This week, the Centers for Disease Control and Prevention (CDC) presented a set of recommendations for Opioid prescriptions. These new guidelines are the first revisions made to the organization’s 2016 suggestions which stopped many with chronic pain from getting the relief they needed. 

The Opioid Epidemic And The CDC

For over 3 decades, the US has been experiencing a serious public health crisis known as the Opioid epidemic. In the 1990s, pharmaceutical companies, insurers, and pain specialists endorsed Opioid pain relievers as being less addictive and safe to use for common ailments. The marketing of drugs like OxyContin led to an increase in prescriptions being written for issues like backaches and arthritis. 

As a result, US overdose deaths rose drastically. From 1999 to 2017, Opioid-related overdose deaths increased almost sixfold. While local and federal governments attempted to restrict prescriptions, the crisis continued. Those who had already become addicted to Opioids turned to Heroin or Fentanyl when they couldn’t get a prescription. In fact, studies have shown that 80% of people who have used Heroin first used prescription Opioids. 

The CDC released a set of guidelines in 2016 aimed at decreasing the number of Opioids being prescribed. The organization urged physicians to explore other treatment options before turning to Opioids. Other medications and non-drug therapies were recommended as alternatives. If doctors chose to prescribe painkillers for acute pain, the CDC proposed a 3-day limit for prescriptions and that doctors prescribe the lowest possible effective dose. These guidelines also applied to treating chronic pain. Despite being voluntary, doctors and local governments implemented these recommendations. 

An Unintended Consequence

Although these guidelines ultimately contributed to a decrease in Opioid prescriptions being written, they were largely opposed due to their effect on a specific group. Many doctors across the US feared there would be criminal or civil consequences if they did not follow them. Doctors became very hesitant to prescribe Opioids and quickly tapered patients off of their prescriptions. This greatly affected many chronic pain patients who rely on doses higher than the 90 milligram ceiling of Morphine listed in the 2016 guidelines. 

Studies have shown that rapid tapering patients off of Opioids can lead to harmful outcomes. One particular study of 100,00 chronic pain patients found there was 68% increase in overdose deaths for patients experiencing tapering compared to those who were not. For the tapered group, there was also a spike in mental health conditions. Chronic pain patients were also more likely to turn to substances like Heroin and Fentanyl to self-medicate their pain after being tapered off their medications. Suicide can also be an outcome of tapering. It has been reported that up to 30% of Opioid overdoses could be suicides. 

The rigid interpretation of the CDC’s 2016 guidelines also affected those who were struggling with a substance use disorder (SUD). Many doctors developed a one strike policy. This meant that if a patient tested positive for an illicit substance, they were not given further treatment. 

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CDC Proposes New Guidelines

Several organizations spoke out against the original 2016 guidelines. In 2019, the US Food and Drug Administration issued a warning about the dangers that can come from suddenly tapering patients off of Opioids. The American Medical Association recommended that doctors immediately suspend the CDC’s guidelines in 2020. In response, the CDC acknowledged that their suggestions had been misinterpreted and misused. Concerned about the reports of people with chronic pain being denied relief, the CDC began to work on revisions to their 2016 guidelines. This time, their recommendations were drafted with no input from drugmakers. 

The new guidelines, released on Thursday, are aimed at balancing the necessary use of Opioids for severe pain and protecting other patients against harmful risks. The 12 recommendations proposed in the 229 page document changes the “one-size fits all approach” to Opioid prescriptions. Doctors are being urged to look at each patient’s situation and assess the risk and benefits prescribing Opioids. Overall, the CDC still believes that non-Opioid therapies should be attempted before prescribing Opioids for pain. At the same time, they removed the 90 milligram ceiling of morphine for chronic pain patients and the 3 day limit for acute pain. 

While the document warns of addiction, depressed breathing, and effects to mental status, they have noted that they serve a very important medical purpose. Relieving pain from traumatic injuries, such as burns and crushed bones, were listed. In these cases, it is recommended that immediate release pills be used rather than long-acting. The CDC also stated that these guidelines do not apply to those with cancer, sickle cell, and end of life or palliative care. 

The CDC also noted that patients who come in and test positive for illicit substances could have untreated pain or a substance use disorder. The new guidelines recommend that doctors offer treatment, counseling, and careful tapering when necessary. In doing so, they can assist patients in improving their quality of life. 

These recommendations are currently available on the Federal register. For 60 days, the public can make comments on the proposed guidelines. The CDC will then review these comments and will likely release a final issue by the end of the year. 

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The ruling of a 2019 Opioid case against Johnson & Johnson was overturned by the Oklahoma Supreme Court on Tuesday. The original case was the first of its kind to go to trial and found that the pharmaceutical company played a major role in the state’s Opioid overdose deaths. In a 5 to 1 outcome, the Supreme Court determined that the original $465 million verdict incorrectly applied the state’s public nuisance law. 

