The Rosenthal Report, published each month by the Rosenthal Center for Addiction Studies, brings its readers insights and commentary on current issues of drug use.
Opioids, Meth and Vaping Pose a Triple Threat to Public Health
The nation’s overdose epidemic is worsening, with prescription opioids and synthetic opioids such as fentanyl accounting for a majority of the nearly 97,000 fatalities between March 2020 and March 2021. Yet, tragically, opioids are not the only drug crisis afflicting the country: We are also dealing with a surge in methamphetamine use, as well as an ongoing vaping epidemic among young people. There are no easy solutions to these complex and deeply rooted crises, but we can take steps to mitigate the damage and implement workable strategies.
As the number of overdoses escalates, city and state governments are coming under pressure to introduce harm-reduction measures, such as safe syringe sites, to help reduce fatalities. Such facilities—where addicts can use in a secure, controlled environment, with trained personnel and overdose-reversal drugs on hand—are controversial. Currently illegal in the U.S., safe sites have operated abroad for many years, with evidence suggesting that they reduce fatalities, slow the spread of infectious diseases from intravenous drug use, and most importantly, help patients get into long-term treatment.
For the U.S., an important element is whether safe sites would require mandatory treatment, as without it, substance users would simply return to the streets and back to a life of drug use. Despite legal obstacles, some states—including Rhode Island, Massachusetts and California—are considering pilot studies to test the concept of safe sites. This could provide valuable data on their impact, and hopefully offer insights into how they might be designed to best facilitate treatment.
In the shadow of the opioid epidemic, we are also seeing an alarming increase in the use of methamphetamines, including a new and more powerful variant of the drug known as P2P. Mainly produced by drug cartels in Mexico, P2P has replaced the revenue they’ve lost from the legalization of marijuana in many U.S. states, and is now found in virtually every corner of the country. According to a recent article in The Atlantic, P2P’s use is widespread among the growing homeless population, especially in California, as well as by those addicted to opioids who are being treated with medications that reduce their cravings but don’t get them high. Meth is a highly addictive stimulant that contributes to mental illness and physical decline. And while there is no specific medication to treat meth addiction, behavioral therapies have shown to be effective.
The third crisis concerns vaping: Roughly 20 percent of high school students and 5 percent of middle school students use e-cigarettes on a regular basis, and the number of adolescents who vape cannabis has doubled between 2013 and 2020.
First introduced about a decade ago as a smoking-cessation tool, e-cigarettes today are only lightly regulated, allowing manufacturers to market them to young people using whimsical names and fruity flavors (about 80 percent of middle and high school students who vape prefer flavored varieties). Yet, the Food and Drug Administration has been disappointingly slow to take on the vaping industry, much of it now controlled by Big Tobacco. Without swift action—including a total ban on all flavored products—we are in danger of ensnaring a new generation in nicotine addiction, after years of declining tobacco cigarette use among this age group.
Taken together, these crises pose unprecedented challenges to our national public health, as they impact every region, age group and population. But we have the resources and expertise to face these drug threats. And with the right leadership, we can bring them under control.
