Heroin overdose deaths in the U.S. have increased for the third year in a row, according to 2013 drug overdose mortality data recently released by the Centers for Disease Control and Prevention (CDC). Drug deaths related to prescription opioids have remained stable since 2012.

The data show a 6% increase in all drug poisoning deaths from 2012, and a 1% increase in deaths involving opioid analgesics over 2012. Deaths involving heroin had the largest upsurge overall, with a 39% increase from 2012, while deaths involving cocaine increased 12%. These results demonstrate that while the Administration’s efforts to curb the epidemic of the nonmedical use of prescription drugs is working, much more work is needed to improve the way we prevent and treat substance use disorders.

Before it ever begins

“The data announced today underscore that the nation’s drug problem is evolving, and requires a comprehensive solution—including preventing drug use before it ever begins, reducing the supply coming from foreign nations, educating our nation’s youth on the risks of substance use, and the work of our nation’s Federal, state, local, and tribal law enforcement to continue reducing the amount of trafficking within the United States,” said Michael Botticelli, Acting Director of the White House Office of National Drug Control Policy.

Substance use disorders are progressive diseases, and, in the case of opioid use disorders, the problem often begins with a prescription, or taking pills from a home medicine cabinet. Nearly 68% of people who begin using prescription drugs non-medically for the first time obtain those drugs from a family member or friend. But more frequent or chronic users (those who used pain relievers non-medically once a week or more on average in the past year) were more likely to obtain the drug from the illicit market than were less frequent users. In 2014, ONDCP joined the Drug Enforcement Administration (DEA) to announce the Final Rule for the Disposal of Controlled Substances, which outlines methods to transfer unneeded or expired medications to authorized collectors for disposal—a pillar of the Obama Administration’s 2011 Prescription Drug Abuse Prevention Plan.          

Healthcare providers can help

Early intervention in a healthcare setting is an essential component of the comprehensive approach to reducing drug use. Healthcare providers are critical to identifying and intervening in a developing disorder. By intervening early and providing medication assisted treatment when appropriate, healthcare providers—including primary care physicians, ER doctors, dentists, nurses, and other healthcare workers—can dramatically reduce the possibility of a future overdose, and significantly improve the likelihood that a patient will enter treatment and sustain a life in long-term recovery.

A growing public health crisis

"These troubling statistics illustrate a grim reality: that drug, and particularly opioid, abuse represents a growing public health crisis," said Attorney General Eric Holder.  "In response, the Department of Justice has been marshaling a variety of resources -- and rallying a broad coalition of public health and public safety leaders -- to implement a comprehensive approach to fight back.  By focusing on treatment and intervention, as well as interdiction and enforcement, we are committed to combating this scourge -- and helping to save and improve lives -- across America."

As part of its broad response to the opioid crisis, the Department of Justice recently released a toolkit for law enforcement on the use of naloxone, the life-saving opioid overdose reversal drug. When administered quickly and effectively to a person experiencing overdose related to opioids—which includes prescription painkillers and heroin—naloxone can save a life. Law enforcement agencies across the nation have equipped and trained officers with naloxone, saving hundreds of lives since the first pilot program was launched in 2010 in Quincy, Massachusetts.

It starts with prescription drugs

“Deaths from drug overdose are tragic, and we need to scale up both prevention and treatment of addiction,” said CDC Director Tom Frieden, M.D., M.P.H. “Most people who use heroin in the U.S. today used prescription opioids first. Reducing inappropriate prescribing will prevent overdose from prescription opioids and heroin.”

The Centers for Disease Control and Prevention provides resources and scientific expertise directly to states to address the key drivers of prescription drug overdose. With $20 million in new funding in 2015, CDC will dramatically expand this work and provide more resources to states on the front lines of the epidemic.

The Office of National Drug Control Policy promotes a balanced approach to reducing drug use and its consequences by directing more funding in the federal drug control budget to treatment and prevention programs than to domestic law enforcement. In 2011, ONDCP established a Prescription Drug Abuse Prevention Plan with four pillars, focusing on educating prescribers and patients about the dangers of prescription drug abuse and misuse; increasing the number of prescription drug monitoring programs nationwide (there are now 49 across the country); promoting proper disposal of prescription drugs; and law enforcement efforts to decrease pill mills, drug trafficking, and doctor shopping.