Donald S. Burke has little trouble finding a parallel with the opioid epidemic's surging death rates and elusive solutions: the early years of AIDS.
Burke led the U.S. Army's research on HIV/AIDS before and after powerful new medications converted a fatal infection into a chronic disease. He remembers the waves of sickness, barriers of stigma, and frustration of being a doctor with no idea what to do. That, he believes, is roughly where the U.S. is now in the fight against addiction.
"We as a medical profession and we as a society let the AIDS epidemic go from what was a few thousand to what grew to be close to 100 million cases around the planet," said Burke, dean of the University of Pittsburgh's Graduate School of Public Health, which conducts extensive research on addiction. "And I think we have to realize that we're on a trajectory that may get a lot worse before it gets better."
Just this month, in fact, newly released federal data showed more than 63,000 drug-related deaths in 2016 _ up 21 percent from the year before and the biggest one-year rise in three decades. Pennsylvania experienced the second-largest jump of all the states.
With substance abuse already a major issue from Philadelphia to the White House this year, the Inquirer interviewed experts in five areas of addiction. Each was asked the same basic questions: Where are we in this crisis? What's coming next? What has to change?
Perhaps the most optimistic comment, from A. Thomas McLellan, a top drug policymaker in President Barack Obama's White House, was this: "The medical community is at least aware that you can get addicted if you are in pain."
