The Opioid Crisis: An Epidemic Years in the Making


The current opioid epidemic is the deadliest drug crisis in American history. Overdoses, fueled by opioids, are the leading cause of death for Americans under 50 years old — killing roughly 64,000 people last year, more than guns or car accidents, and doing so at a pace faster than the H.I.V. epidemic did at its peak.

President Trump declared the opioid crisis a “public health emergency” on Thursday, though he did not release additional funding to address it. Had he declared it a “national emergency,” as he promised to do in August, it would have led to the quick allocation of federal funds.

The New York Times has been covering the outbreak — from when it started bubbling up in towns around the United States years ago to now, as it decimates communities and families.

Here is a roundup of our best reporting on the epidemic, including short answers to hard questions about it.

Snapshots of a Public Health Crisis

A team of reporters went inside the epidemic, from New England to “safe injection” areas in the Pacific Northwest, to explore the experiences of addicts and those trying to stem the tide. “I don’t know how I’m alive, honestly,” one Massachusetts woman said. Here are their stories.

Even babies are affected by the crisis, with a surge of newborns dependent on opioids. CreditTy Wright for The New York Times

The youngest members of society have not been exempt from the crisis. Toddlers and young children are increasingly being found unconscious or dead after consuming an adult’s drugs, and a surge of opioid-dependent newborns has forced doctors to rethink treatment.

The Numbers

Our reporters have been deciphering and providing context to masses of data about the many and varied ways opioids are affecting Americans.

How overdose deaths rippled across the United States.CreditHaeyoun Park and Matthew Bloch/The New York Times

Illustrated in a series of maps, here’s how overdose deaths rippled across the United States from 1999 to 2014, along with a breakdown of the large concentration of deaths in regions like Appalachia and the Southwest.

This interactive quiz aims to provide a deeper understanding of the mounting toll by asking readers to compare drug overdose deaths with other causes of death.

It’s the deadliest drug crisis in American history. It kills about 90 Americans every day. Here are answers to some key questions about the crisis.Published OnCreditImage by Michael Bryant/The Philadelphia Inquirer, via Associated Press

The government’s account of drug deaths in 2016 was the first national data to break down the growth by drug and by state, which revealed that deaths involving synthetic opioids, mostly fentanyls, had risen 540 percent in just three years.

While Mr. Trump fulfilled his vow to add urgency to the rapidly escalating opioid problem, his declaration falls short of the national emergency declaration he had pledged. These are the 28 currently active national emergencies.

Health Care

Drug companies and doctors have been accused of fueling the opioid crisis, but insurers may also be playing a role by making it easier to get opioids than the drugs that treat addiction to them. Here are the findings of our analysis.

A patient had to begin taking a hydrocodone, an opioid, to treat her pain after her insurer changed what it covered.CreditKevin D. Liles for The New York Times

With the soaring death toll, routine autopsies are overwhelming medical examiners everywhere. We spoke to Dr. Thomas A. Andrew of New Hampshire, which had more deaths per capita from synthetic opioids than any other state. Dr. Andrew decided to stop practicing medicine and instead minister to the living about the dangers of drugs. “I’m not an alarmist by nature, but this is not overhyped,” he said.

The Upshot reported on prescription drug monitoring programs, a tool that could be more widely used to fight opioid abuse.

Jails and Justice

Heroin users are filling the country’s jails, but recovering addicts are almost always cut off from their medication while incarcerated. Connecticut, though, is trying something new: a methadone treatment program to help inmates successfully re-enter society. We looked at the conundrums detention centers are facing.

The Times, in collaboration with the PBS series “Frontline,” followed 10 recently released inmates struggling to succeed on the outside.Published On

On Staten Island, prosecutors are leaping into largely uncharted legal terrain to fight the scourge: charging dealers in overdose deaths. And a New York Times Magazine writer traveled to a small town in New Hampshire, where one police officer has been trying to curb the rash of opioid overdoses.

Dealing in the Digital Age

The internet is proving to be a grim tool in the opioid drug trade.

On Reddit, one of the world’s largest online communities, opioid forums have offered a place to buy drugs and find solace for people like Rachel Frazier, who posted on Reddit regularly and dipped into drug-related communities such as “opiates.” She died two weeks after seeking drugs in a forum.

Dealers are embracing the dark web to anonymously send powerful synthetic opioids such as fentanyl to nearly every region of the country. Despite dozens of arrests, new merchants — many of them based in Asia — quickly pop up to fill the void.



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