Overdosing in AL: Understanding the Opioid Crisis

by Shereda Finch, M.Ed. MPA

In Alabama, many individuals, families and communities have been impacted by the Opioid Crisis. As evidenced by reports of opioid overdose deaths across the state, it is clear that the Crisis does not discriminate based on race, zip code or economic status.

What is an Opioid?

Opioids are a class of drugs used to reduce pain. Prescription opioids are prescribed by doctors to treat pain. Some common types of opioids are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. Heroin is an illegal opioid and its use has increased across the country during the Opioid Crisis. Fentanyl is a synthetic opioid and is many times more powerful than other opioids. Fentanyl use is on the rise as the result of the drug being illegally produced across the country.

Chronology of the National Opioid Crisis

According to Governor Kay Ivey’s State Of Alabama Opioid Action Plan, the rate of overdose deaths increased by 82% from 2006 through 2014. During these years, 5,128 overdose deaths were reported in Alabama. In 2016, 741 overdose deaths were reported, representing a rate of 15.3 persons per 100,000.  The Center for Disease Control and Prevention states that prescription and illicit opioids, such as heroin, are the main driver of drug overdose deaths.

While opioid overdoses is not a new phenomenon, the increased rates of overdose deaths involving prescription opioids increased in the late 1990’s. Between 1999 -2016, over 350,000 Americans died from an opioid-related overdose- these included prescription and illicit opioids where naloxone was not used.[1] The CDC has identified the rise in opioid overdose deaths in three distinct waves:[2]


Contributing Factors to the Opioid Crisis in Alabama

The largest contributing factor to the spike in opioid overdose deaths in Alabama can be traced back six years ago. In 2012, Alabama was ranked number one in the nation for having the highest opioid prescription rate per capita with 143.8 prescriptions per 100 residents (almost over 7 million prescriptions). Although the prescription rate decreased in 2016, Alabama still had the highest prescription rate with 121 opioid prescriptions per 100 residents in the country, or an equivalent 1.2 prescription for every man, woman and child living in the state.[3]


Addressing the Opioid Crisis

For the past few years, various efforts have taken place across the state to address the Opioid Crisis. In August 2017, the Alabama Opioid Overdose and Addiction Council was created and tasked with developing a Strategic Plan to address the overdose crisis in Alabama. The Plan can be read at http://www.mh.alabama.gov/Downloads/CO/AlabamaOpioidOverdose_AddictionCouncilReport.pdf. Federal funding has also been secured by state departments implement opioid related initiatives including the following below:

To learn more about what the epidemic and access information and resources, visit The National Institute on Drug Abuse (NIDA) www.drugabuse.gov; Alabama Department on Mental Health (ADMH) www.mh.alabama.gov; Alabama Department of Public Health (ADPH) www.alabamapublichealth.gov; and Substance Abuse Mental Health Services Administration (SAMHSA) www.samhsa.gov; SODIL..

Shereda Finch, Med., is the executive director at the Council on Substance Abuse-NCADD and an adjunct professor in the Rehabilitation Studies Department at Alabama State University.


[1]Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov.

[2] Center for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/epidemic/index.html

[3] Center for Disease Control and Prevention: https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html.