{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:38:56Z","timestamp":1788881936651,"version":"build-2803163510"},"reference-count":167,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NWO","award":["360-52-180"],"award-info":[{"award-number":["360-52-180"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychoactives"],"abstract":"<jats:p>The ravaging COVID-19 pandemic has almost pushed into oblivion the fact that the United States is still struggling with an immense addiction crisis. Drug overdose deaths rose from 16,849 in 1999 to nearly 110,000\u2014of which an estimated 75,000 involved opioids\u2014in 2022. On a yearly basis, the opioid casualty rate is higher than the combined number of victims of firearm violence and car accidents. The COVID-19 epidemic might have helped to worsen the addiction crisis by stimulating drug use among adolescents and diverting national attention to yet another public health crisis. In the past decade, the sharpest increase in deaths occurred among those related to fentanyl and fentanyl analogs (illicitly manufactured, synthetic opioids of greater potency). In the first opioid crisis wave (1998\u20132010), opioid-related deaths were mainly associated with prescription opioids such as Oxycontin (oxycodone hydrochloride). The mass prescription of these narcotic drugs did anything but control the pervasive phenomenon of \u2018addiction on prescription\u2019 that played such an important role in the emergence and robustness of the US opioid crisis. Using a long-term drug lifecycle analytic approach, in this article I will show how opioid-producing pharmaceutical companies created a medical market for opioid painkillers. They thus fueled a consumer demand for potent opioid drugs that was eagerly capitalized on by criminal entrepreneurs and their international logistic networks. I will also point out the failure of US authorities to effectively respond to this crisis due to the gap between narcotic product regulation, regulation of marketing practices and the rise of a corporate-dominated health care system. Ironically, this turned the most powerful geopolitical force in the war against drugs into its greatest victim. Due to formulary availability and regulatory barriers to accessibility, European countries have been relatively protected against following suit the US opioid crisis.<\/jats:p>","DOI":"10.3390\/psychoactives2040020","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T10:59:54Z","timestamp":1699009194000},"page":"317-336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Imperative of Regulation: The Co-Creation of a Medical and Non-Medical US Opioid Crisis"],"prefix":"10.3390","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8156-8436","authenticated-orcid":false,"given":"Toine","family":"Pieters","sequence":"first","affiliation":[{"name":"Freudenthal Institute, Utrecht University, P.O. Box 85 170, 3508 AD Utrecht, The Netherlands"},{"name":"Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80 082, 3508 TB Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"ref_1","unstructured":"(2023, August 19). Overdose Death Rates|National Institute on Drug Abuse (NIDA), Available online: https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/overdose-death-rates."},{"key":"ref_2","unstructured":"National Center for Health Statistics-Vital Statistics Rapid Release-Provisional Drug Overdose Data (2023, August 20). Centers for Disease Control and Prevention: National Center for Health Statistics, Provisional Drug Overdose Death Counts, Available online: https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm."},{"key":"ref_3","unstructured":"World Health Organization (2023, September 10). Opioid Overdose. 29 August 2023. 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