Responding to the Opioid Crisis

The opioid epidemic in the United States is a public health crisis. Opioid overdoses have increased significantly in the last 20 years, quintupling since 1999. In the past 2 years (2021 and 2022), there have been over 100,000 deaths annually attributed to overdose in the United States; a majority (75%–80%) of these deaths involved opioids (https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm). With the latest wave of opioid overdose deaths, most are now attributable to synthetic opioids, with a significant rise in illicit fentanyl use. San Francisco, for example, saw 625 deaths from overdose in 2021, 76% of which were related to fentanyl (https://www.csuhsf.org/_files/ugd/91710f_af336537b8a04ca8a686f24444f9ee54.pdf). The harm of this public health crisis falls disproportionately on people of color, with over 300 of the 625 overdose deaths in San Francisco being among Black/African American individuals.

This month’s Editor’s Choice Collection highlights the public health response to this national crisis. Articles in this collection describe harm reduction policies, such as safe consumption sites and syringe access programs, models of low-barrier access to treatment, and the clinical challenges posed by fentanyl. They include a critical focus on the contribution of social determinants of health and racial and ethnic health disparities in the opioid epidemic.