In 2015, Angus Deaton and Anne Case, two economists at Princeton University, coined the phrase “deaths of despair” to describe America's growing opioid problem. In a paper published in the Proceedings of the National Academy of Sciences, they found that death rates for people ages 45 to 54 are rising in the United States but declining in other high-income countries. The researchers also found that drug overdose deaths were highest among non-Hispanic white Americans. Using data extending through 2013, the authors found that the biggest factors in the rise in these early deaths were poisoning (including overdoses), suicide, and chronic liver disease, the latter of which was linked to excessive alcohol consumption. This research was widely cited in the media and sparked much debate about why working-class white Americans were doing so poorly.

Because of the widespread use of fentanyl, opioid abuse can no longer be considered limited to one demographic group. A recent article published in JAMA Psychiatry by Joseph Friedman and Helena Hansen, medical researchers at the University of California, Los Angeles, indicates that death rates from drug overdoses and liver poisoning among blacks have caught up with those of whites. The authors also point out that fatal overdoses have also increased dramatically among Native Americans, who already had the highest alcohol and drug-related death rates before the introduction of fentanyl.

According to the Congressional Research Service, most illegal fentanyl in Mexico is manufactured from chemicals in China and then smuggled into the U.S. Stopping that trade has proven difficult, in part because of the drug's potency — only a small amount is needed per user. The Drug Enforcement Administration said it seized about 77 million fentanyl pills and about 12,000 pounds of fentanyl powder in 2023, more than in any other year, suggesting demand for the drug is still sky-high.

Some politicians are now trying to target dealers and users of the drug. Oregon recently announced it would re-criminalize drugs, making “possession for personal use” a misdemeanor. The state's residents had previously voted to decriminalize most drug activity in 2020. The new law provides addiction and mental health services as an alternative to prison, striking a middle ground.

Story editing by Shannon Luders-Manuel. Proofreading by Tim Bruns.

This story originally appeared on Counseling Schools and was produced and distributed in association with Stacker Studio.