Editor's note: This story contains quotes and information originally discussed during a Twitter Spaces event hosted by NPR TV critic Eric Deggans and featuring NPR addiction correspondent Brian Mann, Dopesick book author Beth Macy, Dopesick series creator/showrunner Danny Strong and more. Follow us on Twitter, and read more of NPR's addiction coverage here.


The Centers for Disease Control and Prevention released new data this week showing America's drug crisis continues to deepen, with fatal overdoses killing 100,000 people in the U.S. over a 12-month period.

Drug policy experts say that 28% increase in a single year is devastating and unprecedented.

It shows that an addiction crisis that began in the late 1990s — when the health care industry and drug companies like Purdue Pharma distributed vast quantities of opioid pain pills — continues to grow.

These days, many of the overdose deaths are driven by illicit fentanyl and methamphetamines smuggled into the U.S. from Mexico by drug cartels.

But prescription opioids are still a big part of the problem.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 9.5 million people misused opioids in 2020; the overwhelming majority (9.3 million) of those individuals, specifically misused prescription pain relievers.

What follows are quotes from members of the Twitter Spaces panel discussing Dopesick — the Hulu limited series that portrays the opioid epidemic — and outlining some of the challenges deepening this crisis, with suggestions on how to get involved and help out.

Two big factors have worsened the opioid crisis lately

Like many things, the pandemic has acutely impacted the opioid crisis over the past two years. COVID-19 has disrupted every aspect of daily life, and left many struggling to find treatment and support.

According to SAMHSA's 2020 National Survey on Drug Use and Health, not only did the coronavirus outbreak adversely impact many Americans' mental health, but it worsened their preexisting alcohol and drug abuse issues.

"The pandemic ... wrecked a lot of the progress that had been happening in terms of bringing down overdose fatalities," said Beth Macy, author of Dopesick.

"There's a treatment gap," she explained. "Only 12% of people with [Opioid Use Disorder] in the past year have been able to access care. That's a crime."

The other big challenge? Synthetic opioids like fentanyl.

NPR's Brian Mann has reported that overdose deaths surged during the pandemic as more drugs were laced with fentanyl — one reason why the U.S. drug addiction crisis is roaring back.

Most of the street drug supply in the country is contaminated with fentanyl, and it's extremely dangerous.

"People can literally try one pill that looks like a pharmaceutical-grade pain pill at a party or from a friend or purchased on the street, and that one pill can be enough to kill them," Mann said.

"Between fentanyl and the pandemic," he added, "this story has turned sadly darker."

How you can help in your community

For their part, members of the Sackler family maintain they did nothing wrong as they profited more than $11 billion from opioid sales. They have agreed to contribute more than $4.3 billion to an opioid settlement.

Author Ryan Hampton is an activist in recovery who has written a new book about Purdue Pharma, called Unsettled. He now works to inspire others to get involved and make their voices heard about the addiction crisis.

"I'd just encourage folks ... who are touched and have an emotional response to Dopesick, get involved in your community," Hampton said. "There's so much you can do."

Some of the billions of dollars of settlement money from drug companies that is being considered is expected to cover the costs of treatment, and support services — but much of that funding is still in flux.

One other outcome from the popularity of the Dopesick miniseries is that it could help reduce the stigma for those experiencing addiction.

"That's a big takeaway for a lot of people I'm talking to who've watched the show," Mann said. "They see that people with addiction are human. They got caught up in a national crisis. If viewers come away from this with more compassion that's a big step."

Hampton said advocates still hope that money given to communities as part of Purdue Pharma's bankruptcy settlement can support broader change.

"People are a little bit more woke and people are ready to start taking some action in their own communities," he added. "But we shouldn't — and this is happening in the Purdue Pharma bankruptcy right now — have to trade off corporate accountability for real public health solutions."

Policy changes, like making it easier for programs to establish mobile methadone services and funding to purchase fentanyl test strips (which allow users to avoid unintentional exposure to the powerful synthetic) are already underway at the federal level.

Resources for people facing addiction

You should consult your doctor when possible for help with substance use disorder, and proceed cautiously. The addiction treatment industry is rife with scams and low-quality expensive facilities.

For confidential, free help from public health agencies and to find substance use treatment information, use these resources:

Emily Alfin Johnson and Arielle Retting adapted this story for the web.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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