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Well Being: The #1 Killer in the USA, Ages 18-45

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Fentanyl is number one killer in the USA for most age cohorts. Unfortunately, the CDC doesn’t track deaths in a timely manner to confirm that easily… But here is their position: they will say that they don’t really “know”, because “overdose deaths are spread out across four different death categories: accidents, suicide, homicide and undetermined.”

The implication of this CDC spokesperson’s statement is that we live in some reality where the 1950s never ended. Where it is either too painful, shameful or irrelevant for our society to track drug overdoses in a meaningful way. For me, I think the answer is obvious. I think we can probably all know cultural shame when we “see” it. The definition of shame is well known.

Shame: [noun] a painful emotion caused by consciousness of guilt, shortcoming, or impropriety. the susceptibility to such emotion.

OK - but here is where it gets weird. Searching and shifting though the CDC webpages - it turns out that the CDC writes that it does track overdose deaths through a system called SUDORS and another program called DOSE. These are programs that extract data from state death reports. It is a complex program and fairly new, but they basically extract IC-10 death codes and other relevant data from state death reports. But many (most) states don’t track overdose deaths by drug. So, there is a “which comes first, chicken or egg?” problem in fentanyl death data tracking.

Could it be that the CDC is hiding the data? Now that has never happened before <sarcasm>. We all know that during the COVIDcrisis, the CDC was caught numerous times hiding analyzed data as well as not not analyzing data or reporting data. My fear that that maybe this behavior is not new. That the CDC doesn’t want the American public to know that real numbers.

So, I am reading pages and pages on the CDC website about how overdose deaths can be tracked (which is quite complex) and this whole systems appears to be a “work around” because tracking deaths from overdosing from fentanyl does not appear to be a primary CDC objective.

I have a goal. I am searching for numbers - fresh numbers. Numbers that support the claims that we are now are 300 deaths per day from fentanyl overdoses (a number I never could verify). Because that is the number that is “out there” in the press. But on the CDC site - the actual numbers are STILL buried. For instance, at the bottom on one report - there is a link: “Drug Overdose Deaths and where does it take me?

Then I find what appears to be it. The page with my answers. A June 2022 report - and… the data on the June 2022 report is that from 2020… another dead end.

OK- so the CDC most up to date report on drug overdoses is from deaths in 2020.

OK - enough of this.

At this point, I have to give up on the CDC for answers as to how fast this epidemic is growing. I have to trust that the non-profit groups working on this issue have numbers that are trustworthy because our government, near as I can tell, is either completely incompetent or playing “hide the data.” You decide. I know which answer I am betting on.

Then finally, when digging around - I find some more recent data from a CDC website (it turns out there are data on combined drug overdoses).

Basically, about 120,000 people will die from drug overdoses in 2022 (the downturn of the curve in 2022 is a reporting bias - as it is an incomplete data set). That is 334 deaths per day. Now we know where the 300 deaths per day came from!

To put this in perspective, right now -the 7 day rolling average for COVID-19 deaths in the USA is 304 deaths per day.

“Houston we have a problem.”

In the meantime, by extrapolating IC-10 death codes from the CDC databases, various groups have come up with some numbers.

Which don’t always match the official numbers or each other’s numbers.

Fentanyl overdoses have surged to the leading cause of death for adults between the ages of 18 and 45, according to an analysis of U.S. government data.

Between 2020 and 2021, nearly 79,000 people between 18 and 45 years old — 37,208 in 2020 and 41,587 in 2021 — died of fentanyl overdoses, the data analysis from opioid awareness organization Families Against Fentanyl shows. FOX NEWS

Fentanyl overdoses have become No. 1 cause of death among US adults, ages 18-45.

This is something everyone agrees on.

NOT COVID-19. Not car accidents. Not suicides.

FENTANYL.

This is a national crisis.

Even CDC will (sort of) admit it.