Just last week, a California state judge determined that J&J and 3 other drug companies are not responsible for the state’s Opioid crisis. Like the Oklahoma ruling, the California case did not believe a public nuisance was provable in this situation. Currently, there are about 3,000 lawsuits with similar public nuisance claims against drug manufacturers, distributors, and pharmacies. 

What Are Opioids?

Opioids are a class of drugs that are derived from the poppy plant. These substances can relieve feelings of pain by affecting receptors in the brain and body. While Opioids like Heroin and Fentanyl are illicit in the US, some Opioids, such as Oxycodone and Hydrocodone, can be obtained legally through prescriptions. These substances, even when prescribed by a medical professional, have a high potential for misuse and addiction which can lead to fatal outcomes. Individuals who become addicted to Opioids after using a prescription may turn to more dangerous but easier to obtain substances, like Heroin, as an alternative. 

Since 1999, there have been over 760,000 Opioid related deaths in the US. In 2019 alone, 70,630 people in the US died as a result of an Opioid overdose. Oklahoma specifically experienced the loss of more than 4,600 citizens to Opioid overdose deaths from 2007 to 2017. Nationwide and locally, fatalities due to Opioids are considered to be a major public health, social, and economic crisis. 

Johnson & Johnson’s Involvement In The Opioid Crisis

The Opioid crisis, also known as the Opioid epidemic, began in 1995 when the US Food and Drug Administration (FDA) approved a pain medication developed by Purdue Pharma. This substance, called OxyContin, was marketed as being effective in controlling  pain while having a low potential for abuse due to its controlled release formula. Pharmaceutical companies began pushing sales of OxyContin to distributors which led to an increase in Opioid prescriptions in the US. Rapidly, the substance started to be misused by people all over the country. By 2003, 2.8 million people were using OxyContin for non-medical use. 

In the 2019 Oklahoma Johnson & Johnson case, the state provided evidence of the company’s contributions to the Opioid epidemic. This evidence argued that the drug manufacturer targeted high prescribing doctors, women, and veterans and misrepresented OxyContin as being safe to use for every day pain. Additionally, it was presented that J&J created a mutant strain of poppy which allowed them to manufacture Opioids, as well as supply about 60% of the active ingredients for Opioids made in the US. Because Johnson & Johnson was supplying ingredients to other companies, the state claimed that for 15 years the company campaigned the sale of Opioids, even those manufactured by other companies. 

Based on this evidence, Oklahoma declared that Johnson & Johnson’s actions fall under the state’s public nuisance law which was instituted in 1910. A public nuisance is defined as conduct that interferes with the rights of the public. Oklahoma’s law specifically says, “A public nuisance is one which affects an entire community or neighborhood, or any considerable number of persons, although the extent of the annoyance or damage inflicted upon the individuals may be unequal.” 

Oklahoma Supreme Court’s Decision

The Supreme Court’s reversal, as stated in the opinion written by Justice R. Winchester, determined that the 2019 ruling took the public nuisance law too far by extending it to manufacturing, marketing, and prescription Opioid sales. Winchester went on to say that Johnson & Johnson, and companies in general, cannot be liable for how their products are used by patients after they have been sold. They found this to be especially true as there are multiple levels of distribution. Manufacturers sell to distributors and wholesalers who then supply to pharmacies, hospitals, and doctors. It is at this point that Johnson & Johnson’s products are prescribed to patients. 

The lawful use of Opioids for treating pain, such as cancer related pain, was also cited as being a reason the public nuisance verdict was overturned. Additionally, Johnson & Johnson stopped marketing Opioids in 2015 and completely stopped selling them after a 2021 New York lawsuit. This case resulted in a $230 million settlement and the agreement to end nationwide sale of Opioids. Despite this settlement, the company does not admit liability or wrongdoing. 

Although the 2019 case was overturned, the Supreme court does not want to minimize the suffering that Opioids have caused many Oklahoma citizens. Johnson & Johnson also acknowledges the tragedy caused by the misuse of Opioids in the past 2+ decades but agrees with the court’s decision. The company has said that they support the overturning of what they called a misguided and unprecedented attempt to expand public nuisance laws. 

“We recognize the Opioid crisis is a tremendously complex public health issue, and we have deep sympathy for everyone affected. The company’s actions relating to the marketing and promotion of these important pain medications were appropriate and responsible,” Johnson & Johnson said in response to the ruling and on their involvement with Opioid epidemic. 

Because public nuisance laws are different depending on the state, it is not known whether this overturned case and the California ruling will inform the many similar cases against drug manufacturers. Earlier this year, Johnson & Johnson, along with 2 other companies, agreed to pay a $26 billion settlement. Currently, 42 states, 4 territories, and Washington D.C. have signed to this agreement. It is possible that the overturning of the 2019 Oklahoma verdict could convince states that are on the fence into signing on to this settlement. 

