America is struggling to win its battle against drug addiction.

Opioid overdoses jumped 30% from July 2016 to September 2017 in 52 areas across 45 states, the Centers for Disease Control and Prevention said Tuesday. Opioid overdoses increased in the Midwestern region by 70% over the same period and spiked 54% in the largest cities in the country. These figures provide an “early warning system” for health departments to coordinate a response, the report said. “This fast-moving epidemic does not stay within state and county lines,” it added.

The economic cost of the opioid crisis in 2015 was $504 billion, far higher than previous estimates, according to a recent report from The Council of Economic Advisers, part of the Executive Office of the President. That same year, over 33,000 Americans died of drug overdoses involving opioids, it added, more than quadruple the number who died in 1999 from the same cause. Opioids include prescription pills (including Vicodin and Oxycontin), as well as heroin and fentanyl.

Last year, President Trump officially declared the opioid crisis a public health emergency. “We will be bringing some very major lawsuits against people and against companies that are hurting our people,” Trump said. The president, however, did not allocate additional federal funds to fight the epidemic. The Centers for Disease Control and Prevention cited the overprescribing of opioids for pain management as a major cause of the escalation in deaths from overdoses.

The Way to Save Opioid Addicts | Moving Upstream

Who is affected the most by the epidemic?

• The rate of drug overdose deaths in the U.S. in 2015 was more than 2.5 times the rate in 1999, due to a fall in the price of heroin and accessibility to prescription drugs.

• Generation X and baby boomers fared the worse. Drug overdose deaths increased the most for adults aged 55 to 64, from 4.2 per 100,000 in 1999 to 21.8 in 2015.

• In 2015, adults aged 45 to 54 had the highest death rate from drug overdose at 30 deaths per 100,000. Deaths rose 3.5 times among non-Hispanic white Americans over the same period.

Why the surge in pain medication misuse?

People addicted to drugs are buying them on the street, as drugs like heroin are now often cheaper than other illegal drugs, and people with genuine need for pain medication leave drugs lying around or they develop an addiction to pain medication after being prescribed opioids for an injury or ailment, experts say. The Partnership for Drug-Free Kids launched a “Mind Your Meds” campaign three years ago with the aim of preventing 500,000 teenagers from abusing medicines by 2017.