An Epidemic with No End? Experts Fear 1.2 Million More Opioid Deaths by 2029


Plus: Staggering fentanyl seizures at the U.S. border, and a regimen for managing post-op pain without opioids

By William Wagner

Opioids have claimed more than 600,000 lives in the U.S. and Canada since 1999. And unless strong action is taken in the coming years, the death toll will rise dramatically, experts say.

In related developments, we take a look at the massive amounts of fentanyl seized at the U.S. border in the past year and a promising study aimed at decreasing post-op opioid prescriptions.

From The Lancet:
A Grim Opioid Forecast

A group called the Stanford-Lancet Commission on the North American Opioid Crisis, formed to examine soaring opioid-related death rates since the late 1990s and comprised of scholars and other experts from the U.S. and Canada, has reached a dire conclusion. Without aggressive public health reform and tight reins on the pharmaceutical industry, 1.2 million additional opioid-related deaths could occur in North America by 2029.

“The opioid epidemic is a public health crisis that has developed over decades, and it could take at least that long to unravel it,” says Stanford University’s Keith Humphreys, chair of the commission. “To save lives and reduce suffering immediately, a cohesive long-term public health strategy that can restrain and ultimately overcome the pharmaceutical industry’s powerful influence over healthcare systems is urgently needed. Healthcare systems also need to dramatically step up their effort to help people struggling with addiction. Our commission’s recommendations are an important guide to begin reversing the opioid crisis in North America.”

Look for more on the Stanford-Lancet Commission report in the coming weeks from

“We can save and improve lives by summoning the resources and political will necessary to eliminate the sources of addiction and boldly implement policies that will maximize efforts to treat it.”

—Keith Humphreys, Stanford-Lancet Commission on the North American Opioid Crisis

Among the actions called for by the commission:

  • Treating addiction as a chronic condition
  • Focusing on prevention
  • Enacting policies that are geared more toward treatment than punitive measures
  • Placing more of an emphasis on medication-assisted treatment (MAT)
  • Developing safer prescribing protocols for pain management
  • Investing in at-risk communities and youth

“Ending the opioid epidemic in North America and preventing its global spread is an audacious but achievable goal,” Humphries says. “It requires a dramatic shift in policy and culture where innovation, collaboration and regulation are encouraged. We can save and improve lives by summoning the resources and political will necessary to eliminate the sources of addiction and boldly implement policies that will maximize efforts to treat it.”

From U.S. Customs and Border Protection (CBD):
Fentanyl Seizures Skyrocket

The rapidly accelerating use of the synthetic opioid fentanyl is reflected in statistics released early this year by the CBD. In Fiscal Year (FY) 2021 (Oct. 1, 2020, to Sept. 30, 2021), CBD officers at eight South Texas ports of entry seized 588 pounds of fentanyl, a 1066% increase from FY 2020. “Our significant gains in fentanyl and cocaine seizures [8,592 pounds, up 98% from FY ’20] underscore the deadly nature of the contraband we encounter,” said Randy J. Howe, director of field operations in the Laredo (Texas) Field office. Fentanyl was a major culprit in the record-setting 100,000-plus OD fatalities for a 12-month period (ending in April 2021).

From the Journal of the American College of Surgeons:
An Opioid-reduction Initiative Shows Promise

Amid all the distressing opioid-related developments, there is some good news. In a study backed by the American College of Surgeons, 10 children’s hospitals curtailed opioid prescriptions for appendectomy patients by nearly 80%. Relying instead on a regimen of mostly non-opioid pain medications, like acetaminophen and ibuprofen, and family education about pain management, the participants—1,524 children in all—seemed none the worse for wear.

There was, according to the study, no uptick in ER visits among the participants following their procedures, and family satisfaction with the pain management was scored as high. “We were able to demonstrate that we could minimize opioid prescribing and, at the same time, still show there was no increase in emergency room visits after surgery or that families were dissatisfied with pain management,” said lead study author Lorraine Kelley-Quon, MD, a pediatric surgeon at Children’s Hospital Los Angeles.

Photo: Volodymyr Hryshchenko