According to experts from Northwestern Medicine in Chicago who examined patterns and applied a predictive model to identify areas where deaths would increase, the upcoming wave of opioid overdoses "will be worse than ever witnessed before."
Due to the dangerous practise of combining highly addictive opiates with other drugs, the number of opioid overdoses will increase both in rural and urban regions. According to the report, rural areas will have a greater increase in opioid overdose deaths in 2020 than urban areas.
In order to examine spatial patterns in opioid deaths between 1999 and 2020, the researchers used data from the WONDER database of the US Centers for Disease Control and Prevention for 3,147 counties and areas that are equal to counties. In order to hypothesis about potential future waves, the team was attempting to ascertain whether location played a role in previous waves.
According to Post, overdose fatality rates increased for the first time in six different categories of rural and urban counties between 2019 and 2020. This is the first time in America, we are experiencing the highest rate of escalation, and this fourth wave will be the worst one yet, according to Post. It will result in widespread death.
“I’m sounding the alarm because, for the first time, there is a convergence and escalation of acceleration rates for every type of rural and urban county,” said corresponding author Lori Post. She is director of the Buehler Center for Health Policy and Economics at Northwestern University Feinberg School of Medicine. “Not only is the death rate from an opioid at an all-time high, but the acceleration of that death rate signals explosive exponential growth that is even larger than an already historic high,” Post said in a Northwestern news release.
The research team examined toxicology reports and found that people are using fentanyl (a synthetic opioid that is 50 to 100 times more potent than morphine) and carfentanil (a synthetic opioid approximately 100 times more potent than fentanyl) in combination with methamphetamines and cocaine. This lethal cocktail can make it harder to save someone experiencing an overdose with an overdose-reversing drug like naloxone.
“The stronger the drugs, the harder it is to revive a person,” explained study co-author Alexander Lundberg, assistant professor of emergency medicine at Feinberg. “The polysubstance use complicates an already dire situation.”
Post said, “It appears that those who have died from opioid overdoses had been playing pharmacist and trying to manage their dosing. This is a bigger problem because you have people misusing cocaine and methamphetamines along with an opioid, so you have to treat two things at once, and the fentanyl is volatile.”
The authors of the study suggested that methadone clinics, which provide medication-assisted anti-addiction therapy, as potential options. Urban regions tend to have more of these. According to Post, there are no medication-assisted treatment alternatives available in rural areas, and what is effective in big cities probably isn’t as helpful there.
Everyone avoids becoming a drug addict. It makes no difference if you are taking Percocet because you died while in high school or if you damaged your back while mining. They did break into Grandma’s medicine cabinet, after all.
Post emphasised the urgent need to address opioid addiction and overdose prevention. The only way forward, she continued, is to raise awareness of opioid use disorders and offer medication-assisted treatment that is socially acceptable and stigma-free in rural communities.
Parvathy Sukumaran 
