan Law,” protecting people who call 911 during an overdose from prosecution for possession charges. Today, most states have some version of the law.

the heroin problem wouldn't be one-tenth as bad if we hadn't primed the pump with prescription opioids and all the controlled substances ... In states like Kentucky that disciplined or jailed rogue doctors and curbed the actions of others, painkiller prescribing has ebbed. In states slow to respond...the flow of narcotics has barely budged ... fatal overdoses have climbed as heroin moved into areas that developed a taste for narcotics at the hands of healers.

Like Colorado, Washington, D.C., is a center of extensive substance use ... ranking among the nation’s leaders for cocaine, alcohol and marijuana use ... As the most religious region of the country, the Southeast and Bible Belt have long tended to have lower consumption of intoxicating substances — particularly alcohol — than the rest of the country. Yet non-medical painkiller use is an exception to this general rule, with most of its top consumers being in or near this region

At most exchanges, the needles are just one small part of the program. Many provide services like HIV testing, screening for hepatitis C, counseling or even referral to drug treatment programs. The research indicates that those ancillary services and the human connections make the programs successful, along with the sterility of the needles they provide. It’s those other programs that the federal government is now willing to pay for (the ban on paying for the actual syringes is still in place).