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The opioid epidemic was created by the rapid increased use of prescription and non-prescription opioid drugs in the United States beginning in the early 1990s and continuing to present day, resulting in a dramatic increase in overdose deaths.  These drugs are estimated to be the cause of over one million American lives lost since 1999.  
‍Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold as OxyContin or Percocet), hydrocodone (Vicodin, Norco), and the very strong painkiller, Fentanyl, which is synthetically manufactured to resemble other opiates such as opium-derived morphine and heroin. The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as medical treatments and as recreational drugs. Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, failure and death.

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1st WaveBeginning in 1991 deaths involving opioids began to rise following a sharp increase in the prescribing of opioids for pain treatment.  The increase was influenced by reassurances given to physicians by pharmaceutical companies and medical societies claiming that the risk of addiction to prescription opioids was very low.  During this time, pharmaceutical companies also began to promote the use of opioids in patients with non-cancer related pain even though there was a lack of data regarding the risks and benefits to these patients.  

In the mid-90’s Johnson & Johnson started a new venture, cultivating poppies in Tasmania. Its scientists genetically modified the poppy plants, engineering so-called “super poppies.”  These poppies were exported to the U.S. and refined by subsidiaries into oxycodone and hydrocodone powders that were shipped to U.S. pill makers such as Purdue Pharma.  Their products were marketed as being safe, effective, and without significant risk of addiction.

In 1996, Purdue Pharma first released OxyContin and created a marketing campaign blitz presenting OxyContin as the next miracle drug. It falsely claimed that the pill’s extended release of painkiller medication would addict less than 1% of patients. Doctors were encouraged to liberally prescribe the medication for all sorts of conditions. Due to a combination of aggressive marketing and misleading information, the market was flooded with OxyContin. When tolerances increased, the company’s marketing response was “increase the dose”.  In 1997, there were approximately 670,000 prescriptions for OxyContin. In less than five years, that number ballooned to 6.2 million prescriptions.







By 1999, 86% of patients using opioids were using them for non-cancer related pain like accident and sports injuries
as well as dental surgery.  Communities where opioids were readily available and liberally prescribed were the first places to experience increased opioid abuse and diversion (the illegal transfer of opioids from the individual for whom they were prescribed to others).  In its early years, the Opioid Crisis went relatively unnoticed by medical professionals and law enforcement agencies. By the time agencies took notice, the effects were catastrophic.


2nd WaveThe 2nd wave of the opioid epidemic started around 2010 with a rapid increase in deaths from heroin abuse.  As early efforts to decrease opioid prescribing began to take effect, prescription opioids became harder to obtain and the focus turned to heroin, a cheap, widely available, and potent illegal opioid. The use of heroin increased in both sexes, most age brackets, and all socioeconomic groups.  Deaths due to heroin-related overdose increased by 286% from 2002 to 2013, and approximately 80% of heroin users admit to having misused prescription opioids before turning to heroin.  When prescriptions were ‘cut off’ by doctors, many of those addicted turned to the streets to stave off severe withdrawals. The product was cheap and accessible…and thus, the downward spiral of the disease began. It also had the potential to be more contaminated or cut with other illicit drugs or synthetic ingredients increasing the risk of sickness or death.  Heroin is also commonly injected, which puts users at risk for injection related diseases like HIV/AIDS, Hep B and C, skin infections, bloodstream infections and infections of the heart.






3rd WaveThe 3rd wave began in 2013 with an increase in deaths related to synthetically manufactured opioids like fentanyl.  Fentanyl is 100x more potent than morphine and 50x more potent than heroin.  In 2016 alone there were over 20,000 deaths from fentanyl and other chemicals being deceptively added to many street drugs. As of October 16, 2017, the U.S. government declared the opioid epidemic a public health emergency.


