Opioid-related mortality in the United States has soared in the past two decades. A combination of institutional shifts in approaches to pain management, widely publicized unscrupulous marketing and prescribing practices, and increases in the availability and heightened potency of illicit opioids has resulted in such broad loss of life that the US has seen a decrease in the national life expectancy two years in a row. The peak of the HIV/AIDS crisis resulted in a one-year drop in life expectancy in 1993, but a multi-year drop has not been seen since 1963, with the occurrence of the Hong Kong H3N2 influenza pandemic.

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