America is one of the most unique countries in the world. The American economy is the largest in the world and the country is the richest nation in human history. America's defense spending is higher than the next several countries put together, and the U.S. military the capability to project power in any region in the world. American industry has pioneered disruptive technologies such as the Internet and the semiconductor - both of which have shaped the world as it is today.
However, at the same time, some problems are uniquely American as well. For instance, America has the highest rate of gun violence in the world. And, the American healthcare system is known for its high costs. At the same time, one of the worst prescription drug crises in modern history also originated in the U.S. This is the renowned opioid crisis, which saw doctors prescribe highly potent painkillers to patients only to see them become addicted to the medicine instead. In fact, while opioid misuse is quite well known in America, a little known fact is that Americans consume 80% of the world's opioids even though America represents roughly 5% of the world's population.
The opioid crisis also led to one of the largest court settlements in American history (another unique fact about the U.S. is a tough legal system). This settlement was made by the consulting firm McKinsey after it was discovered that it had advised drug makers to turbocharge their sales of addictive drugs to the market. Analysis of court documents filed against McKinsey showed the consulting firm's work with the OxyContin maker Purdue Pharma to incentivize retailers to stock up on more pills. After Purdue found out that Walgreens had reduced its prescription pill inventory, McKinsey reportedly advised Purdue to lobby the pharmacy chain to stock more products. At the same time, McKinsey also developed a multi pronged strategy to boost OxyContin sales. This included lobbying doctors who were already prolific prescribers of OxyContin to push out even more pills, and if they refused, then build up the pressure through patients to force the doctors to comply. Additionally, and as if this weren't enough, McKinsey also advised its client to offer distributors a rebate for every overdose on a pill they sold. This naturally not only encouraged the distributors to supply more pills but also countered a potential ethical dilemma with a financial incentive.
The end result led to McKinsey agreeing to pay nearly $600 million to 47 American states to redress the harms that had resulted from its devastating strategies. This massive figure indicates the scale of the opioid crisis. Just as 80% of the world's opioids are used in the U.S., most of the drug deaths in America are also due to these deadly pills. Data from the Centers for Disease Control and Prevention (CDC) shows that there were 91,799 drug related deaths in America in 2020 - out of which 70% are related to opioids. This also opens up a massive market to treat opioid abuse disorders. According to research from Future Market Insights, this market will be worth $3 billion by the end of this year. From then until 2030 the market is expected to grow at a compounded annual growth rate (CAGR) of 10.5% to be worth $8.4 billion by the end of 2033. This growth rate makes the market one of the few that will see an accelerated growth rate in the future, as the research firm shares that between 2018 and 2022 the industry had growth by 7.89%.
Currently, there are three medications that help people wean away from their opioid addiction. These are Methadone, Buprenorphine, and Naltrexone. Out of these, Buprenorphine received renewed attention recently after the FDA approved Brixadi, an injectable form of the drug. Another drug called Opvee is a nasal spray designed to combat opioid overdoses.
Another firm that recently agreed to a settlement related to opioids is Teva Pharmaceutical Industries Limited (NYSE:TEVA) and management shared details about it in a recent earnings call where it outlined:
I also want to provide you with an update on the progress with the nationwide opioid litigation settlement.
With these details in mind, let's take a look at the U.S. cities with the greatest opioid deaths.
To compile our list of American cities with the highest number of opioid deaths, we used data from Drexel University's Big City Health Coalition to choose American cities, large and small, rich and poor, with the largest rate of opioid-related deaths per 100,000 people. The data is irrespective of race or gender, and it is compiled using the CDC's data.
Cities with the Highest Opioid Deaths in the U.S.
20. New York City, New York
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 16
New York City is America's largest city in terms of population with 8.8 million people. Despite this, it ranks on the bottom of our list of the twenty American cities with the highest number of opioid overdose deaths.
19. Portland, Oregon
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 16.6
Portland is the largest city in Oregon and has more than six hundred thousand residents. It is an important port city, which handles millions of tons of cargo each year.
18. Seattle, Washington
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 16.9
Seattle is a major city in the American Northeast. It has rapidly emerged as a technology hub in its state and is known for having the headquarters of Amazon.
17. Denver, Colorado
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 21
Denver is the capital of Colorado and houses more than seven hundred thousand people. Its location makes it a transportation hub in its state.
16. Phoenix, Arizona
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 26.9
Phoenix is one of the largest cities in America through its population of more than 1.6 million people. It is also an economic hub and has headquarters of several Fortune 500 companies.
15. Minneapolis, Minnesota
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 27
Minneapolis is one of the smaller cities on our list despite being Minnesota's largest city. It has a variety of important banking and retail companies.
14. Boston, Massachusetts
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 29.5
Boston is one of the most prosperous and developed cities in America. It is a hub for the biotechnology industry and also has some of the largest and best hospitals in America.
13. Chicago, Illinois
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 32.6
Chicago is the third largest city in America in terms of population through its 2.7 million residents. It is also one of America's major business cities, but one that often suffers from high crime rates.
12. Tucson, Arizona
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 35.9
Tucson houses more than half a million people, making it one of Arizona's largest cities. It is also one of the oldest cities in America since it was set up in the late eighteenth century.
11. San Francisco, California
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 36.04
San Francisco is the technology hub in America, with most of the world's biggest technology firms either located in the city or near it.
10. Memphis, Tennessee
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 37.8
Memphis is the second largest city in Tennessee in terms of population, however, it ranks the highest in the state when it comes to the unfortunate statistic of high opioid abuse deaths.
9. Washington, D.C.
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 38.6
Washington, D.C. is the capital city of America. It has some of the highest costs of living in the U.S.
8. Indianapolis, Indiana
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 44.8
Indianapolis is the capital of Indiana and houses close to a million people. It is also a logistics and transportation hub in its state.
7. Milwaukee, Wisconsin
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 47
Milwaukee is the largest city in Wisconsin and has a diversified economy with several Fortune 500 firms.
6. Detroit, Michigan
Opioid-related drug overdose deaths (per 100,000 population, age-adjusted): 48.7
Detroit is the largest city in Michigan and an important player in the automotive industry.
