Why there is an opioid crisis
Drug overdoses, primarily from opioids, have now overtaken motor vehicle accidents as the leading cause of unintentional injury deaths in this Nation. How did this happen and what role should ob/gyns have in curtailing the issue?
Unlike Hurricane Irma, the opioid crisis took me unawares. I first began noticing more cases of heroin abuse among pregnant women when I moved to New Haven from NYC in 2002. But when I arrived in Columbus, Ohio, in 2011 the sheer number of addicted pregnant patients attending the Ohio State high-risk clinic was staggering. Nor was the problem limited to Ohio.
From 1999 through 2011, overdose deaths from prescribed opioids tripled nationally, and while these numbers remained relatively constant over the next 4 years, the number of overdose deaths from illicit narcotics-mostly heroin and fentanyl-tripled.1 Thus, by 2015, more than 2.5 million Americans had an opioid use disorder (OUD) from either prescription medications (77%) or illicit drugs (23%)1 and 90 Americans died of an opioid overdose every day.1,2 Drug overdoses, primarily from opioids, have now overtaken motor vehicle accidents as the leading cause of unintentional injury deaths in this Nation. It was also no accident that I found there to be an opioid epidemic in Ohio. By the time I arrived there, it had become the nidus of a national opioid epidemic.
How did this happen? Why now? Why Ohio? In his meticulously researched book, Dreamland, author Sam Quinones, starts and ends in Portsmouth, Ohio, to answer these questions.3 But his findings have far broader application for American medicine and society as a whole.
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