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Emmy nominated actor Michael K. Williams was found dead in his Brooklyn apartment on Monday, September 6th, 2021. The 54-year-old, best known for playing Omar Little on HBO’s “The Wire,” more than once spoke publicly about his substance use. He described addiction as an everyday struggle that he had to continue to fight. 

In a 2012 interview with Inside Jersey, Williams made it clear that his openness on the subject was intended to help others. The actor said, “God saved me for a purpose. So, I decided to get clean and then come clean. I’m hoping I can reach that one person.” 

Williams’s Addiction Journey

Williams, whose mother was an immigrant from the Bahamas, had a childhood characterized by sexual molestation and bullying. By age 19, Williams had developed a substance use problem and was already experiencing the cycle of treatment and relapse. To maintain his dependency on illicit substances, the actor turned to credit card fraud and carjacking which ultimately left him with an arrest record. At age 25, a mugger took a razor blade to his chest and face and gave Williams his signature face scar. The next day William’s mother took out a second insurance policy on his life and told the actor he was not likely to live past the age of 30. 

Williams’ struggles with addiction continued as his acting career began. During his time on “The Wire,” Williams got lost in the character of Omar Little, a notorious robber in the Baltimore drug scene. To cope with the intense character traits of Little, Williams began using Cocaine. According to the New York Times, he spent most of his earnings from the show on drugs which led to him being kicked out of his apartment. He began living out of hotels and also the floor of a drug house in Newark, NJ. Producers of “The Wire” have said they knew he was struggling and that they refrained from firing him in fear of how it could have worsened his substance use. 

In his 2012 interview, Williams credited a pastor at Christian Love Baptist Church in Irvington, NJ with helping the actor to get clean. Reverend Ronald Christian, who passed away in 2015, was the first person that Williams felt he could be completely open with. 

“I laid it all out. It was the first time I really laid everything out to anyone. I was a total stranger to him, but I felt very comfortable with him,” Williams told Inside Jersey. 

The current pastor at the New Jersey church, Brandon K. Washington, has said that Williams would visit the parish unannounced a few times each year. “All the times he would come, he would always reference his struggles. He was always confident in his relationship with God,” Washington said. 

Williams continued to be open about his struggles with addiction up until February 2020 when he spoke at an event for former prisoners seeking to re-enter society. He told the group, “This Hollywood thing that you see me in, I’m passing through. Because I believe this is where my passion, my purpose are supposed to be.” 

Celebrity Overdose Deaths And The Opioid Crisis

Although the cause and manner of Williams’s death have not yet been confirmed, officials have said that Williams likely overdosed. The New York Police Department found drug paraphernalia and what appeared to be Heroin on the kitchen table in the actor’s apartment. Williams’ possible drug overdose may be added to a list of recent celebrity drug related deaths that speak to the Opioid epidemic in the US. 

Along with Williams, 2 comedians, Faquan Johnson and Enrico Colangeli, were found dead at a party in Los Angeles this past Saturday. Their deaths were determined to be overdoses after ingesting Cocaine that was laced with Fentanyl, a synthetic Opioid which can be 80 to 100 times stronger than Morphine. This substance has been frequently found laced with other substances like Heroin, pain pills, Cocaine, and even Marijuana over the past few years.

Because Fentanyl is cheaper to produce and lighter to transport, manufacturers of illicit substances may be using it for economical reasons. It is also possible that the substance becomes laced with others as a result of cross-contamination. In either case, it is extremely dangerous when those who do not have a tolerance for Fentanyl or other Opioids unknowingly consume it. Additionally, Fentanyl is almost impossible to visibly detect so determining how much has been laced is very difficult. These factors can lead to unintentional overdoses which have been on the rise. In 2020, the highest number of overdose deaths were reported in a 12-month period at 81,000 in May. Of these reported drug related deaths, synthetic Opioids were the primary cause which increased by 38%. 

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Addiction Is An Everyday Struggle

Michael K. Williams was open about his struggle with substance use in an effort to help others. He wanted to let others know that an addiction doesn’t just go away and that recovery is something to work towards everyday. If Williams’ death is proven to be an overdose, along with Johnson’s and Colangeli’s deaths, they will speak to the Opioid crisis in the US which has caused an increased amount of unintentional deaths. 

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After 20 years, $2 trillion spent, 4 presidents, and 2,448 American lives lost, US forces in Afghanistan are officially withdrawing after Taliban militants seized the country’s capital, Kabul, this month. Because it is currently the world’s biggest Opiate supplier, some UN and US officials are concerned that Afghanistan’s opium production will increase under the Islamic fundamentalist group who has been profiting from the industry. 

