VSknown for his song Gangsta’s Paradise of 1995, Coolio died in September 2022, at the age of 59, at a friend’s house in Los Angeles. The medical examiner’s report released Thursday by Los Angeles County claims the rapper died of a fentanyl overdose and adds that the musician suffered from heart disease and asthma.
Coolio thus joins the long list of deaths by opiates in the United States. A crisis that has lasted for more than 30 years in the country. In 2021, overdoses killed one person there every five minutes, resulting in nearly 108,000 deaths. The figure is up 15% compared to 2020. In question: fentanyl, which has become the most deadly drug in the United States. The American opiate crisis has been aggravated by the Covid-19 pandemic, which has increased the isolation of certain populations.
READ ALSOScience – The Dangerous Drug: Fentanyl, Abuse and Addiction
What is Fentanyl?
Fentanyl is a synthetic opiate with euphoric properties. In its legal form, it is a drug used as a sedative in the treatment of severe pain, especially for cancer patients. Available only by prescription, it is considered 50 times more potent than heroin, an illegal opiate, according to the National Institute on Drug Abuse.
But it has for several years been diverted from its medical use, manufactured and sold illegally in the form of powder, spray or counterfeit tablets, and has caused the number of opiate deaths to explode since 2013. Traffickers frequently mix it with other substances, such as heroin or cocaine, because of its greater profitability.
How many deaths?
According to the US Centers for Disease Control and Prevention (CDC), more than 564,000 Americans died from opioid overdoses between 1999 and 2020. And the crisis accelerated: opioids claimed the lives of nearly 82,000 people between February 2021 and February 2022, according to one of the latest reports.
In February 2023, US President Joe Biden recalled that fentanyl alone is responsible for the deaths of “more than 70,000 Americans each year”. According to a survey by washington post dating from December 2022, it is the leading cause of death among 18-49 year olds.
The United States has passed a record of more than 100,000 deaths in one year (April 2020-April 2021). Fentanyl is often involved. He is notably at the origin of the death of the star of the cult series TheWireMichael K. Williams, September 6, 2021.
READ ALSODrugs: the story of a pandemic
Whose fault is it ?
Many experts now recognize that the opiate crisis began with the overprescription of painkillers such as OxyContin from the American laboratory Purdue, whereas until the mid-1990s they were reserved for the most serious illnesses.
Purdue and other companies like Johnson & Johnson or Teva that have made similar drugs, as well as major US pharmacy chains, are accused of aggressively promoting these drugs and failing to react to warning signs. about the abuses to which they were subjected.
They face an avalanche of legal complaints, emanating from American states and local authorities of all kinds, who want to recover the billions committed to stem the crisis.
In 2021, the main companies sued had agreed to pay $26 billion to end a series of lawsuits. This agreement is still being finalized.
The CDC estimated in 2019 at 78.5 billion dollars per year “the economic burden” of the crisis, including health costs, lost productivity and costs for the criminal justice system. A study published the same year by the American Society of Actuaries estimated the cost at $631 billion for the four years 2015-2018.
What are the authorities doing?
In April 2022, the government of Joe Biden announced an action plan to combat this crisis, focusing on two aspects: more care for dependent people, and the fight against drug trafficking.
The American Medicines Agency (FDA) authorized on Wednesday March 29 the sale without a prescription of a very effective antidote to revive victims of opioid overdose, Narcan. This decision was eagerly awaited in order to deal with the opioid crisis that is ravaging the United States, because it will make it possible to expand access to this nasal spray, authorized since 2015.
The Trump administration also made the opiate crisis a public health priority in October 2017, releasing significant funds to fight the crisis, improve the treatment and prevention of drug addiction, and find non-addictive solutions to pain.
Beyond cracking down on opiate trafficking, the National Institutes of Health (NIH) in April 2018 launched an initiative called HEAL to find medical and scientific solutions to the crisis, which was allocated for the 2019 fiscal year. the record sum of $945 million.
Is Europe preserved?
The situation in Europe “is very different”, summarized in 2019 the scientific director of the European Monitoring Center for Drugs and Drug Addiction (EMCDDA), Paul Griffiths, by advancing several protective factors: better regulated painkiller prescriptions, heroin use less common among young people and easier access to heroin substitution treatment, which is less powerful and less risky than fentanyl.
The EMCDDA has no overall figures on deaths directly linked to fentanyl in Europe. It simply counts 8,200 overdose deaths (all types of drugs combined) in Europe in 2017. “About 70% of them are linked to opioids and of these 70% are due to heroin”, details Paul Griffiths .
Due to a lack of precision in European toxicological analyses, the role in the recorded deaths of fentanyl and its multiple derivatives could be underestimated, according to the organization. Seizures of this drug are on the rise in Europe. According to the latest available data, around fifteen kilos were intercepted in 2017, compared to just one the previous year. Enough to manufacture “millions of doses”, explains Paul Griffiths to the EMCDDA.
As a sign of this new availability, some European countries such as the United Kingdom and Sweden experienced occasional peaks in fatal fentanyl overdoses in 2017.
In France, the consequences remain limited and the cases of small scale. At the OFDT, Magali Martinez mentioned in 2020 “less than 10 deaths per year” directly linked to fentanyl and “seven fatal cases which concerned fentanyloids” (derivatives and analogues of the substance) between 2015 and 2018.