The silver lining of America’s opioid tragedy

The opioid addiction sweeping America is devastating. It kills around 60,000 people annually, far more than the number who die in traffic accidents or from gun violence. It has contributed to three years of falling American life expectancy—the first such sustained fall since the first world war. But there is one small but significant silver lining: organ donations. In 2017 one in eight deceased organ donors in America died from an overdose, compared to one in 100 in 2000.

Fatal drug overdoses usually kill by starving the brain of oxygen. As far as organ donation is concerned, brain death is the more useful kind. That is because it takes some time for the heart to register the loss of brain function and stop beating—at which point organs begin to deteriorate rapidly. Moreover, the opioid epidemic has been concentrated among younger middle-class people, who are in otherwise good overall health. “These are extremely high-quality organs,” says Dorry Segev, a transplant surgeon at the Johns Hopkins School of Medicine in Baltimore.

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