While the number of opioid prescriptions and opioid overdose deaths has fallen, fatalities from heroin and black-market synthetic heroin and opioids are on the rise, according to research from the American Action Forum, a center-right think tank based in Washington, D.C.

After growing at a 14.3% annual rate between 1999 and 2010, the number of opioids prescribed started to decline by 4.3% per year, and the annual growth rate of prescription opioid overdose deaths dropped from 13.4% before 2010 to 4.8% after.

A Void in the Market

With authorities cracking down on opioids and prescribing practices, international cartels identified a gap in the market and are filling it with heroin and potent synthetic opioids like fentanyl.

When prescription opioids become more difficult to acquire, people turned to whatever alternatives were available. According to the study, “Transnational criminal organizations have been capitalizing on the nation’s rising opioid dependency by producing and distributing an abundant supply of these illicit and lethal opioids.”

Although restrictions on prescription opioids appear to have slowed the growth in overdose fatalities related to those substances, the overall number of opioid-involved overdose fatalities has increased significantly due to an increase in overdose deaths that involve heroin and synthetic opioids. For example, the annual growth rate of heroin deaths skyrocketed from 4.1% before 2010 to 31.2% after, and the growth rate of deaths related to fentanyl climbed from 13.7% in 2010 to 36.5% after.

The sharp increase in overdose fatalities caused by synthetic opioids like fentanyl is staggering: Between 2013 and 2016, the number of deaths involving these substances increased by 84.2% each year, according to data from the Centers for Disease Control and Prevention.

Lethal Risks Are Unbeknownst to the End-User

So, what’s the blame for such a sharp increase in fatal overdoses? For starters, many users don’t know what substances they’re using. In some cases, they are unknowingly ingesting lethal amounts of synthetic opioids like fentanyl and carfentanil, an animal tranquilizer. These deadly synthetic heroin and substances are often cut into heroin or pressed into pills that the end-user believes to be a painkiller or other drug. Even more worrisome: these synthetic drugs are resistant to overdose-reversing substances such as Narcan.

In an interview with The Washington Post, Ben Gitis, director of labor market policy at AAF and co-author of the study, said that although lawmakers need to tackle the surge of illicit opioids into the country, they can’t neglect the core issue at hand: addiction.

“Say policymakers were to start turning more attention to the supply of illicit opioids, heroin and synthetic opioids, which is obviously something that needs to happen,” Gitis said in the interview. “Doing that without addressing dependency could turn users to other types of drugs to use in their addiction.”

Although restrictions on opioid prescribing practices appear to be working, this study reveals additional obstacles to overcome to put an end to the opioid epidemic. Until then, we have to address the root issue of addiction, per Gitis’ recommendations.

At Guardian Recovery Network, we’ve seen firsthand the devastation the opioid epidemic has caused. Our continuum of care, which includes detox, residential treatment and aftercare, has equipped hundreds of people with the tools necessary to sustain lasting recovery. For more information about how our services can help you or someone you care about, contact a Guardian Recovery Specialist at 877-831-2533.