Opioid epidemic

What is the opioid epidemic (opioid overdose crisis)?

The opioid epidemic, also known as the opioid overdose crisis, refers to the alarming rise in opioid misuse, addiction, and overdose deaths in the United States and other parts of the world. The crisis has evolved over several decades, with three distinct waves marking its progression.

Historical context

The opioid crisis has its roots in the late 1990s when pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers. As a result, healthcare providers began prescribing them at greater rates, leading to widespread misuse and addiction.

The three waves of the opioid epidemic

  • First wave: Heroin - In the 1990s, the first wave was primarily associated with heroin abuse, which has been a long-standing issue.
  • Second wave: Prescription opioids - The second wave began in the late 1990s and was marked by a dramatic increase in overdose deaths involving prescription opioids such as oxycodone, hydrocodone, and methadone.
  • Third wave: Fentanyl and synthetic opioids - The third wave started around 2013, when overdose deaths involving synthetic opioids like fentanyl and its analogs began to surge.


The opioid crisis has had a devastating impact on individuals, families, and communities. According to the Centers for Disease Control and Prevention (CDC), nearly 500,000 people died from opioid overdoses in the United States from 1999 to 2019. In 2020 alone, more than 91,000 people died from drug overdoses, with opioids accounting for the majority of these deaths.

Treatment and overdose prevention

Addressing the opioid epidemic requires a multifaceted approach, including evidence-based treatment and overdose prevention strategies. Medication-assisted treatment (MAT) combining medications like methadone, buprenorphine, or naltrexone with behavioral therapy has been proven effective in treating opioid use disorder (OUD). Overdose prevention efforts include increasing access to naloxone, a life-saving medication that can reverse opioid overdoses, and promoting harm reduction practices such as syringe service programs (SSPs).

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