"If one assumes that the other synthetic narcotics category for those 18 to 45 is 90% fentanyl, then one can argue that unintentional fentanyl overdose is likely the leading cause in that age group.  However, because we don’t have exact numbers of fentanyl deaths for that age category, we cannot say for certain that this is accurate."

- CDC spokesperson

Despite all of the CDC tracking programs, the truth is that most state crime laboratories and coroner’s offices do not track fentanyl-related deaths, and official fentanyl death statistics can be difficult to come by. This may or may not be why the CDC hedges.

But what everyone can agree on is that is why the numbers produced by the CDC can only be an underestimate of the true death rate.

One thing that shocked me in looking at this data, was that this is not teenagers “overdosing.”

These deaths are adults, mostly between the ages 25-64! These are our parents and grandparents. These are our adult family members dying of drug overdoses.

What is going on?

In reading about fentanyl, it is clear that the problem is multi-factorial. Fentanyl is extremely cheap and extremely potent. It is easily cut into other drugs, so that the newly formulated product potency is much greater than the actual product.

Because the potency of fentanyl is so high, it is hard to meter out correctly. The tiniest amount can be lethal. Combine this with the fact that there are some drugs, like marijuana, where people view the product as not having significant toxicity. Basically they smoke a lot. So, on the weekend maybe - they smoke “a bunch of weed” and don’t realize they have ingested a lethal dose of fentanyl. Yes, this actually happens.

This is important. For me, I don’t smoke. Heck, I rarely have a drink. I prefer to keep my mind clean. However, I am from California and I have a lot of friends and family that “used” to, or maybe still do smoke. What comes to my mind is that one thing people can do to protect themselves, other than quitting - is to ensure a safe source of Marijuana or other drug product. But Fentanyl-laced Marijuana in particular is problematic. Maybe it is time for some people to invest in an aero garden? Better yet, quit. Marijuana is a drug that people use recreationally. It is not in my place to lecture, but knowing this risk is out there, is it worth it?

The other issue is that fentanyl is being cut into cocaine, and this is now a fairly routine practice. Near where I live, there was recently a news story of multiple overdoses, which resulted in a conviction.

BAILEY'S CROSSROADS, VA — On Wednesday, a Dumfries man was convicted by a federal jury for six overdoses, including one death in Bailey's Crossroads.

According to prosecutors, Michael Vaughn, 28, distributed cocaine laced with fentanyl at a party in the Skyline area of Bailey's Crossroads. He was convicted on charges of distribution of fentanyl resulting in death and serious bodily injury, and possession with the intent to distribute fentanyl.

Then there is this fact:

Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids. Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl.

Synthetic opioids such as fentanyl are now the most common drugs involved in overdose deaths in the US. The percentage of opioid-related deaths involving fentanyl increased from 14.3% in 2010 to 59% in 2017.

Then there is the fact that fentanyl has “cut into, or even replaced entirely, the supply of heroin and other opiates (wiki).” Fentanyl is mainly coming from Chinese factories and is then trafficked to other countries for illicit production and sale. In the United States, a lot of the fentanyl is coming in through Mexican cartels - having been imported from China. Although it is unclear how much is coming directly from China into the USA and then added directly to other products for distribution. This is a border security issue. And the current executive branch (and UN Agenda 2030) position is pro- “open borders”. To a significant extent, the flood of fentanyl that is killing as many or more Americans than COVID currently on a daily basis is a consequence of USG Executive Branch policies. Which may account for the reluctance of the CDC to provide timely data.

But let’s face it. A lot of people were abruptly weaned off of oxycodone when the prescription crack down occurred in 2014 and they have found fentanyl to be a good substitute. There are many who are chose this drug because they are already addicted to prescription opioids or heroin. Most addicts hold jobs, have families, or go to school. They are people that we interact with daily. They maintain their addiction through time - and are careful to keep their addiction under wraps.