Since 2001, the US has been unsuccessful in halting the production of Heroin that in 2017 accounted for 7% of Afghanistan’s gross domestic product (GDP). Despite not having control of the country for 2 decades, the Taliban has benefited greatly from this market that supplies 8o% of opium worldwide. UN officials estimate that the group made a profit of $400 million between 2018 and 2019. It is believed that the Taliban has become involved in all aspects of the opium industry in Afghanistan including planting, extraction, trafficking, taxing, and building drug labs.

What Are Opioids? 

Opioids are made from a compound that is extracted from the poppy seed. Currently, Afghanistan has over 550,000 acres of poppy fields. Although Opioids, such as Morphine, are usually prescribed to treat pain, all forms of this substance can be highly addictive and lead to fatal outcomes if use is non-medical or prolonged. There is an especially high risk for addiction with Heroin use which was involved in 19.8% of US drug overdose deaths in 2019. Opioid use and fatalities have been steadily increasing worldwide over the last 4 decades with opium being present in 70% of drug use deaths. This growing problem is often referred to as the Opioid crisis or epidemic. 

How The Taliban Became Involved With The Opium Industry

Although poppy has grown in Afghanistan for centuries, the country did not significantly produce and trade the substance until the late 1970s. In 1979, the government lost control of the rural land along the Pakistani border as they warred with the Soviet Union. Guerilla fighters began to use opium as a way to fund large scale arms purchases. Between 1972 and 1980, surrounding countries, Iran, Pakistan, and Turkey, banned the production and sale of opium which opened the market for Afghanistan. 

In 1996, after the Soviet Union had withdrawn, the Taliban, a religious-political group often associated with terrorism, seized control of Afghanistan. Initially, the group encouraged opium growth as its production required 9 times the amount of laborers than wheat (one of the country’s main crops) did. Due to human rights violations, terrorism support, and increasing opium production, the Taliban regime in Afghanistan was isolated by most other world governments. In an effort to gain international acceptance, the Taliban banned the production of opium in the year 2000. This ban received much backlash from civilians and negatively affected the country’s economy by causing a severe loss of income for 15% of the population. It is likely that this helped weaken the Taliban, making them vulnerable to US invasion 1 year later. 

Since their collapse in 2001, the Taliban has spent the last 2 decades rebuilding and gradually gaining more control over the rural areas where poppy is grown and opium is produced. They profited off of the booming industry by imposing taxes and tariffs on farmers, labs, and traders. The head of the Kabul office of the UN Office of Drugs and Crime, Cesar Gudes, was quoted saying that the group has been relying on opium trade as their main source of income. 

The Current State Of Opioid Production In Afghanistan 

During the war in Afghanistan, the US focused on limiting the production of opium to stop the Taliban from profiting, amongst other reasons. Attempts, such as poppy eradication, air strikes to suspected Heroin labs, and alternative crop programs, cost the US over $8 billion. These efforts were ultimately unsuccessful. Farmers and laborers, who depend on the production of opium, grew angry with the US involvement in Kabul and began to support the Taliban. 

With the Taliban recently gaining control over Kabul and US involvement retreating, Afghanistan is experiencing a state of economic and humanitarian crisis. The longest war in America’s history has left the country with years of widespread destruction. Millions of civilians have been uprooted from their homes while foreign aid has been cut and local spending is decreasing. These factors are likely to cause many impoverished Afghans to be more dependent on the production of opium. In 2019, opium harvesting supplied 120,000 jobs for the country. 

Taliban spokesman, Zabihullah Mujahid, addressed the country’s opium industry at a press conference last week. He vowed that Afghanistan will not be a country of opium cultivation and that they will bring opium cultivation to zero again, in reference to the 2000 ban. To stop Heroin production and drug smuggling, Mujahid says the country will need help. 

“From now on, Afghanistan will be a narcotics-free country but it needs international assistance. The international community should help us so that we can have alternative crops. We can provide alternative crops. Then, of course, very soon, we can bring it to an end,” Mujahid said. 

Experts believe that this vow is unlikely to come to fruition as opium trade has become too integral to the Taliban and Afghanistan’s economy. The country is on track to become a “narco-state” because the poppy plant is much more lucrative than any of their other cash crops. Cultivation of opium in Afghanistan has seen a 37% increase in the past year alone. By banning Afghanistan’s opium production, the Taliban risks alienating the country’s rural areas and the farmers who are financially dependent on the substance. This kind of economic impact can lead to a possible rebellion against them. At the same time, the group is hoping to avoid the isolation they experienced in 1996 when they first gained control. 

“We don’t want to repeat any conflict anymore again. We want to do away with factors for conflict. Therefore, the Islamic Emirate does not have any kind of hostility or animosity with anybody; animosities have come to an end and we would like to live peacefully. We don’t want any internal enemies and any external enemies,” Mujahid said of the group’s intentions. 

