A month ago, I crashed into a pickup truck. I spent ten days in the ICU, trying to figure out how the accident happened—until the police officer told me the reason: the pickup driver was so high on drugs that he decided to make a U-turn on highway.

This is not just a accident happened on me, but a public health and social crisis that is happening. It is a great fortune to me that I survived in this accident, but how about those who died due to drug abuse. This thought motivates me to explore on how much drug abuse is causing to death and the origin of drug abuse.

According to HCD dataset, deaths caused by drug abuse increased steadily over the past decade. Between 2010 and 2020, the number of deaths almost doubled. Drug abuse is not just a small deal, it is becoming a national emergency. We first begin by exploring drug abuse in United States, and we fine an interesting observation between United States and global drug abuse.

Globally, the number of deaths caused by drug abuse is also growing (United states Drug Abuse and Global Drug Abuse). Comparing two graphs, the Global trend shares a similar pattern as United States’ trend. The similar pattern raises a question: Why the Global abuse seems to follow the same pattern as the United States’s? By plotting out the top ten counties with the highest number of drug abuse related deaths, the United States ranks at the very top. Actually, United States account for around 57 percent of all drug abuse related deaths since 21st century. The United States is not just struggling with addiction, it is defining the global drug addiction.

By plotting out the top ten counties with the highest number of drug abuse related deaths, the United States ranks at the very top. Actually, United States account for around 57 percent of all drug abuse related deaths since 21st century. The United States is not just struggling with addiction, it is defining the global drug addiction.

Referring to the question beginning, the follow up thought to this result is: Why is drug abuse so severe in the United States? From the graph above, we do have somewhere to start: drug abuse-related deaths in the United Staes increased sharply in the late 1970s. What happened at that period about drugs?

According to NCHS (CDC, n.d.), among all drugs, opioid-related drugs ranked at the top. This pattern aligns with a historical event—the Vietnam War.

The Vietnam War made a significant impact on influencing America’s contemporary drug culture, according to Stanton’s (1976) study. Southeast Asia was a major source of widely available opioids, consisting of heroin and morphine, during the war. The combination of extreme physical stress, psychological trauma, and easily available drugs rendered opioid use a type of self-medication and escape for many American soldiers encamped, perhaps. About one-fifth of American service members consumed opioid-related substances while serving in Vietnam, according to Stanton (1976). The normalisation of drug use in the war had a profound effect on public attitudes toward narcotics in the United States, despite the fact that the vast majority of veterans were disrupted when they returned home. By placing drug consumption into the country’s psychological and cultural landscape, notably among the younger generation disenchanted by war, the experience constructed a social foundation for later drug epidemics. In this way, the Vietnam War set the course for the impending opioid crisis in addition to a political and military turning point.

Just like showing in the “the United States Drug Abuse, Death by Year”, a further visible increase in drug-related deaths occurred around the 1990s. The rise in prescription opioids, notably OxyContin, constitutes a close association with this second wave. The American pharmaceutical company Purdue Pharma intensely emphasised OxyContin in the middle of the 1990s, claiming that it supplied long-lasting pain relief with little chance of feeling addicted (NDIC, 2001). In reality, the company’s business plan strongly undervalued the drug’s potential for addiction (GAO, 2003). In 1996, the U.S. Food and Drug Administration (FDA) sanctioned OxyContin, encouraging its widespread distribution (NDIC, 2001). Shortly then, doctors began dispensing it abnormally, and illegal reselling spread. In a large number of states by the early 2000s, where medical professionals did little oversight, “pill mills” began cropping up (NDIC, 2001). The country’s opioid dependency and overdose deaths increased substantially as a direct result of the overprescription of the drug. The high potency and simple access of the drug resulted in what would become referred to as the first major wave of the opioid epidemic in the United States. Communities in rural and poor America witnessed climbing mortality rates, family breakdown, and a rising stigma regarding addiction.

By comparing each drug type and observe the cause of death from these drugs, we see the trend of drug overdose.

Around 2010, there was a third major surge that surfaced in the U.S.A. Showing in the graph above, a new drug category called synthetic opioid, known as fentanyl, started increase rapidly (Ciccarone, 2021). Fentanyl was legally manufactured at low prices and purchased in large amounts, in comparison with OxyContin, which constituted a controlled prescription drug (Ciccarone, 2021). Following the FDA’s decision in 2013 (U. S), the FDA removed approval for the original OxyContin formulation. Many opioid users switched to fentanyl as a substitute. The result was catastrophic. According to FDA (2013), just a few milligrams of morphine can result in death. Fentanyl is 50 to 100 times more powerful than morphine (DEA, 2024). Dosage control became almost impossible owing to its high potency, which prompted accidental overdoses to fluctuate. By the late 2010s, fentanyl became the primary cause of drug overdose deaths in America (Ciccarone, 2021). This third wave differed from the first two since it was driven by synthetic drug manufacturing and international trafficking networks instead of war or prescription marketing. These three historical booms, which also include Vietnam War’s heroin use, the 1990s’ prescription opioid boom, and the 2010s fentanyl explosion, plot the evolution of America’s drug crisis from corporate exploitation to industrialized addiction on a global scale.

The United States’ history of drug abuse is neither random; it has been driven by global trade, industry, and war. In the 1990s, OxyContin and its false promise of “safe” pain relief were prescribed to a generation of soldiers during the Vietnam War; in 2010, they encountered the deadly rise of fentanyl. The nation’s dependence and loss are exacerbated by each wave as it builds on the previous. About 57 per cent of all global drug deaths are still triggered by Americans, which produces an international pattern from a domestic crisis. What began as a medical issue has grown into a product of corporate greed, policy failure, and social inequality. The drug epidemic is not only murdering bodies; it is additionally outgrowing the moral and structural foundation of American society, despite the fact that it was just one story out of millions.

Reference list:

Centers for Disease Control and Prevention. (n.d.). Provisional drug overdose death counts. National Center for Health Statistics. U.S. Department of Health and Human Services. Retrieved October 30, 2025, from https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

Ciccarone D. The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Curr Opin Psychiatry. 2021 Jul 1;34(4):344-350. doi: 10.1097/YCO.0000000000000717. PMID: 33965972; PMCID: PMC8154745.

National Drug Intelligence Center. (2001, January). OxyContin diversion and abuse: Background. U.S. Department of Justice. https://www.justice.gov/archive/ndic/pubs/651/backgrnd.htm

Stanton MD. Drugs, Vietnam, and the Vietnam veteran: an overview. Am J Drug Alcohol Abuse. 1976;3(4):557-70. doi: 10.3109/00952997609014295. PMID: 1032764.

United States General Accounting Office. (2003, December). Prescription drugs: OxyContin abuse and diversion and efforts to address the problem (GAO-04-110). U.S. Government Printing Office.

U.S. Food and Drug Administration. (2013, April 16). FDA actions on OxyContin products, 4/16/2013. U.S. Department of Health and Human Services. https://www.fda.gov/drugs/information-drug-class/fda-actions-oxycontin-products-4162013

U.S. Drug Enforcement Administration. (2024). Fentanyl: Drug fact sheet. In Drugs of abuse: A DEA resource guide (2024 ed.). U.S. Department of Justice