On Monday, President Trump is expected to release his administration’s plan for dealing with opioid-related overdoses and deaths. Since writing about the issue two years ago (see: 9 Things You Should Know About the Opioid Epidemic), the crisis has worsened, and the need for public awareness has increased. Here then are nine more things you should know about the opioid epidemic:

1. The U.S. government may have been significantly undercounting opioid overdose deaths, according to a recent study published in the journal Addiction. For example, the official figure released by the Centers for Disease Control found that 33,091 drug deaths involved opioids in 2015. The study, though, found that to be an undercount, with the actual number being approximately 39,999 and that corrected counts and rates of any opioid and heroin/synthetic opioid-involved drug deaths being 20 percent to 35 percent higher in every year than reported figures.

2. The National Survey on Drug Use and Health found that in 2016 an estimated 11.8 million people misused opioids in the past year, including 11.5 million pain reliever misusers and 948,000 heroin users.

3. The percentage of people who misuse opioids is far greater than those who are addicted to the narcotics. According to a review article published in The New England Journal of Medicine in 2016, the repeated administration of any opioid almost inevitably results in the development of tolerance and physical dependence, but addiction will occur in only a small percentage of patients exposed to opioids. Rates of carefully diagnosed addiction have averaged less than 8 percent in published studies, notes Nora Volkow, director of the National Institute on Drug Abuse, whereas rates of misuse, abuse, and addiction-related aberrant behaviors have ranged from 15 percent to 26 percent.

4. A study published in 1998 in the British medical journal The Lancet found support for the theory that overdoses were more likely to occur in heroin users who relapsed after a period of abstinence from the drug. The research found that most individuals in the study who died from heroin overdose had virtually abstained from heroin during the four months preceding their death.

5. Possibly related to the study listed above, a 2007 study published in The New England Journal of Medicine found that inmates released from prison were 129 percent more likely to die of a drug overdose within two weeks after release, as compared with other state residents. Of those deaths, heroin accounted for 18 percent, methadone another 18 percent, and more than one substance (e.g., heroin and alcohol) for an additional 27 percent.

6. A considerable percentage of drug overdose deaths include both opioids and another substance. According to the National Institute on Drug Abuse, from 2002 to 2010 the number of deaths involving cocaine that also involved opioids, and the number of cocaine-related deaths that did not involve opioids, was roughly equal. Since 2010, deaths involving both cocaine and opioids have more than doubled, while cocaine deaths not involving opioids have increased by only nine percent. During that same period there was a 5.9-fold increase in the total number of deaths involving heroin and non-methadone synthetics (mostly illicit use of fentanyl), and the number of benzodiazepine (e.g., minor tranquilizers) deaths involving opioids increased two fold more than those not involving opioids.

7. Several studies found there is an increased risk of suicide among drug users addicted to opioids, especially women. “[Based on the literature that’s available] it looks like it’s anywhere between 25 and 45 percent of deaths by overdose that may be actual suicides,” says Maria Oquendo, immediate past president of the American Psychiatric Association. Experts say it’s unclear whether the addiction is driving the suicidal ideation or if pre-existing mental problems are causing an increase addiction to opioids.

8. A new (and controversial) study released this month claims that Naloxone, a drug that can save lives when administered during an overdose, may unintentionally increase opioid abuse through two channels: (1) saving the lives of active drug users, who survive to continue abusing opioids, and (2) reducing the risk of death per use, thereby making riskier opioid use more appealing. The researchers found that broadening access to Naloxone led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.

9. According to Politico, the plan by the Trump administration to solve the opioid crisis includes a call for the death penalty as an option in “certain cases where opioid, including Fentanyl-related, drug dealing and trafficking are directly responsible for death.”

Other posts in this series:

The Unification ChurchBilly Graham • Frederick Douglass • Memphis Sanitation Strike of 1968 • Winter Olympics • The ‘Mississippi Burning’ Murders •  Events and Discoveries in 2017 • Christmas Traditions • Sexual Misconduct • Lutheranism • Jewish High Holy Days • Nation of Islam • Slave Trade • Solar Eclipses • Alcohol Abuse in America • History of the Homeschooling Movement • Eugenics • North Korea • Ramadan • Black Hebrew Israelites • Neil Gorsuch and Supreme Court Confirmations • International Women’s Day • Health Effects of Marijuana • J. R. R. Tolkien • Aleppo and the Syrian Crisis • Fidel Castro • C.S. Lewis • ESV Bible • Alzheimer’s Disease •  Mother Teresa • The Opioid Epidemic • The Olympic Games • Physician-Assisted Suicide • Nuclear Weapons • China’s Cultural Revolution • Jehovah’s Witnesses • Harriet Tubman • Autism • Seventh-day Adventism • Justice Antonin Scalia (1936–2016) • Female Genital Mutilation • Orphans • Pastors • Global Persecution of Christians (2015 Edition) • Global Hunger • National Hispanic Heritage Month • Pope Francis • Refugees in America • Confederate Flag Controversy • Elisabeth Elliot • Animal Fighting • Mental Health • Prayer in the Bible • Same-sex Marriage • Genocide • Church Architecture • Auschwitz and Nazi Extermination Camps • Boko Haram • Adoption • Military Chaplains • Atheism • Intimate Partner Violence • Rabbinic Judaism • Hamas • Male Body Image Issues • Mormonism • Islam • Independence Day and the Declaration of Independence • Anglicanism • Transgenderism • Southern Baptist Convention • Surrogacy • John Calvin • The Rwandan Genocide • The Chronicles of Narnia • The Story of Noah • Fred Phelps and Westboro Baptist Church • Pimps and Sex Traffickers • Marriage in America • Black History Month • The Holocaust • Roe v. Wade • Poverty in America • Christmas • The Hobbit • Council of Trent • Halloween and Reformation Day • Casinos and Gambling • Prison Rape • 16th Street Baptist Church Bombing • Chemical Weapons • March on Washington • Duck Dynasty • Child Brides • Human Trafficking • Scopes Monkey Trial • Social Media • Supreme Court’s Same-Sex Marriage Cases • The Bible • Human Cloning • Pornography and the Brain • Planned Parenthood • Boston Marathon Bombing • Female Body Image Issues • Islamic State