Overview of Problem
In the last twenty years, the progression of opioid abuse in the United States is alarming. According to TIME Magazine’s recent issue, “The Opioid Diaries,” over 64,000 Americans died from drug overdoses in 2016. Drugs classified as opioids include morphine, heroin, and prescription painkillers such as: Vicodin, Percocet, and OxyContin. Opioids release intense amounts of dopamine, a neurotransmitter that controls the reward center of the brain helping regulate pain and providing one with an intense feeling of euphoria. For this reason, opiates are highly addictive and often abused (Katz). In 2016, of the 5,376 total overdose deaths in individuals ages 15-24, 3,151 were a result of opioid overdose (NDA for Teens). In the 2017 New York Times article, “Opioids on the Quad,” author Kyle Spencer details the extent of this problem: “Opioid-related deaths among Americans twenty-four and under almost doubled from 2005 to 2015.” These statistics were shocking to me and intrigued me as to what I could do to educate others about the extent of opioid use on college campuses.
Through additional research, I discovered answers to my most pressing questions: How much of a problem is opioid use for college students? What factors may lead a student to become addicted to opioids? What role does peer pressure play in opioid addiction? How do students access opioids to feed their addiction?
In his New York Times article entitled, “Short Answers to Hard Questions About the Opioid Crisis” Josh Katz notes, “overdoses killed more people last year than guns or car accidents.” In fact, “31 women and 60 men die every single day as a result of opioids” (Brody). Opioid abuse in America is both a cultural and health issue. Because pain is stigmatized in our culture, people normalize taking substances to relieve any symptoms of discomfort. A recent Forbes article discusses the cultural factors that may lead college students to become addicted to opioids including: “an anything-goes approach to alcohol and drugs; high pressure; and lack of structure” (“Colleges Must Do More”).
The factors which led to the opium habit in “the civilized world” were “early uncurbed use of opium to deaden pain, lack of scientific knowledge of the danger…[and] the discovery that opium could be [used for non-medical purposes]” (Marks). Opioid use originated from the poppy plant at the time of Ancient Civilizations and spread through trade and migration. Specifically, artifacts from the fourth millennium B.C. of both Babylonia and Sumeria note the poppy plant and its “euphoric” and “medical” properties (Terry). Such knowledge passed down to the Turks and Arabs. Also, “Greek and Roman medical literature refers to [opium use]” (Terry). Arab traders brought opium to China in the early Seventh century A.D. The Chinese used the poppy as a cure for “dysentery,” severe diarrhea. Dutch traders brought opium from India along their trade routes. In 1773, English merchants from Calcutta took up the use of opium, and in 1781, the East India Trade Company expanded the use of opium through trade (Terry).
Throughout the 19th century both Europe and America used opium in treatment of many illnesses, and the overemphasis of opioid use resulted in the problem of addiction. With the smoking of opium in China, “[t]he first evidence of a social problem [of addiction] was found” (Terry). Wherever the Chinese migrated, the smoking of opium spread. Opium use was brought to the United States in the 1860s through Chinese migrant laborers.
The writings of important individuals and the results of battle further ignited the spread of opioid use and abuse. One of the first warnings about opium was in 1832 when W.G. Smith, a physician at the University of the State of New York, wrote his dissertation titled “The Opium Problem” detailing the dangers of unrestricted use of opium (Marks). Unfortunately, another author, Thomas De Quincey, increased the problem of addiction with his vivid account of the euphoric properties of opium. His writing “Confessions of an Opium-Eater” intrigued countless others to experiment with the drug (Terry). In America, opium use became widespread during the Civil War (Marks). Soldiers and those treating the wounded were in search of a relief to the agonizing pain of wartime injuries, and “after 1865 opium became known as the ‘army disease’” (Terry). World War One spread the use of opium to the participating countries of Germany, France, and Italy. Key to the increase of opioid use were scientific discoveries allowing for more potent forms of opioids and faster delivery methods. In 1845, the development of a hypodermic syringe allowed its users to directly inject opioids to the bloodstream for faster delivery (Terry). One of the most important events in the spread of addiction occurred in 1898 when a German pharmaceutical worker named Dreser discovered heroin. He falsely suggested the new formulation was not habit forming and useful in treating opioid addiction; as a result, heroin’s greater potency led to more addicts. Increased demand for more potent opioids led to drug trafficking, a key culprit to the expanse of addiction.
