Are we taking the drug overdose epidemic seriously?

I recently argued that:

The drug overdose epidemic is a public health catastrophe in the same class as AIDS.

Arguably, it’s worse. Annual deaths by drug overdose are substantially higher than the worst year of the AIDS epidemic. The current very rapid increase in deaths by drug overdose shows no signs of slowing. Drug overdose is now the leading cause of death for Americans under 50. AIDS never achieved that.

If you measure the magnitude of an epidemic by the sum of the years of life lost by the victims, drug overdoses compete with cancer, not just AIDS. Many more Americans die of cancer (about 600,000) than drug overdose (an expected 60,000 in 2017). But more than half of cancer deaths occur in people 75 years or older (UK data). The average drug overdose victim dies in his or her early 40s and loses many more years of life.

Are we responding to the drug overdose epidemic in a way that is commensurate to these facts?

I don’t think the NIH is. The 2017 NIH Budget request slides presented by Director Francis Collins discussed:

  • The National Cancer Moonshot.
  • The Precision Medicine Initiative.
  • The Brain Initiative.
  • AIDS research.
  • Alzheimer’s research.

These are all great things to do with federal dollars. But it’s remarkable that Collins did not mention drug or alcohol abuse or the current epidemic.

Why aren’t we focused on this epidemic? It’s the same problem that plagued the early years of AIDS. The victims were stigmatized and those not in their families or neighbourhoods didn’t take their deaths seriously.

Turning the tide on AIDS required that we rethink our values, not just our virology. Now it’s time to rethink how we feel about the people suffering from drug and alcohol problems.


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