The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis

The economic and social costs of the opioid crisis are enormous, with estimates approaching $80 billion per year. Estimates to address it range from $60 billion for treatment over the next 5 years (Simmons, 2017) to $100 billion for a multi-pronged approach to prevention, treatment and community resilience efforts (Katz, 2018). The opioid epidemic is the latest phase of a multi-decade increase in drug-related mortality (Jalal et al., 2018). With overdose deaths increasing steadily since 1979, regardless of the primacy of any particular drug, more resolve is needed to address the structural determinants of this relentless epidemic.