The drug overdose epidemic in the United States, now primarily driven by synthetic opioids like ultra-deadly fentanyl, costs the nation roughly $1 trillion a year, according to a new bipartisan congressional report released Tuesday.
"Whether measured in lives or in dollars, the United States' drug overdose epidemic should shock everyone," the report reads. "It is unacceptable."
The report provides a unique level of comprehensive review into the opioid crisis, with particular emphasis on the need to improve mental health services and expand health care access for those suffering from addiction.
A White House Council of Economic Advisers assessment pegged the cost of the opioid crisis at $700 billion three years ago.
The new report derives the new $1 trillion estimate based on the increase in overdose deaths seen since 2018.
Drug overdose deaths have more than doubled in recent years, from about 44,000 in 2013, to more than 100,000 between May 2020 and April 2021. Overdose incidents are responsible for more deaths in the U.S. each year than firearms, suicide, homicide or car crashes, according to the report.
When it comes to understanding the demand for synthetic opioids, the report's authors wrote: "Authorities are largely flying blind."
"The United States does not have the data infrastructure to adequately measure the amount of illegally manufactured synthetic opioids consumed in the United States or the number of people who use them," the report reads.
Tracking fentanyl is difficult, especially when it comes mixed with other substances, including counterfeit pills, which users might not know are fake.
A series of target raids done across the U.S. last year as part of a new crackdown on counterfeit prescription medication resulted in the seizure of 1.8 million fake pills, and authorities saw increases in the number that contained fentanyl, according to the Drug Enforcement Administration. The number of fentanyl-laced pills seized during the enforcement push at the time was enough to kill 700,000 people.
"The United States has never experienced such a rapid and unprecedented shift in illegal drug markets, especially a shift that is causing so much death," the report reads.
Rep. David Trone, D-Md., and Sen. Tom Cotton, R-Ark., chair the bipartisan commission that produced the over 500-page report.
Combating the opioid crisis is personal for Trone, as his 24-year-old nephew died from a fentanyl overdose in 2016. It was that family tragedy what has fueled his continued work on the issue.
"We've got to put names behind these statistics, because we're numbed," Trone said. "We just hear these big numbers."
Transnational criminal organizations rely on raw materials sourced from China and trafficking routes through Mexico to maintain an expansive supply chain which has funneled fake versions of Oxycontin, Vicodin and Xanax, or stimulants like Adderall.
"The cartels are entrepreneurs and are phenomenally powerful with $100 billion-plus business and they have really shaped their drug to fit the American market," Trone said.
A significantly greater level of potency, about 50 times that of heroin, combined with being relatively easy to manufacture, makes fentanyl an attractive product for drug traffickers.
Counterfeit versions of real prescription drugs also create challenges in identifying the scope of the demand and marshaling resources for treatment, according to the congressional report.
"It's incomprehensible that our government's reaction has been so inadequate," Trone said.
The report recommends elevating the head of the White House Office of National Drug Control Policy to a cabinet level position and empowering the office to analyze trends and respond to threats more quickly.
This week, the DEA announced the launch of a new enforcement initiative aimed at dismantling illicit drug trafficking networks in communities across the country. A majority of the networks already identified by the DEA are known for distributing fentanyl or methamphetamines.
"DEA will bring all it has to bear to make our communities safer and healthier, and to reverse the devastating trends of drug-related violence and overdoses plaguing our Nation," the agency's chief administrator, Anne Milgram, said Monday.
But the new congressional report is clear to emphasize the need for a public health solution as well. Methadone and buprenorphine, two treatment medications designed to reduce opioid cravings and withdrawal symptoms, are identified as two of the most effective intervention methods.