The silver lining of America’s opioid tragedy

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The silver lining of America’s opioid tragedy
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The opioid epidemic is a national tragedy, but there is one small but significant silver lining: organ donations

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.

That, luckily, is becoming less of a problem. Thanks to new technology, it is easier to know whether a donor was infected with a disease. In the past, tests were not sensitive enough to pick upor hepatitis C if the infection had been acquired in the previous six months or so. The testing methods used today may miss only infections picked up in the previous week. And if they were infected, it matters less too.

As a result, more patients agree to transplants from donors who they know are infected. Last year, they included Robert Montgomery a transplant surgeon at the New York University Langone medical centre, who got a heart transplant from a donor who he knew had hepatitis C. Dr Montgomery became infected and then cured of the virus.

All this is good news for the 6,500 Americans who die on the waiting list for transplants each year—as well as for the 114,000 who are currently on the list, most of whom will not get lucky this year . And for some of the families bereaved by the opioids tragedy, the possibility that their loved ones may give a new lease of life to others may be a flicker of light in the darkness.

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