For the first time in 50 years the US has seen a second consecutive fall in life expectancy, while fatal drug overdoses have leapt by 21%.
For the second year in a row the richest country in the world has posted a shocking decline in life expectancy.
It is the first time in half a century to see two consecutive annual falls in the US, mostly down to the opioid crisis. The last double rise was in 1963 when tobacco was king and there was a flu epidemic.
Fatalities jumped last year due to overdoses, many of them on prescription painkillers like OxyContin or Vicodin, now standing at 63,600 nationwide, a 21% increase on 2015.
The biggest problem is in West Virginia, a state which suffers from a decline in traditional industries like coal mining.
Donald Trump won the state with ease in the 2016 presidential election. Drug sales here have soared.
Drug wholesalers protest that they are not to blame as chemists and doctors are responsible for distribution. But critics point to the staggering amounts of opioids cleared for sale in the state. A report last year said that, ignoring rising overdose rates, over six years wholesalers pumped 780 million hydrocodone and oxycodone pills into West Virgînia, enough for 433 pills for every man, woman and child.
The out-of-state companies ensured places like Kermit, population 392, were supplied with nine million pills, all sold through one high street store. While corrupt chemists are part of the problem, they cannot sell what they do not have on the shelves.
Taking on giant pharma was a theme of Donald Trump's election campaign. He has gone quiet on it since entering the White House.