Is the Opioid Epidemic Finally Cresting?

After a decade of going up by leaps and bounds, the death rate in the US from opioids seems to have stabilized and may even have declined slightly this year. This is preliminary data and we won't have the real results for months, but it is certainly encouraging. The Times sent a reporter to Dayton, Ohio, where opioid deaths are down 50% from last year, to investigate what might behind it. For one thing, the hardest-hit states have gotten serious about treatment:

Mayor Nan Whaley thinks nothing has had as big an impact on overdose deaths as Gov. John Kasich’s decision to expand Medicaid in 2015, a move that gave nearly 700,000 low-income adults access to free addiction and mental health treatment.

In Dayton, that’s drawn more than a dozen new treatment providers in the last year alone, including residential programs and outpatient clinics that dispense methadone, buprenorphine and naltrexone, the three medications approved by the F.D.A. to treat opioid addiction.

“It’s the basis — the basis — for everything we’ve built regarding treatment,” Ms. Whaley said in an interview at City Hall. “If you’re a state that does not have Medicaid expansion, you can’t build a system for addressing this disease.”

Naloxone and the knowledge of how to administer it have also been widely pushed, which has saved quite a few lives, and the dangerous drug Carfentanil has largely disappeared from the city, probably because it was so dangerous that even dealers and addicts are now shunning it. Pressure on doctors to write fewer opioid prescriptions may also be a factor.

Good economic times may also be helping; the epidemic took off as a side-effect of hopeless unemployment in the wake of the financial crisis, and that has changed in many places.

The opioid boom may also have been a sort of fad that took off as fads often do, an "everybody's doing it so maybe I'll give it a try" sort of thing, and maybe the number of deaths and the amount of depressing news coverage have dampened the allure.

Not that America's drug problems are anything close to ending. In places where heroin use is down, meth use is up, a real devil's bargain, and even if opioid abuse goes back down to the level of ten years ago that would still be a terrible waste of life. The sad fact is that living just hurts for millions of people, and what to do about that I have no idea.