A dear friend of mine who lives in rural Georgia lost her daughter in 2016 to oxycodone. The backstory was that her daughter had been addicted, got clean through the help of an inpatient rehab. Soon after release, she went to a wedding where a cousin brought over her stash. They got high together. So, she took the same amount of oxycodone that she had been taking prior to getting clean. Because her body was no longer acclimated to the drug, it was a lethal dose. This death changed my friend and her family forever. It is cliche to say that that there is nothing worse than losing a child, but in this case it was true.

I have another friend who we have known since 2003, who has been suffering from addiction for the past decade. Like many now addicted to opioids, she “used” to be an alcoholic. After almost losing her marriage, and months in and out of rehab to the tune of $100,000+ dollars, she kicked alcohol. Only to find opioids the year after. This addiction has cost her marriage. Her husband of 20 years finally gave up after a decade of watching her decline and doing everything possible to save her. Finally, he had to save himself. I have watched her go from a promising young scientist, with a passion for horses and gardening to a shell of herself. And she is a shell. Her mind is blown. Her body is wasted. Jill and I have had her stay with us - have tried to help her over the years, but she just can’t escape her addiction. The end stage of this addiction is not pretty, not for the faint of heart to witness. It is devastating.

The impact of losing a functioning adult with years of potential left is enormous. An adult who has a family, maybe with children - who is unable to function normally in society or dead. Children who have to watch their parents unconscious on the couch, unable to cook dinner day after day. These drugs cause real damage not only to those addicted but to those who love them, live with them and are with them. We all know this. But what to do? That is the question.

Unfortunately, at the individual level - the “help” all seems to center around expensive rehab centers.

Outpatient centers are generally thought to be good transitions from in-patient to outpatient. But not so good for actual detox.

I tried it hard to find “the official” number of people who regularly use or are addicted to opioids. That number is curiously elusive. For instance, HHS cites the following numbers but fails to include fentanyl in their survey instrument.

In 2019, an estimated 10.1 million people aged 12 or older misused opioids in the past year. Specifically, 9.7 million people misused prescription pain relievers and 745,000 people used heroin.

They also write that, 1.27 million Americans are receiving medication-assisted treatment (this data appears to be from 2019).

The average cost of treatment per episode are enormous.

Hypothetical numbers: If each episode cost $32,000 and five million people were treated - that would be 160 billion dollars per year.

There are 14,000+ in substance abuse facilities in the USA.

In the end, on a national level - what can be done.

The non-profit group, Families Against Fentanyl argues that Congress must call fentanyl a “weapon of mass destruction.” That the war on drugs must be taken to the next level. That would mean of course, World Health Organization and United Nations involvement.

To me, that seems extreme for what is a homegrown societal problem, aided by countries like China and Mexico.

Even if we shut down all of these drugs from entering through Mexico, how does the US government stop entry through the Chinese shipping channels? I don’t see an answer to stopping the flow of fentanyl in the USA by involving the United Nations. I do believe that negotiations with China to stop drug production must be a priority for the administrative state. But that is only part of the answer.

The bigger issue, the elephant in the room is “how does America stop its drug addiction problem?” This is “our” problem - we must own it, before we can fix it.

In researching this article, I discovered that the CDC puts little effort into understanding this crisis. Outdated webpages and outdated statistics. Government pages that have different statistics from differing years. The lack of solutions and cohesion on these pages is astounding. To say there is a lack of resources coming from the US government is the under statement of the year. This isn’t a “war on drugs.” Our government seems to have opened the flood gates on drugs coming in overseas.

Fentanyl addiction is the elephant in the room that the CDC and the US government have virtually ignored for years.

To end, below are a few resources and some ideas about what to do and not do if you suspect an overdose.

If you suspect an overdose, lay the person on their side to prevent choking.

About narcan (naloxone):

There is no happy note to conclude this essay with except to love your family and friends, discuss the issue of fentanyl addiction with everyone you know, and keep careful watch.

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