If we date the current drug epidemic from the early 90’s (as most do), beginning with that big push to expand opioid use in healthcare, it’s clear we’re edging up to a fourth decade without a foreseeable end.

Does that seem possible? It does, given that something similar happened with the cocaine and crack epidemics. Just as one began to recede, a second wave emerged, with a  new crop of users from different steps on the socioeconomic ladder.

Were the experts ever surprised! But they probably shouldn’t have been.

Drug epidemics seem to follow a wave pattern. With opioids, prescription drugs led the way, fed to us by Big Pharma and the pill mills. Not unheard of; after all, heroin, scourge of the 20th Century, was a product of the Bayer company of Germany, initially marketed as a safer substitute for morphine.

The second wave came in the wake of new restrictions on prescription opioids. Those already addicted fled to the streets, and heroin. We should have seen this coming too, since it’s happened before. The  Harrison Narcotics Act of 1914 was intended to stop the spread of opium smoking, but also inadvertently snared thousands of war veterans who’d been maintained for decades on morphine by their personal physicians.

Now we find that fentanyl, a synthetic opioid designed for cancer treatment, has been co-opted as an adulterant or “cut” for a host of popular drugs — from heroin and coke to meth and benzos. Relatively small amounts can dramatically increase the risk of overdose. In many regions, those fatality numbers are once again climbing.

Even as we struggle to survive the above, there’s a push to revive a host of other drugs we’ve had problems with in the past– like LSD and the hallucinogens, and ketamine and MDMA, and whatever it is people are spraying on that plant material and calling it “synthetic marijuana”. It’s as if we can’t conceive of life without drowning ourselves in abusable substances. Even cannabis, once the least worrisome of drugs, is now repackaged in amped-up forms with largely unpredictable effects.

I hate to be a Cassandra, but things don’t look that bright. We’re even facing a shortage of addiction counselors, mostly due to retirement, just when we could really use a whole lot more of them.