美国国家公共电台 NPR Fentanyl-Linked Deaths: The U.S. Opioid Epidemic's Third Wave Begins（在线收听）

RACHEL MARTIN, HOST:

We have new evidence showing just how severe the opioid epidemic is here in the U.S. New data from the Centers for Disease Control and Prevention shows that overdoses of the synthetic opioid fentanyl have increased exponentially. The report also shows that the opioid epidemic is hitting men and people of color the hardest. We're joined now by Martha Bebinger of our member station WBUR in Boston, who's been looking through this data.

Martha, good morning.

MARTHA BEBINGER, BYLINE: Good morning, Rachel.

MARTIN: So the reports showing that deaths involving fentanyl are just going up and up - what does that mean exactly?

BEBINGER: 2013 was the first year that we started to see a surge in this drug that's now dominating the epidemic in many parts of the country, Rachel. It's the beginning of what public health experts call the third wave. So the first was the prescription pain pills like OxyContin that we've heard so much about. In the second wave, people switched to heroin because it was cheaper than the pills. And in some cases, it was easier to get.

So now with this research, starting in '13, we see drug dealers starting to push fentanyl, which is cheaper to produce than heroin. And today's study shows us how that changed the look of the epidemic.

MARTIN: So let's talk about that - who's being affected most. There's a disparity in the numbers of overdoses that we're seeing between men and women.

BEBINGER: Yes. So if you go back to 2011, 2012, heroin hit men a bit harder. But something started to happen in '13 when fentanyl came on the scene. Men started dying at an almost three times faster rate. There are some theories about why.

MARTIN: Yeah.

BEBINGER: Men are more likely to use alone; women more likely to use with a partner. When you use alone and fentanyl is present - since it kills people so quickly - it can stop breathing in less than a minute - it's very dangerous when you're alone.

MARTIN: So if you're with someone else, at least there's the chance that someone might call 911.

BEBINGER: Or use Narcan, or naloxone, the drug that reverses the opioid - the overdose themselves, yes.

MARTIN: Yeah.

BEBINGER: Now, also with women, Rachel, they seem more likely to ask for help, more likely to call 911, more likely to seek treatment. So that suggests that to combat this disease with men, we really need to be sure that they are encountering someone who's going to be - put them in touch with the medical community, whether it's an outreach worker, a clean needle exchange program, something like that.

MARTIN: Yeah.

What about race? This is an epidemic that's been framed by the media as a white, rural problem. This data says something different. This is affecting people of color more than we thought.

BEBINGER: Yeah. So whites are still dying as a total group more than anyone else. But the rate of increase for deaths was highest among blacks and then Latinos and then whites. So why might that be? Well, blacks and Latinos are incarcerated at higher rates than whites. When those former drug users come out of prison and they haven't used in a long time, that first shot - especially with fentanyl - can be deadly.

There's also the factor, Rachel, that blacks and Latinos may be less likely to trust first responders so less likely to call 911. Latinos have a very hard time finding bilingual treatment programs. And also, fentanyl is being mixed with cocaine, which may disproportionately affect blacks.

MARTIN: This is all grim, Martha. Is there any sense from the data that this is getting under control, the epidemic, at all?

BEBINGER: Seizures of fentanyl are still increasing, particularly in the areas that have been hardest hit. But deaths are starting to drop in the state where I report, Massachusetts. That doesn't mean overdoses are dropping, but it may mean more access to treatment and that drug Narcan.

MARTIN: Yeah. Martha Bebinger of member station WBUR. She's in an NPR reporting partnership with Kaiser Health News as well.

Martha, thanks we appreciate it.

BEBINGER: Thank you, Rachel.