While the total number of fatal drug overdoses nationwide has plateaued for six consecutive months, stimulants such as methamphetamine and cocaine have triggered the next wave of the addiction crisis.
In the 12-month period ending in March 2018, the Centers for Disease Control and Prevention (CDC) reported that overdose deaths from cocaine spiked 22% from prior year to 14,205.
Annual drug overdose data shows the addiction crisis has been developing for almost four decades, and the explosion in the rate of growth increased sharply after the financial crisis of 2007-2008 with the introduction of the opioid epidemic. In the 12-month period ending in March 2018, 46,655 people died from opioid overdoses, a small decline of 2.7% from the top of 47,944 in 2017.
Daniel Ciccarone, a professor at the University of California at San Francisco, told Bloomberg, CDC figures suggest the opioid epidemic is in its later stages. "We could interpret this as good news because the heroine cycle could be peaking or waning," he said.
According to the National Institute on Drug Abuse, cocaine overdose deaths could be connected to opioids. There has been a surge in drug users knowingly and unknowingly ingesting cocaine cut with synthetic opioids, which could explain the recent acceleration of cocaine deaths.
Historically, opioid epidemics are followed by a rise in the use of stimulants such as methamphetamine and cocaine, Ciccarone said. "As people's heroine habits deepen they grow increasingly tolerant, cocaine comes in as a booster -- the speedball."
"The system has set us up for failure," said one Baltimore junkie, who shoots up heroin in front of the camera, then overdoses before he can smoke his crack cocaine.
President Trump declared the opioid epidemic a national public health emergency in late 2017, saying that "we can be the generation that ends the opioid epidemic."
"This epidemic is a national health emergency," he said. "Nobody has seen anything like what is going on now."
He added: "As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction. Never been this way. We can be the generation that ends the opioid epidemic. We can do it."
In 2016, more than 2 million people in the U.S. reported receiving medical treatment for drug abuse, including prescription drug misuse, or for medical problems associated with illicit drug use. The health crisis extends into the broader economy, particularly in the Rust Belt and Midwest regions, are experiencing an addiction timebomb that detonated in the last two decades and has decimated the workforce.
"After 40 years of this predictable growth pattern, we can only hope that the curve is finally bending downward for good," Dr. Donald Burke, the dean of University of PittsburgGraduateate School of Public Health, wrote in an email to STAT.
The addiction is far from over and not limited to opioids, cocaine, and stimulants; methamphetamines are now killing more than 10,000 people a year, a surge that has only been observed in the last two years.
"Whether we're looking at cocaine or methamphetamine, we are seeing a crisis in the United States," said Ray Barishanksy, a deputy secretary at the Pennsylvania Department of Health.
Health experts have predicted that a turning point in America's drug epidemic would start with a gradual curve flattener and then the crest of the curve that measures fatal overdoses over time. However, turning points take time to construct.
America's addiction crisis is not over; total overdoses are still at record levels; a surge in cocaine deaths has triggered the next wave.