While the Taliban is claiming that they want to stop opium production that was involved in 50,000 US overdose deaths in 2019, balancing possible economic effects and resistance with their need for international support will be difficult. This is particularly true as the group has been and continues to benefit from the trade of the extremely dangerous and illicit substance. 

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President Nixon launched the War on Drugs campaign in the 1970s and its legacy that still exists today. The campaign attempted to bring attention and awareness to the impact drugs have had on the American people. Arguably, benefits such as Nixon’s signing of the Controlled Substances Act in 1970 has helped officials classify and regulate dangerous drugs. The campaign helped people gain education on side effects of drugs like LSD and Heroin and take them more seriously. 

Nixon criminalized drugs like Marijuana, which many believe brought harmful stereotypes to the Hippie or anti-war left population. Additionally, Nixon’s harsh punishment for drugs like Heroin and Crack Cocaine crippled the black community in the 70s and created stereotypes and harsh jail sentences for Black people. Criminalizing drugs like Heroin and Crack Cocaine was not just created to penalize Black Americans, as an overdose from these drugs can be fatal. Nixon believed drug use, especially when done by the youth, was a social rebellion, negatively impacting and weakening America. Some believe Nixon had underlying motives for his campaigns, including targeting Black people and the “anti-war left.” John Ehrlichman, called “the Watergate conspirator” spoke out about Nixon’s alleged race and antiwar left discrimination. CNN states he candidly admitted: 

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and Black people. You understand what I’m saying? We know we couldn’t make it illegal to be either against the war or be Black but by getting the public to associate the hippies with Marijuana and the Black people with Heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about drugs? Of course we did.” 

Drug Laws, Sentencing, And Disparities

A modern effect and a strong example of drug laws, race, and sentencing includes those surrounding crack and powder Cocaine. According to Vox, the 1986 Anti Drug Abuse Act, “created a 100 to 1 disparity between the amount of Crack Cocaine that triggers a federal mandatory minimum sentence versus powder Cocaine.” This means 5 grams of crack equated to a 5 year sentence, where 500 grams of powder Cocaine would warrant the same sentence. In 2019, officials noticed 81% of convicted Crack offenders were Black. Many believe it is because powder Cocaine was associated with White populations where Crack Cocaine was with Black populations.

Unjust Consequences From The War On Drugs Campaign  

Recently, several media outlets have questioned if the War on Drugs has done any good. A recent CNBC report suggested the War on Drugs may have been less effective than planned in response to the recent surge of American drug use in the last 50 years. With the rising number of Opioid overdoses, and drug abuse related to COVID-19 mental and emotional health challenges, America has recently spent over a trillion dollars fighting drug addiction. This has led many to believe the War on Drugs campaign has not done much over the years for the American people. For Black people (as well as those in the LatinX community impacted by racial stereotypes), the disproportionate number of arrests and racial stereotypes remain visible.

A human rights news article penned 2 years ago mentioned that the U.N. believes that states should face the racial discrimination in enforcement of drug laws. They further acknowledged African American people endure more consequences noting how people of African descent are disproportionately affected by drug policies and drug laws.  The result has left many, “barred from a wide range of employment, educational, social security and other benefits.” This does not include police brutality, some Black people’s mistrust of police officers, racial profiling, and discrimination some medical professionals have toward Black people when prescribing medications. Disparities in prescribed Opioids occur as some doctors feel Black patients are physically stronger than White patients, accounting for why 29% of Black patients are less likely to be prescribed. Other media outlets have reported Black people do not use drugs any more than their White counterparts, but suffer more frequent, longer, and harsher prison sentences for doing so.

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Reworking A Trickle Down Effect 

Not only did strict drug laws from the War on Drugs target Black offenders, but it aided in creating harmful stereotypes surrounding Black populations. Those most impacted by prison sentences and racial stereotypes were Black people who engaged in drug use and distribution. As a result of harmful stereotyping, more Black people have been incarcerated for drug possession and distribution percentage wise compared to their White counterparts. 

Despite such aims for drug control and drug education, Black and LatinX American populations are still extremely impacted by the War on Drugs and its side effects. This issue remains topical and controversial, and there isn’t a simple answer. Some have examined and proposed drug reform by reducing drug trafficking sentences to misdemeanors. Others have proposed treating drug-related crimes and use as a public health concern to lessen strict jail time. As for the direction in the future, changes must be made as well as maintaining awareness and sensitivity to this ongoing problem.

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On March 23, 2021, viewers got a deep and personal look into Grammy nominated pop-star Demi Lovato’s experience with addiction, overdose, and recovery. The signer held nothing back in the first 2 episodes of their YouTube documentary series Demi Lovato: Dancing with the Devil. Lovato and their friends, family, employees, and even the doctor who worked on Lovato after their 2018 overdose spoke in the documentary, leaving no details out and nothing to the imagination. The series’ first 2 episodes previse a story that tells the real and ugly truth about addiction.