The history of the opioid crisis in America stems from many factors including changes in medicinal practice, pharmaceutical greed, and a misunderstanding of addiction. At the end of the 1800s, Bayer, an international chemical company, began distributing heroin for pain relief as well as cough suppression. By 1910 people became so hooked they resorted to crushing pills and inhaling them to get their fix (Elkins). In the midst of an addiction crisis, The Federal Bureau of Narcotics forbade opiates for all, even those with chronic pain, and the stigma of addiction lived on into the late 1900s. In 1973, the International Association for the Study of Pain was established, and the pain societies were advocating for pain relief with the belief that addiction could be prevented (Elkins). Successful in their efforts, by the late 1990s, pain was added as the “fifth vital sign” to be monitored by doctors in order to assess the state of a patient’s body functions. With newfound emphasis on pain relief in medicine, the makers of prescription drugs knowingly exploited the system. “The beginning of the opioid crisis can be traced back to the release of OxyContin, Purdue’s best-selling drug” (Lopez). Oxycontin was released to the market in 1996, and the pain relief movement spread. The company spent 207 million dollars to market the drug. The company also held many pain management conferences in vacation destinations to entice physicians into prescribing the drug to their patients (Elkins). Purdue misled patients and doctors into believing that the opioid, OxyContin was a non-addictive and beneficial way to deal with pain. Anna Lembke, author of Drug Dealer M.D., emphasises the industrialization of medicine also contributed to the pattern of overprescribing by physicians. This change moved physicians from private practices to large medical corporations where doctors saw roughly forty patients a day with less than five minutes per patient. As a result, patients received quick, short-term “fixes” as opposed to more thoughtful, long-term pain management to keep the “customers” happy. Most importantly, Lembke states that the “demonizing” of pain resulted in patients making incorrect assumptions of their ability to tolerate pain. The direct result of this greed and misinformation, caused countless more to become addicted to opioids. Clearly seen throughout its history, drug addiction is a disease, both a physical and mental in nature and the grasp of opioid addiction extends through all demographics.
On college campuses, intense social and academic stress leads many students to seek relief. In the height of the United States’ Opioid Crisis, such relief comes in the form of prescription medications. Dr. Robert DuPont, a psychiatrist who specializes in drug abuse, summarizes the problem, “[In college] you’re surrounded by people who are using alcohol and drugs in addictive ways. Someone else is paying the bills and there’s no supervision” (Wiltz).
In 2016, out of the total 5,376 overdose deaths for individuals ages 15-24, 3,151 were a result of an opioid overdose (NDA for Teens). On college campuses, prescription opioid abuse is concealed instead of being addressed. In fact, colleges are not required by federal law to report drug deaths unless the death results from a criminal offense (Korn and Kamp). Many colleges and universities choose to conceal the issue of opioid addiction in hopes of maintaining a clean school image (Godar). Despite the pattern of secrecy, some leaders and organizations are working to inform students, establish laws, and fund programs to deal with this crisis.
The path to recovery and awareness is not necessarily an easy one. On December 12, 2017, New Hampshire’s Congresswoman Carol Shea-Porter, secured unanimous support for an amendment requiring colleges and universities to adopt drug and alcohol abuse policies, specifically addressing the opioid crisis (US House of Representatives Documents). Shea-Porter stated, “Today, traditional college age Americans, those between the ages of 18 and 25, are at highest risk of abusing opioids… [her] amendment specifie[d] that [programs] must address opioid use with plans that support prevention, harm reduction, and recovery on campus” (US House of Representatives Documents). Unfortunately, former Congresswoman Shea-Porter’s efforts did not become a law. “This bill was introduced on July 25, 2018, in a previous session of Congress, but was not enacted” (H.R. 6535).
Sober dorms are what Dr. Robert DuPont describes as, a “major new development in the recovery movement.” He explains, “they’re unique because they get to the heart of the beast,” (Wiltz). Successful programs allow students to have their own space, while providing counselors to aid the students. Some programs also include courses where one can learn about recovery, wellness programs, and consistent check-in meetings. In contrast to the 35 recovery housing programs offered in 2012, there are currently 150 colleges across the United States that offer recovery housing including: Oregon State University, Texas Tech University, and Rutgers University (Wiltz).
An alternative option to recovery houses on university campuses, recovery schools, offer a community of supportive peers for teens battling opioid addiction; however, one challenge recovery schools face is unstable funding and questions about the quality of education they provide. Many advocacy organizations and researchers are working to help aid these schools but still more must be done. “The schools are funded in so many different ways that there’s uncertainty from year to year,” says professor Andrew Finch, board member of the Association of Recovery Schools (Godar). Some schools, such as Horizon High School, located in Madison, Wisconsin, are partnering with nonprofits that are focused on improving mental health of those addicted. Minnesota and Massachusetts have added grant funding for recovery schools. Congress has explored doing the same, but hasn’t done so yet (Godar). “And more than half of the 77 U.S. recovery schools that have opened since 1979 have closed, some after only two or three years” (Godar).
Although many people and organizations are working to solve the problem of opioid addiction on college campuses, there are places where their efforts fall short. Even though some universities recognize this issue, others choose not to address the problem. There is much more that can be done to educate students, spread awareness, and provide treatment for those addicted. It is important that universities address the problem of opioid consumption and addiction among college students. However, first, the leaders of colleges and universities must accept the reality that their students are indeed among those affected and step away from the, ‘Oh, no that’s not our campus. That’s not our kids’ mindset (Korn and Kamp).