We’re in the midst of an opioid epidemic, but that doesn’t mean there aren’t other drugs causing problems, addictions, and overdose deaths.

Opioids are drugs that have effects similar to opiates, such as morphine and heroin. Common opioids include oxycodone and hydrocodone, also known by brand names such as OxyContin, Percocet, and Vicodin. The number of prescriptions actually peaked in 2012, at least in part due to increased monitoring and limiting of prescriptions, but the rate of overdose deaths has continued to increase.

That’s because addicts switched to other, more dangerous drugs, such as heroin and fentanyl, a super-powerful (50 to 100 times as strong as heroin or morphine) artificial opioid that is available in a legal form but is also relatively easy and cheap to make. Because it is so strong and because drug dealer chemists aren’t quality controlled by the government, accidental overdoses and deaths are more frequent than with other drugs.

Musicians Prince and Tom Petty are among those who died as a result of their fentanyl use.

But opioids aren’t the only drugs being abused and they aren’t the only ones causing deaths. The use of methamphetamine, a stimulant, also is on the rise. In fact, it is rising in areas and among populations where opioid use is decreasing (though overdose deaths from opioids still far outnumber overdose deaths involving methamphetamine).

While opioids are primarily used as painkillers and stimulants for increased energy and focus, both produce euphoria. Opioid addicts who receive monthly injections of Vivitrol (naltrexone), and so can not get high on opioids, sometimes take methamphetamine instead.

In some ways meth is worse than opioids:

  • While many meth users start taking the drug to feel more confident, desirable, and potent, over time meth robs users of all those attributes.
  • There is no anti-overdose drug for meth, so emergency first-responders can only treat the symptoms, which often include stroke, heart attack or other organ failure..
  • Meth users often suffer from an extreme rot and decay of the teeth known as meth mouth. The reasons aren’t completely clear, but reduced saliva may allow the acids in the mouth to damage the teeth, make the users desire lots of sugary foods and neglect brushing.

Worse news is that, according to a study from University of Pittsburgh Graduate School of Public Health, when you examine the rate of overdose deaths for all drugs combined, the rate has increased about 8 percent every year between 1979 and 2016.

Tightening the legal opioid prescription market hasn’t reduced opioid abuse; many addicts just switched to heroin and fentanyl. Cracking down on domestic manufacture of methamphetamine hasn’t slowed that market down either; now we get most of it from Mexico. (Building a southern border wall won’t stop that either; most drugs come through seaports, airports and other legal ports of entry, not open countryside.)

Opioids may be the star right now, and meth may be on the rise, but we don’t have just an opioid addiction problem or a meth addiction problem. Depending on how you define drug, it may not even a drug abuse problem. We have a substance abuse problem. We need better access to treatment, not more punishment of drug users.

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