According to the CDC, over half a million people died of drug overdoses between 2000 and 2015. In that time span, overdoses on prescription opioids more than quadrupled. Currently, around 91 Americans die every day of an opioid overdose — a fatality rate that has now surpassed the number of gun homicides in the U.S.
From 2002–2013, all indicators of heroin use rose among 18–25 year olds with approximately three out of four users reporting abusing prescription opioids prior to using heroin.
Considering that 1 in 5 people provided with a 10 day supply of opioids will become a long term user and many end up graduating to heroin, it’s not surprising that as sales of prescription opioids have nearly quadrupled from 1999 to 2014 overdose deaths and heroin abuse rates rose at a similar rate.
Interestingly, during this same time period there was no noticeable increase in the amount of pain that Americans reported overall. Yet that hasn’t stopped doctors from prescribing opioids to 1 out of every 5 patients with non-cancer pain or another pain related diagnosis — with the CDC noting that the rate of prescribing among specialists treating chronic and acute pain rose steadily from 2007 to 2012.
As heroin use continues to trend upwards, the majority of users are those who have graduated from prescription opioids that they either no longer have access to through a physician or can no longer afford. Heroin is much cheaper and more potent than prescription opioids, especially those purchased illicitly.
This means that out of the millions of Americans who would lose healthcare, as well as those who would see sharp increases in their premiums and copays, countless patients would be forced to go off their prescription opioids cold turkey as an economic necessity.
It’s statistically inevitable that many of these people would subsequently turn to heroin. At those rates it wouldn’t be out of the realm of possibility to see the total number of overdose deaths in the U.S. top 1 million before the end of President Trump’s first term, despite his campaign pledge to end the opioid epidemic.