Family History Of Substance Abuse

When you realize someone is battling addiction, you often see them at the end of the line, after addiction has inflicted its consequences on the individual and those around them. However, typically a lot happens before things come crashing down. Everyone has a story and Lovato’s starts from a very young age. Lovato opened up about their father who they described as an alcoholic and addict. He was abusive to Lovato’s mother, and according to Lovato’s mother, Demi witnessed some of the abuse as a child. Lovato’s father was also reportedly diagnosed with bipolar disorder and schizophrenia.

Those with mental health disorders are much more likely to develop a substance use disorder than the general population. One study found that among those with bipolar disorder, 61% had history of a drug or alcohol use disorder. Among those with schizophrenia, 47% have a serious problem with drugs or alcohol. Using substances to attempt to self-medicate is common for those with mental illness, especially if they do not seek out professional treatment. Due to Lovato’s fathers toxicity in Demi and Demi’s mother’s life, Demi had to create distance from him. This made his death a heartbreaking revelation, when Lovato’s father died alone and his body was not found for a week and a half.

Children of parents who struggle with addiction are at a higher risk of developing an addiction themselves. Lovato’s mother also opened up about her Xanax misuse. When childhood trauma involving abuse and drug misuse is left without professional intervention, it oftentimes presents itself as a repeated cycle when the children grow up. Lovato has spoken openly about their own substance abuse and the effects it has had on their life. Lovato started using alcohol as a student and tried Cocaine for the first time at age 17. During this time, Lovato was working for the Disney Channel. In Lovato’s new documentary, they explained that they used Cocaine and Xanax together. That combination would eventually escalate to even more dangerous drug use.

The Overdose

Since 2010, Lovato has a history of substance abuse, receiving treatment in rehabs, relapsing, and regaining sobriety. The popstar had a long stint of sobriety, stating that they were celebrating 6 years sober in March 2018. However, in July 2018 the media was flooded with reports that Demi Lovato had suffered an overdose.

When Lovato relapsed in 2018, they said in their documentary series, “I picked up a bottle of red wine that night and it wasn’t even 30 minutes before I called someone that I knew had drugs on them.” Lovato proceeded to use drugs that they hadn’t tried before like Methamphetamine. At a party one night Lovato explains using Meth with Molly, Cocaine, Marijuana, alcohol, and OxyContin. Lovato reflects back realizing that that alone should have led to their death. At one point Lovato asked their dealer if he had Xanax and Cocaine and he said no, but he did have Heroin and Crack Cocaine.

Lovato says at that point they began using Heroin recreationally and became physically dependent on it. Heroin is a powerful Opioid drug made from Morphine that comes with severe withdrawal symptoms, such as muscle and bone pain, diarrhea and vomiting, cold flashes, and uncontrollable leg movements.

The night of the overdose, Lovato shares that they told their friends they were going up to bed, but actually went upstairs to call a dealer. Lovato used Heroin that they now assume was actually Fentanyl. After providing the drugs and taking advantage of Lovato, the dealer left Lovato alone. When Lovato’s assistant found Lovato in the morning, Lovato was naked and blue. At 11:22am on July 24, 2018, a 911 call was made and paramedics rushed to the house, administering Narcan trying to save Lovato’s life.

The overdose caused Lovato to suffer 3 strokes and a heart attack. They suffered brain damage from the strokes, has blind spots in their vision, and is now unable to drive. They received dialysis at the hospital as doctors tried to save Lovato, and they did even after Lovato suffered multiple organ failure. The documentary shares that if it had been another 5 to 10 minutes without treatment, Lovato would have died.

Demi Lovato’s Recovery

Since the overdose in 2018, Lovato focused on their physical and mental recovery. Lovato shared in the documentary series that the quarantine brought on by COVID-19 helped with working through past traumas and brought a period of rediscovery. Despite their struggles with substance abuse, Lovato was able to produce 5 award winning albums from 2009 to 2017, and will be releasing a new album April 2^nd, with a similar name to the documentary series: Dancing with the Devil … the Art of Starting Over.

Demi Lovato: Dancing with the Devil is a reminder that addiction can reach anyone. It doesn’t matter how successful and wealthy a person is, addiction does not discriminate. Lovato’s vulnerability in this series demonstrates that fact. As the series progresses, Lovato will open up more about their history with addiction, sexual assault, an eating disorder, sexuality, and self-growth.

This article was updated on 9/6/2021 based on new information.

