Since 1999 there has been a increase in the number of women, ages 30 to 64, dying due to a drug overdose, and an even larger increase for drug overdoses involving opioids, according to a Centers for Disease Control and Prevention report. 

Some of theses deaths (which are still lower than the rates for men) involved the use of more than one drug (opioids are particularly dangerous in combination with benzodiazepines such as Xanax or Valium), and some may be suicides. (Not everybody leaves a note, not all families report it, and not all coroners keep track of it.)

This has occurred despite the decrease in the number of opioid drug prescriptions, which was due to concerns that the epidemic was caused in part because of the new and supposedly safer opioids, which some believe were too freely prescribed to patients, which led to the addictions and overdoses in the first place. 

The problem is that when addicts can no longer obtain their drug of choice (DOC), they don’t shrug their shoulders and say, “Oh, well, I guess I’ll just stay sober”.  Instead they look for their DOC on the black market, steal it from the medicine cabinets of their friends and family members, or try something else. 

Heroin and the even deadlier synthetic opioid fentanyl have been the big go-to drugs for those addicted to OxyContin/oxycodone but cannot find them any longer at any price. Because they are illicit, they are of unknown purity and safety. Fentanyl in particular is sometimes used in place of or added to other drugs without the buyer’s knowledge, leading to accidental overdoses. 

Addiction also may be the result of self-medication for another mental health disorder, a condition known as co-occurring disorders or dual diagnosis that is too often overlooked in part because addiction has not always been recognized as a mental health disorder itself. A large percentage of the population, including some older members of the addiction treatment community, think addiction is a moral failing.

What this proves is that we can’t regulate or legislate our way out of the opioid (or other drugs) epidemic. That will only happen when it is easier and cheaper to get clean than it is to get high. 

It is far easier to fall into addiction than to find one’s way out of it. Obstacles to recovery include: 

• The cost of treatment (despite changes to health insurance laws under the Patient Protection and Affordable Care Act, addiction rehab is not always completely covered or covered at all)
• The prevalence of the 12 step abstinence-only philosophy (which does not work for everyone, especially absent additional cognitive behavioral therapy)
• The reluctance to use medication-assisted treatments such as methadone and buprenorphine (Suboxone) because they also are drugs. 

Making rehab more affordable, increasing the number of inpatient treatment beds, and better monitoring of the rehab industry is a start, but it is not the whole answer either. The reason many people abuse drugs is that (at least at first), they like it. We need to find out why and fix that, too.