Last week, an estimated 174 people overdosed on heroin in Cincinnati. The Ohio town is the latest to be plagued by a spike in opioid-related drug overdoes—but it’s not the only city to deal with the problem. The abuse of heroin and other opioids has become such a epidemic that the U.S. Surgeon General is sending a letter to every doctor in America asking them to help combat this public health crisis.

Here are nine things you should know about America’s opioid epidemic:

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1. Opioids are drugs, whether illegal or prescription, that reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus.

2. Prescription drugs that fall into this category of opioids include codeine (sometimes found in cough medicines), hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), and morphine (e.g., Kadian, Avinza).

3. According to the Centers for Disease Control (CDC), in 2013 there were more than 249 million prescriptions for opioid pain medication written by healthcare providers. This is enough for every adult in America to have a bottle of pills.

4. The most abused form of illegal opioid is heroin, a narcotic that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. In 2011, 4.2 million Americans aged 12 or older (approximately 1.6 percent of the total population) had used heroin at least once in their lives. An estimated 23 percent of individuals who use heroin will become dependent on it.

5. In 2014, more people died from drug overdoses than in any year on record, and the majority of drug overdose deaths—more than six out of ten—involved an opioid. A study of emergency rooms in the U.S. found that since 1999, the number of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. Altogether nearly half a million people died from drug overdoses in the years from 2000-2014, and 40 more Americans die every day from an opioid overdose.

6. Overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths, says the CDC. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report.

7. Heroin use has also increased sharply across the United States among men and women, most age groups, and all income levels, notes the CDC. The number of people who started to use heroin in the past year is also trending up, and among new heroin users, approximately three out of four report abusing prescription opioids prior to using heroin. The rising use has been attributed to heroin often being cheaper, easier to obtain, and more potent than prescription opioids. According to data from the DEA, the amount of heroin seized each year at the southwest border of the United States was approximately 500 kg during 2000–2008; this amount quadrupled to 2,196 kg in 2013.

8. Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally made fentanyl. Fentanyl is a synthetic opioid pain reliever, approved for treating severe pain (e.g., advanced cancer pain) that is 50 to 100 times more potent than morphine. Most fentanyl-related harm, though, is due to the illegally created non-pharmaceutical forms of the drug, which is often mixed with heroin or cocaine.

9. Last month the U.S. Congress passed the Comprehensive Addiction and Recovery Act (CARA) in an attempt to address the opioid problem through education, prevention, and treatment. According to the National Law Review, CARA includes several provisions concerning the need for expansion of prevention and education on the misuse of prescription painkillers and heroin; allows law enforcement agencies and first responders to distribute naloxone for the reversal of overdose; implements evidence-based treatment and intervention programs for prisoners; provides safe disposal sites for prescription medications to diminish the opportunity for ill use; and creates a medication assisted treatment program for pain management and expands states' drug monitoring programs to eliminate doctor shopping.

Other articles in this series:

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 • Margaret Sanger • 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 • C.S. Lewis • Halloween and Reformation Day • Casinos and Gambling • Prison Rape • 6th Street Baptist Church Bombing • 9/11 Attack Aftermath • 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