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The year 2020 has not only been deemed the deadliest year in American history but also a dangerous and deadly year for substance abuse. America has been fighting the impact of the Opioid Crisis prior to 2020. While many states lost Americans to drugs like Heroin, Fentanyl, and prescription medications, states like Virginia, Ohio, and Oregon have the highest rates of overdose deaths.

In 2020, numbers of drug overdoses hit an all-time high, with the aforementioned states. Oregon witnessed a 40% “death spike” with 580 fatalities because of illicit chemicals. Use of drugs like Meth increased 37% in a year in Oregon, Cocaine deaths climbed to 57%, Fentanyl deaths contributed to a shocking 92% of deaths, and Heroin reached 9%. Virginia also suffered record highs for drug abuse and fatalities, with 2,035 drug overdoses in 2020, exceeding its record of 1,626 overdoses within a year’s time. Ohio lost 548 individuals to drug abuse in the spring of 2020, increasing in 14 years. Furthermore, the summer months of June and July lost 481 and 442 people in the state.

Staggering Numbers Of 2020 Deaths Continue To Concern Many

2020 death tolls have alarmed many and have gained the year the reputation of being the “deadliest year in American history.” Interestingly, the Centers of Disease Control predicted higher numbers of deaths to occur throughout the year. The COVID-19 pandemic, which has ended the lives of over 318,000 Americans in 9 months, is a major influence on high death tolls. While much research is being done to understand the connection between 2020-related substance abuse and the effects of COVID-19, both the pandemic and drug overdoses have greatly contributed to many lost lives in 2020.

In addition to such effects of the pandemic, declining mental health due to COVID-19 infections and adjustments has encouraged more substance abuse to occur. As a result, drug abuse and suicide have contributed to the high number of deaths. Sadly, numbers are expected to rise to 3.2 million by the end of 2020. Lastly, deaths from conditions like dementia, diabetes, and cardiac problems have been also connected to 2020 increases in death.

2020 Death Rates: COVID-19 Considerations, Drug Abuse And Diseases Of Despair

Diseases of despair have also been connected to rises in drug abuse, due to the impact of COVID-19. Diseases of despair, which have resulted in suicide, declining mental health (anxiety, depression, loneliness, poor coping mechanisms), financial insecurity, and stress from isolation have caused many to experience new mental health challenges and worsen pre-existing ones. Because of this, some of those affected have turned to self-harm, substance abuse, or have increased their tolerance to or dependence on harmful substances.

Drug statistics have drastically shifted when compared to previous years. The Centers for Disease Control and Prevention (CDC) notes, “After declining 4.1% from 2017 and 2018, overdoses have increased 18.2% from the 12 months ending in June 2019.” Another source echoes a similar finding. According to United Press International (UPI), drug abuse and suicide rates increased 170% between 2009 and 2018; however the spread of COVID-19 has caused sharp increases in such findings. As a result, studies noticed a 59% increase in alcohol use, increases in Opioid overdoses and rises in suicidal thoughts. Additional statistics include 81,000 reported drug overdoses in a 12-month period during 2020, becoming the highest ever recorded in a year. The awareness is causing media outlets to spread the word in order to educate people. Essential workers in the medical field use Naloxone to try and revive those who overdosed on Opioids.

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Tse Chi Lop A.K.A. Asian “El Chapo”

For over a decade, the AFP has tentatively tracked Tse Chi Lop for his suspected involvement with the Sam Gor syndicate. Nicknamed “Operation Kungur,” the AFP and about 20 other foreign agencies led the international investigation. The multinational pursuit followed the drug conglomerate’s money trails. They eventually arrested 27 suspects and cut off a few global distribution networks. Based on the sheer size and billions generated by “the company,” people have dubbed Tse Chi Lop as the Asian “El Chapo.” Experts even believe the ex-convict to be among the leagues of Joaquín “El Chapo” Guzman and Pablo Escobar. Tse’s organization is, perhaps, the largest illicit narcotics trading ring in Asian history. But what is most concerning is the short amount of time it took him to build his empire.

The Rise of Sam Gor Syndicate

From 2015 to 2019, the syndicate rapidly expanded. It quadrupled the rate of crystal-methamphetamine trafficking in Asia. Tse’s Asia-Pacific drug trade supplied methamphetamine and other synthetic drugs globally. They also produced heroin, MDMA, and meth. The illicit operation became successful almost overnight. By partnering up with smaller groups of criminals, the conglomerate gained territory quickly. They traveled from nation to nation, creating deals with local gangs.

Before 2019, the accused drug kingpin, Tse Chi Lop, lived in the shadows. Police sources claim the wealthy man even traveled with a guard of Thai kickboxers. It wasn’t until Reuters published an investigative article that everything came to light. The piece revealed Tse’s identity. Only then were authorities able to close in on him. According to the report, Tse ran his operation from Hong Kong, Macao, and Southeast Asia. It also connected Tse’s syndicate to 13 drug trafficking cases.

