Over the past two decades, the United States has experienced a growing crisis of substance abuse and addiction that is illustrated most starkly by the rise in deaths from drug overdoses. Since 2000, the annual number of drug overdose deaths has quadrupled from 17,500 to 70,000 in 2017. Most of these deaths involved opioids, including heroin, prescription painkillers, and synthetic opioids such as fentanyl. In the years since the U.S. Centers for Disease Control and Prevention (CDC) declared overdoses from prescription painkillers an "epidemic" in 2011, the opioid overdose crisis has evolved rapidly from a problem tied mostly to prescription opioid painkillers to one increasingly driven by illicitly trafficked heroin and synthetic opioids. More recently, early evidence suggests that the problem also may be spreading beyond opioids to other illicit drugs, such as cocaine and methamphetamine. This brief provides high-level information about opioids and opioid addiction, presents the historical context for the epidemic of opioid and related addiction and mortality in the United States, and examines trends in opioid-related mortality across the country and among the states.
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