Rose A. Rudd, MSPH1; Puja Seth, PhD1; Felicita David, MS1; Lawrence Scholl, PhD1,2

What is already known about this topic?
The U.S. opioid epidemic is continuing. Drug overdose deaths nearly tripled during 1999–2014. In 2014, among 47,055 drug overdose deaths, 61% involved an opioid. During 2013–2014, deaths associated with the most commonly prescribed opioids (natural/semisynthetic opioids) continued to increase slightly; however, the rapid increase in deaths appears to be driven by heroin and synthetic opioids other than methadone.
What is added by this report?
From 2014 to 2015, the death rate from synthetic opioids other than methadone, which includes fentanyl, increased by 72.2%, and heroin death rates increased by 20.6%. Rates of death involving heroin and synthetic opioids other than methadone increased across all demographic groups, regions, and in numerous states. Natural/semisynthetic opioid death rates increased by 2.6%, whereas, methadone death rates decreased by 9.1%.
What are the implications for public health practice?
There is an urgent need for a multifaceted, collaborative public health and law enforcement approach to the opioid epidemic, including implementing the CDC Guideline for Prescribing Opioids for Chronic Pain; improving access to and use of prescription drug monitoring programs; expanding naloxone distribution; enhancing opioid use disorder treatment capacity and linkage into treatment, including medication-assisted treatment; implementing harm reduction approaches, such as syringe services program; and supporting law enforcement strategies to reduce the illicit opioid supply


The rate of deaths from opioid overdoses now exceeds the HIV epidemic at its peak.  We need the carrot & stick approach.  Buprenorphine works GREAT for opioid abuse/addiction.  Unfortunately we are only allowed to treat a maximum of 275 patients at a time with this drug, there is a lot of unnecessary paperwork required to preserve bureaucracy.  Remove this!  Make BUP freely available WITHOUT Prior Authorizations (It’s a tier-1 generic medication!).  For those who don’t want to get clean and sober, institute work camps where addicted folks can learn a trade so that when released they’ll be able to get a job and earn a living to support themselves and pay their own taxes

Dr. Raymond Oenbrink