Reuter’s Grand Reveal

Shortly after Reuter’s grand reveal, AFP issued a warrant for Tse Chi Lop’s arrest in 2019. Yet, after learning about the multinational investigation into him, he hid in Taiwan. Finally, last Friday, authorities caught the supposed “Asian El Chapo” in the Netherlands. The Dutch now detains Tse, and the Australian government has requested his extradition. Tse Chi Lop’s arrest is a win against the global war on drugs. But the was is not over. The demand for synthetic drugs remains strong. If efficient change is not made soon, it is only a matter of time before someone new steps up and replaces Tse.

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During the week of Thanksgiving, the United States surpassed 267,000 COVID-19 related deaths. The spike in cases has the country scrambling as companies race to approve a vaccine. Since the start of the year, the media and governments worldwide have remained focused on the urgent health crisis. Yet, as COVID-19 continues to spread throughout the states, another epidemic is growing in its shadows. 

The 2020 Opioid Epidemic 

The Opioid epidemic is picking up momentum once again. In a recent study published by the Vermont Department of Health, the rate of Opioid-related overdoses rose. Non-fatal overdoses climbed up 137% from 2019 to 2020. Experts suspect that drug-related deaths will be even higher. 

The global pandemic is creating the perfect conditions for a deadly storm. Why? There is no exact reason, but loneliness is a significant contributor. According to the National Institutes of Health, loneliness increases the probability of making hazardous choices. The sensation is a leading risk factor for depression, anxiety, and comorbidity. Since most of 2020 has centered around social distancing and protecting the public, it is no surprise people are lonelier than ever. The distancing measures have helped contain the spread of the disease yet also led to higher loneliness rates. 

Other reasons for the jumps are disrupting drug supply and the end of in-person prevention and treatment services. Based on data released by the White House’s drug policy office, the long term effects of the COVID-19 crisis are already being felt. By April of this year, drug overdose deaths were up 11.4%. Non-fatal overdoses were also up 18.6% in comparison to 2019. 

Below are some of the states dealing with a rise in drug overdose fatalities based on recently released data: 

• Connecticut, up 19%
• Colorado, up 28%
• Kentucky, up 30%
• Cook County, Illinois, up 28% 
• Maryland, up 9.1%

The states listed are only some of the many dealing with a rise in drug-related deaths. These numbers are shocking, but unfortunately, it is not the first time this has happened. 

The Opioid Epidemic Throughout The Years 

For over 30 years, Opioids have been wreaking havoc in the United States. The first fatal wave of the epidemic began in the 1990s. During those early years, pharmaceutical companies pushed medical professionals to prescribe the drug. Their aggressive campaign lasted nearly a decade. Eventually, through misleading marketing and false claims, those companies succeeded in making Opioids mainstream. 

By reassuring that Opioids had little to no health risks, big pharmaceutical companies caused a ripple, leading to the Opioid epidemic. Countless physicians over-prescribed the painkiller. Within a few years, communities across the country were hooked and feeling the drug’s destructive effects. 

Outbreaks quickly sprouted in different cities. The first Opioid wave in 1999 killed thousands of individuals. The next big surge started in 2002 and lasted nearly a decade. From 2002 to 2013, heroin-related overdoses increased by 286%. Within 11 years, the age-adjusted drug overdose death rate doubled. In 2000, 6.2 people were overdosing per 100,000 persons. Four years later, the number rose to 14.7 per 100,000. The third wave was caused by synthetic Opioids like Fentanyl and started in 2013. By 2016, 63,600 people had died from a drug overdose. The age-adjusted rate of drug overdose deaths rose by 21%. This surge was the deadliest, with over 19.8 people overdosing per 100,000 persons. 

Opioids Today

Today the Opioid epidemic is once again picking up momentum. In 2019, 18 states and the District of Columbia reported a 10% increase in Opioid-related fatalities. Drug overdoses rose 4.6%, with over 70,980 recorded deaths. This uptick follows a decline reported in 2018 after 30 years of increasing cases. The Trump administration considered the short-lived win as one of their most outstanding achievements. Unfortunately, according to preliminary federal data, the number of lethal overdoses in 2019 surpassed 2018’s cases and even 2017’s. The amount of Opioid-related deaths are expected to rise even further this year. Experts are projecting more than 75,000 people dying from suicide or drug and alcohol use. 

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Since one of the main themes of this year is social distancing, it is no surprise that loneliness has pushed many people towards drugs. The current pandemic, economic downturn, and political climate are pushing people past their limits. Humans should not be isolated from one another or under constant stress. The pandemic, fear, and loneliness are driving Americans to use Opioids for relief. We must not forget about the deadly epidemic that is still destroying the lives of families worldwide. The Opioid epidemic is not over yet. 

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