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The Opioid Problem Is Our Problem

Tonic takes a look at drugs, addiction, and death among young people in the US.

Read Tonic's opioid coverage here.

Earlier this month, former Centers for Disease Control and Prevention head Tom Frieden commented that there is one single way in which America's health is significantly worsening: drug overdose deaths. (What he didn't say is that we also appear to be infecting ourselves with record numbers of STDs, but that's a story for another time.)

You've read about this, surely. You've heard it's a middle class, middle-aged-person problem, that these days, white people smack in the center of their lives are dying at unprecedented rates. You've pointedly wondered aloud why there wasn't such an uproar in the 70s and 80s, when the combined forces of addiction and overly punitive drug laws ravaged communities of color. You've gotten so used to the grim reports that your eyes have started to glaze over the headlines.


But we're here to tell you that not everything you think you know about this epidemic is true. For one thing: This isn't a middle-aged-person problem, really; this is a young-people problem. As Maia Szalavitz reports for Tonic, more than 90 percent of all addictions start when people are in their teens or early 20s. The people doctors need to be most careful with when prescribing opioids, she says, are not typically older folks in chronic pain, but youth. The drug overdose death rate among white 25- to 34-year-olds is five times what it was in 1999, and the death rate in that group overall is higher than it's been since the AIDS epidemic a quarter-century ago.

For another thing: The soaring stats likely don't even capture the extent of the damage. Preliminary analyses from the New York Times, taken from local records across the country, found that drug overdose deaths likely exceeded 59,000 in 2016. But as Maggie Puniewska reports for Tonic in her stunning piece about the accuracy of death certificates, only a portion of drug deaths are recorded as such; it's likely that there are many, many more not being documented.

The solutions to this massive problem so far put forth by the Trump administration have been mockable, what with Health Secretary Tom Price suggesting that God is the answer, and an opioid panel that will be stymied by deep cuts to a Medicaid system that has supported the treatment of thousands of Americans with addiction, not to mention the possibility that states could choose not to cover addiction treatment (an "essential benefit" under the Affordable Care Act) if the Senate passes its bill to repeal the ACA.

With deaths among young people rising at a frightening pace, and hopes not very high on the government front ("There really isn't anything this commission is going to figure out that we don't know already," Andrew Kolodny, an opioid policy expert at Brandeis University's Heller School for Social Policy and Management, told the Times), Tonic is taking a look at some of the less-discussed solutions. Our United States of Addiction series puts an appropriately young, human face on this sprawling epidemic, on these astounding numbers. We traveled to three states where overdose deaths have surged—Maine, Pennsylvania, and Ohio—to look at how young people are getting addicted, how we're dealing with those addictions, and how we're dying.

And as our reporting reveals, it's the options we're not pursuing that are perhaps some of the most innovative, and promising: Consider, for instance, a vaccine that leverages the human immune system to fight overdose and addiction—something that scores of young people and their parents wish they could get their hands on, Tonic reporter Arielle Pardes writes, if only there were better funding for studying it.

If science can't save us, then maybe harm-reduction techniques can: Writer Zach Siegel makes a compelling case for the potential of legally administered heroin to treat people with addiction. Giving heroin users a safe, regulated dose under the watch of doctors and nurses is effectively removing the user from a dangerous black market, he argues, protecting them from the risks of street heroin and illicit fentanyl, which together killed nearly double the number of people prescription painkillers did in 2015.

Tonic talked to authorities about the solutions that are being overlooked, what options might ease this horror, and the political, social, and economic factors that are continually dragging us under. Because the opioid problem isn't a middle-aged thing, or a midwest thing, or just a white people thing. It's an us thing; a you thing. It's our old high school classmates, our coworkers, our nieces and nephews. And until we all navigate this vast hall of mirrors and choose to take on the problem as our own, it's not going anywhere.