Austin, Texas

Two Grim Decades, More Than One Million Lives Lost to Drugs

On November first, 2006, I began working in the field of addiction recovery. At that time, I would never, ever have thought that drugs could kill more than a million Americans in just 21 years. The next few years were eye-opening for me. Because I’m still working in this field, I now see how this happened and, what’s worse, I see that there are no signs of it getting better in the future. Not yet, anyway. 

Starting My Work in Addiction Recovery 

In 2006, our most significant drug problem was prescription opioids—painkillers prescribed by unscrupulous doctors who were only concerned about how much money they could make. Or pills obtained by stealing prescription pads and writing fake prescriptions. Or patients would travel from one doctor to another to get multiple prescriptions, sell some and consume some. Pharmaceutical companies had been hugely responsible for creating this problem but that’s another story. 

Cocaine was waning, marijuana wasn’t doing anything shocking. Heroin was always in the background but there were no startling increases. Meth was a serious problem in the Midwest and on the West Coast but laws would be enacted in the following year that would knock that problem down considerably. So it was prescription opioids that were taking the most lives at that time. 

Ninety-four people a day were dying of drug overdoses across our country. By the end of the year, we had lost 34,425 Americans. 

To account for increases in population, it’s customary to calculate a rate of death per 100,000 population. At that time, the rate was 11.5 deaths per 100,000. Families were gathering in Washington, D.C. to protest their increasing loss of loved ones. They had no idea what the future would bring and just how much worse it could get. 

The Problem with Most Government Statistics.

Go to a government website like one for the Centers for Disease Control and Prevention (CDC) or the National Institute on Drug Abuse and there is a common problem. These sites often make statements like this: 

In 2018, there were 67,367 drug overdose deaths in the United States, 4.1% fewer deaths than in 2017 (70,237).

Most of their comparisons are with adjacent years. The numbers, either increasing or decreasing, are small. Or smallish. 

Those small numbers seem—to me—to downplay the true disaster we are living with every day. What if we go back further? Back a whole generation? How would these numbers look then?

I have a theory that people get accustomed to the numbers they have been seeing for the last several years and forget how these numbers compare to the numbers a little further back. But we don’t really have an accurate measure of our situation unless we take a broader view. 

If, just 40 years ago, we had a dramatically lower number of drug overdoses, what keeps us from achieving that lower number of deaths now? That’s a question that must be asked. 

I remember 40 years ago. So do many other Americans. Let’s compare our current fatal drug overdose situation with the one in 1979. 

Comparing 1979 with 2020

In 1979, our national rate of overdose deaths was 1.13 per 100,000.

What was the national rate in 2020? It was 28.3 per 100,000. 

That’s a 2500% increase. Putting it another way, our losses were 25 times higher in 2020 than they were in 1979. 

Spotlight on the States

Let’s look at how this increase has affected some of our states. 

For the last few years, West Virginia’s rates of overdose deaths have been the highest in the country. In 2020, this small state suffered 81.4 deaths per 100,000.

I don’t have their rate of death in 1979 but I do have it for 1999. At that time, the rate was 4.1 deaths per 100,000. That’s nearly a 2000% increase. In other words, their loss of life was nearly 20 times higher in 2020 than it was just 21 years before. Coroners, medical doctors and law enforcement personnel had to deal with the deaths of 1,330 souls rather than the 75 they dealt with in 1999. 

Kentucky’s 2020 rate of death was 49.2 and in 1999, it was 4.9 per 100,000. That’s a 1000% increase. 

Delaware’s 2020 rate of death was 47.3. In 1999, it was 6.4, nearly a 740% increase. 

Even Nebraska, one of the states that has suffered less than the others, went from 2.3 deaths per 100,000 to 11.3 deaths, a 450% increase. 

More Increases after 2020

That’s not even the end of the story. WIth the arrival of COVID and escalating fentanyl supplies, our rate of loss has been climbing to entirely new levels. According to the CDC, in 2020 we lost 93,655 lives to drug overdoses. In 1999, we lost 16,849 lives. We went from 46 lives lost each day to 256 lives. That’s 256 people dying every day, 365 days a year.

We don’t have final estimated figures for 2021 yet. What we do know is that this number climbs almost every month. The CDC keeps a running total per twelve-month period and updates it every month. So as of the twelve-month period ending October 2021, the CDC estimates that we lost 105,752 lives in the prior twelve-month period. 

Explanation: The CDC has to estimate this figure because it can take several months for all the autopsy reports to get into their hands. They provide a count of the number of reports they have received and then calculate their estimate of the final number. As time goes on, the final numbers that are reported catch up with the estimates. 

Each month in 2021, the number of deaths for the prior twelve-month period increased 80 to 100 deaths over the estimate for the prior month. By the time we have calculations for the end of 2021, we can expect to see 107,500 deaths for the year. That’s nearly a 15% increase in one year. 

Compared to 1999, that will be a 636% increase. 

Two Decades — More than One Million Lives

Using the CDC’s numbers, we see that over the course of two dreadful, destructive decades, we have lost more than one million of our fathers, mothers, brothers, sisters, children, businesspeople, nurses, waitresses, construction workers, musicians, professors and other Americans. 

In the 21 years between 2001 to 2021, we have lost 1,008,977 individuals. 

Unless something changes this year, we could lose another 120,000 next year and 130,000 the year after that. 

We Must Not Forget

We must not get caught up in a 10% increase or a 5% decrease in these statistics. We must remember that in the same country, with the same culture and a shift of just a few decades, our losses were vastly lower. We must not settle for slight improvements. We should settle for nothing less than rolling back the clock to a time when our losses were minimal. 

In truth, there should be no losses at all. But I expect some people will always wander off the safe path and lose their way. Our goal should be saving every life possible.


Offer drug rehabilitation that works

Allow law enforcement personnel to do their jobs. Here’s the story of one highly-placed DEA agent who resigned when he was prevented from being effective at his job. 

Educate every child, every year, with a drug prevention curriculum that is proven to work. 

Through every channel possible, convince parents that they must cover the dangers of drug and alcohol abuse with their children thoroughly and provide educational guides to help them. 

Also educate parents on what signs to look for that indicate their children are using drugs or drinking. This Washington Post article mentions a police detective who noticed his daughter had lost weight and her skin looked bad. But it wasn’t until she mentioned that she was constipated (a side effect of opioid use) that he realized she might be addicted. 

It’s not that easy for loving, trusting parents to realize that the changes they see in their child (of any age) could be due to drug or alcohol addiction. Parents need education and help, too. 

Who Gets Addicted?

When I first went to work at a drug rehab, I had no idea what types of people needed rehab. To be honest, I thought they must be people who started out living marginal lives. I soon found that was untrue. They were often successful, smart people who loved their families. Some people became addicted after using medications just like their doctor recommended. Others became addicted after just a few missteps. 

When we help people recover from addiction—really recover, defined as leaving addiction behind for good—we return them to the best possible lives they can live. They can once again take care of their families and contribute to their communities. We become stronger as communities and as a nation when we help these individuals recover fully. Our communities become safer and, in turn, so do our own families. It is a goal worthy of our attention. Talk to me if you want to know how to help. 

Regarding the image at the top of this page: That’s Austin, Texas, a city with just over a million residents. What if we had suddenly erased this city from the map? America would be staggered, outraged and would demand justice. Drug abuse and addiction happen much more slowly. They have almost become invisible problems, especially as other news items have clamored for our attention. But that’s the truth: We are wiping out an entire city every couple of decades. This situation must change. (Photo by Carlos Alfonso on Unsplash)

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