Fentanyl and fentanyl precursors are mostly being produced in China and then distributed by Chinese transnationals to Mexican cartels who then transport throughout the U.S.  Compared to the start of the fentanyl crisis, the flow of fentanyl into the U.S. in 2019 became more diverse and complicated with new source countries globally manufacturing and shipping fentanyl, fentanyl-related substances and fentanyl precursors as well as new transit countries emerging as significant trafficking nodes. This highly challenges law enforcement operations and policy efforts to stem the flow. While Mexico and China are the primary source countries trafficking to the U.S., India is emerging as a source for finished fentanyl powder and fentanyl precursor chemicals.  Fentanyl production and precursor chemical sourcing may also expand beyond the currently identified countries as these substances lack the geographic source boundaries of heroin and cocaine which must be produced from plant-based materials.  Fentanyl deaths are now being labeled ‘poisonings’ or ‘murders’ by many.














Drug overdoses are now at record highs, largely due to synthetic opioids and have currently become the leading cause of death of Americans between the ages of 18 - 45. The overall life expectancy of Americans for the past several years has decreased, with young men disproportionately more affected.

  • Over 289 people die from opioid overdose every day, according to some sources. 

  • There were 100,000 overdose deaths in 2021, a. 28.5% increase from the prior year, according to the CDC.

  • In 2021, 3,124 people in New Jersey died of overdoses. 

  • This epidemic has been dramatically impacted by the Covid-19 pandemic due to social isolation, mental health issues, lack of in-person treatment, and economic stressors.

  • Fentanyl 'poisoning' deaths occur on average every 5 minutes in the U.S.    

  • Fentanyl contamination has been found in heroin, cocaine, methamphetamines, ecstasy, and even marijuana…and in  counterfeit pills made to look identical to prescription medication such as Oxycontin, Percocet, Xanax, Adderall, and others.

As soon as May 2022, thousands of U.S. communities will receive opioid recovery funds from $26 billion global settlements with pharmaceutical manufacturers.  The National Prescription Opiate Litigation Plaintiffs’ Executive Committee ( confirmed in February 2022 that over 90% of litigating local governments have confirmed participation in these global settlements approved by the “Big Three” drug distributors AmerisourceBergen, Cardinal Health, and McKesson, along with opioid manufacturer Johnson & Johnson Washington, D.C.  Additionally, on March 3, 2022, Purdue Pharma reached a nationwide settlement for $6 billion. The bottom line is that financial help is on the way for governments, first responders, and healthcare workers on the front lines of this public health crisis. Nothing can make whole what was lost in this country, but what we can do is ensure that thousands of communities nationwide have the tools they need to help prevent the opioid epidemic and fentanyl crisis from taking more lives. It is also important to remember that while this is a vital step, it is only one of many that are necessary to put an end to this crisis. The settlements are the first of their kind to administer resources directly to the state and local governments specifically for relief programs to help rebuild the devastation caused by the opioid epidemic.  

Filling Prescription
Prescription Drugs
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Heroin Bags.jpg
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One Pill Can Kill Poster DEA.jpg


01/12/2023: NJ teens can get opioid OD reversal drug naloxone for free anonymously

A soon to start 2023 New Jersey program, through the NJ Dept. of Human Services, will allow anyone as young as 14 to obtain free naloxone (Narcan) from participating NJ pharmacies. No prescription required and purchase may be anonymous. Naloxone can reverse opioid overdose (including fentanyl overdose) if administered on time.

Source: USA Today Network – New Jersey 1-12-23

12/08/22: Somerset County Agencies Distribute Naloxone to Area Businesses

The Somerset County Prosecutor's Office, Somerset County Dept. of Human Services, and Empower Somerset announced the program. The Somerset County Overdose Fatality Review Team in collaboration with Somerset County's Operation Helping Hand and Stigma Free Somerset County will support local businesses by supplying them with naloxone and opioid education and training. Somerset County businesses seeking naloxone kits, training, and education can contact Empower Somerset, Kristen Schiro at:


11/03/22: CVS, WALGREENS to pay $10B opioid settlements

The two largest U.S. pharmacy chains announced agreements to pay approximately $5 billion each to settle thousands of lawsuits nationwide in which state and local governments claimed pharmacies filled prescriptions they should have flagged as inappropriate. Neither company admitted to any wrongdoing. Both companies have started educational programs and installing safe disposal units for drugs in stores and police departments.

