Opioid Epidemic Behind Decline in US Life Expectancy in 2017

November 29, 2018 Updated: November 29, 2018

The life expectancy for Americans born in 2017 slightly decreased from the year before, prominently reflecting the increase in deaths from opioid overdoses, according to data released by the Centers for Disease Control and Prevention (CDC) on Nov. 28.

An average American born in 2017 could expect to live 78.6 years, a 0.1 year less than those born 2016 (pdf).

The leading factor is the rising death rate for unintentional injuries, which includes unintentional drug overdoses. The overdose death rate has skyrocketed in recent decades, tripling since 2000, and largely prompted by the proliferation of prescription opioids. Over 70,000 people died of drug overdoses in 2017, according to the CDC. The numbers, however, have started to taper off in 2018, provisional data shows.

Death rates also increased for several other leading causes of death, including influenza and pneumonia, Alzheimer’s disease, diabetes, stroke, some chronic respiratory diseases, and suicide.

On the other hand, the rates decreased for the two top causes of death: cancer and heart disease.

The life expectancy of Americans have been improving for decades, and for older folks, it still is. An average 65-year-old could expect to still live for 19.5 years in 2017—about 7 weeks more than the year before and about 19 months more than in 2000.

In fact, death rates have declined for all age groups since 2000—except one. For people between 25 and 34, the death rate has increased nearly 23 percent. It has also been the age group with the steepest increase in drug overdose rates.

Opioid Scourge

The explosion of opioid abuse behind the overdose epidemic is commonly linked to the 1995 release of OxyContin by Purdue Pharma. The company marketed the drug as a low-risk pain pill that won’t make patients develop an addiction, because it releases the opioid, oxycodone, gradually.

It didn’t take long for people to figure out that it only took crushing the pill to release all its euphoric effect at once. Many people who were initially prescribed oxycodone or other opioid painkillers like hydrocodone or oxymorphone kept using the drugs even after their pain disappeared and developing an addiction. Aside from the psychological addiction, opioids also induce a physical one, making withdrawal all the more difficult when they try to quit.

In 2007, Purdue pleaded guilty to illegally misleading physicians about the risks of OxyContin and agreed to pay a $600 million settlement. Several Purdue executives paid settlements too, but none went to prison.

It may be too simplistic to blame the start of the epidemic solely on Purdue though. The increase in opioid prescriptions began in the 1980s, when some medical professionals argued for a more liberal use of opioids to manage pain (pdf).

It 2010, Purdue released a version of the pill that is hard to crush, making it unattractive for abuse. By then, however, the millions addicted to the drug (pdf) already appeared to have switched to heroin, which was flooding in through the southern border. On the black market, heroin was actually cheaper than the prescription pills.

By around 2013, synthetic opioids, prominently fentanyl, took off. Fentanyl poses a high risk of overdose due to its potency—it’s about 50-100 times stronger than morphine, according to CDC. Much of it originates from China and is smuggled to the United States either directly by mail or through Mexico, where it could be mixed with heroin. While heroin and prescription opioid overdoses appear to have declined in recent months, fentanyl-related overdoses continue to climb, albeit at a slower pace.

Battling Opioids

The opioid epidemic has prompted nationwide efforts to improve addiction prevention and treatment and overdose prevention as well as overhaul the approach to managing pain.

President Donald Trump declared the opioid crisis a national public health emergency in 2017 and directed all federal agencies to find ways to counter it.

In October, Congress nearly unanimously passed a $6 billion bill to fight the crisis. The bill authorizes, among other things, increased education and awareness campaigns, setting up recovery centers, assistance to hospitals on using painkiller alternatives to opioids, and training doctors on how to administer medication like methadone that can help people overcome opioid addiction.

The bill also seeks to prevent “doctor shopping” by requiring prescriptions for some controlled substances to go through electronic programs and includes a measure that will make it easier for law enforcement to crack down on kickbacks in the addiction-recovery business.

“Together we are going to end the scourge of drug addiction in America,” Trump said before signing the bill on Oct. 25. “We are going to end it, or we are going to at least going to make an extremely big dent in this terrible, terrible problem.”

In addition, Health and Human Services Secretary Alex Azar announced a new initiative in October to help addicted mothers and their babies on Medicaid. The Centers for Medicare and Medicaid Services will distribute some $65 million in grants to up to 12 states to pay for health services including medication-assisted treatment for opioid use disorder, maternity care, and certain primary care services.

Azar also called for a more holistic approach to managing pain, such as using alternative treatments like physical therapy and nutrition. To this end, Medicare Advantage plans will be allowed to pay for therapeutic massage starting next year.

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