Source: Associated Press, Geoff Mulvihill. Courier News.

09/29/22:  Mexican cartels and Chinese drug networks are behind fentanyl crisis DOJ and DEA say

DEA Administrator Anne Milgram said on Tuesday [9/27/22] two major cartels in Mexico — the Sinaloa Cartel and the Jalisco New Generation Cartel — are the driving force behind getting fentanyl across the U.S. border, calling the groups “the greatest threat” facing U.S. communities. She emphasized the cartels work closely with co-conspirators in China to obtain the necessary precursor for their drugs and to launder their illegal profits. . . . The Chinese Foreign Ministry announced in early August it was carrying out eight “countermeasures” to punish the U.S., including “suspending China-U.S. counternarcotics cooperation.”


09/23/22:  The largest one-time seizure of fentanyl pills in Phoenix Police Department History

Detectives seized over 1 million fentanyl pills and arrested two. [Phoenix is not a border town]


08/08/22:  NJ adds more weapons to its harm-reduction arsenal

New Jersey developing regulations to implement law signed by Gov. Murphy in January - Expanded access to syringe-exchange programs and increased free access to naloxone kits for emergency responders, addiction treatment and support programs, libraries, homeless shelters and other approved entities. Access to these services improves peoples’ chance of surviving an overdose, makes them three times more likely to stop using drugs and 50% less likely to acquire HIV or hepatitis C. (New Jersey Spotlight News)

07/21/22: Grand Junction, Colorado. Alert: New Synthetic Opioid Found in Colorado

A new synthetic opioid has been found in Colorado.  Called "Pyro" -

Dangerous! It is more potent than fentanyl.


07/08/22: Mexico City, Mexico.  Mexico seizes 'historic' load of fentanyl.

Mexico's army and National Guard seized approximately 1,200 pounds of fentanyl in the northern city of Culiacan. "Fentanyl is so deadly because it is pressed into pills made to look like Xanax, Adderall or Oxycodone, or mixed into other drugs." "As little as 2 milligrams of fentanyl can be lethal." "That has lead to tens of thousands of overdose deaths in the United States because people often do not realize they are taking fentanyl." 

Source: Associated Press (MYCENTRALJERSEY.COM).


04/26, 2022: New Jersey. Fentanyl is making it harder than ever to fight the opioid crisis

Article Highlights:

  • New Jersey, all 21 counties and 241 municipalities to share $641 million through 2038 after settlement agreements last year with Johnson & Johnson and three distributors: AmerisourceBergen, Cardinal Health, and McKesson, pertaining to their roles in the opioid epidemic.

  • In 2019 2,914 New Jersians died from an overdose with 2,248 of those deaths linked to fentanyl.

  • In 2021 96% of suspected heroin submissions contained fentanyl.  This synthetic opioid is now found in virtually every drug on the street.

  • A national analysis by the DEA found that four out of every 10 counterfeit pills contained lethal doses of fentanyl.


04/19/22: CHARLESTON, W.Va.  West Virginia awarded $99M in opioid lawsuit.

Settlement completed 4/18/22 with J&J subsidiary Janssen Pharmaceuticals Inc. in lawsuit over drugmaker’s role in perpetuating the opioid crisis. Source: Associated Press.


04/18/22: LOS ANGELES  Dealer sentenced to almost 11 years in rapper Mac Miller’s overdose death

Ryan Reavis pleaded guilty to one count of distribution of fentanyl. His attorney described him as a “runner” who delivered pills containing oxycodone but did not know they contained fentanyl. Source:

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