In 1991 the opioid epidemic began, and dangerous opioids were introduced to the U.S. at a profound rate and quickly took the lives of many. Shortly after, opioid related deaths started to rise exponentially because doctors and pharmacies were overprescribing opioids to people who were not in need of them, and without telling them the risks of addiction.
Why I Am Interested
I chose the opioid epidemic for my research project because I wanted to further understand the impact that this crisis has had on the United States. Recently I watched a 60 Minutes three-part investigation about who is responsible for the start, and rapid progression of the opioid epidemic. While watching this 60 Minutes docuseries, I thought about how easy it was for extremely addictive drugs to be distributed and prescribed, and how it should have been prevented.
To further understand my topic, I will ask a couple of research questions. First, how did the problem get to where it is today? To follow up on that question, I will need to ask who is responsible? Finally, what is the state of the opioid crisis today and what is its impact? To begin my preliminary research I went back to when the problem first started, in the early 1990s.
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History of the Opioid Epidemic
Starting in the early 1990s the opioid epidemic was a huge drug crisis that hit the United States causing millions of Americans to become addicted to dangerous narcotics. Opioids are a type of drug that is found in the opium poppy plant (NIH). Opioids come in two forms, either naturally from the plant, or synthetically produced to mimic the natural forms’ effects (CFR). Opioids are used to help with pain relief and create a more relaxing feeling throughout the body. Though they do have positive effects like helping people control their pain and promote relaxation. There are also negative effects because opioids are heavily addictive which unfortunately causes people to become dependent on them, and as a result, people transition to other drugs (NIDA). Many people that were prescribed opioids became addicts to not only the legal opioids like oxycodone but also the illegal and much more dangerous opioids like heroin. Heroin is not only a much cheaper alternative, but it is also very accessible.
The widespread use of opioids in the late 1990’s began due to one leading factor which is the overprescription of legal opioids such as, oxycodone, hydrocodone, and morphine. Doctors who were overprescribing opioids were displaying unethical business practices because they promised their patients that opioids were not addictive and a quick fix to their pain (Brand). After opioids were introduced in the 1990’s they began to pick up popularity across the country and shortly after were found in the hands of those who had anywhere from moderate to severe pain. Opioids were first used as pain relief for patients in recovery from surgery or cancer treatments. Then doctors started prescribing opioids to almost any patient complaining about the pain they were experiencing, this included complaints about common pains most people experience like joint and back pains. Due to the increasing number of patients on prescribed legal opioids in the mid to late nineties, the number of people addicted to illegal opioids was increasing as well. Patients had less caution taking opioids because they were told that these drugs were harmless. In many cases, after taking opioids people got addicted, and they longed for the feeling of freedom from their pain. To ease their addictions, the easiest way to get more opioids was to buy illegal and cheaper opioids like heroin instead of oxycodone which is much more expensive and usually requires a prescription. In a study done by the New York Times, they found that “A large proportion — 80 percent by one estimate — of heroin users in the United States previously used prescription opioids. In some cases, they were directly prescribed narcotic pain relievers, perhaps after a painful dental procedure or operation” (Frakt). The opioid epidemic in this country primarily started because people were getting addicted to prescribed opioids, by doctors, but grew into much more than that once addicts started to want more from their opioids and realized that there are cheaper and more accessible alternatives.
In the past, there have been some approaches to solve the widespread opioid addiction problem in the United States. One of the most common approaches was to cut people off from prescriptions completely. This was in hopes that this would stop their dependency from the drugs. Unfortunately, this strategy did not work too well, being that it did not decrease the number of deaths due to opioids at all, and it only decreased access to opioids for the people who were already patients (Austin). This strategy did not take into account all the people who were getting opioids illegally or from a second-hand source. Some other strategies include the signing of the Comprehensive Addiction and Recovery Act, and of the Synthesis Tracking and Overdose Prevention Act into law. These tried to help stop the trafficking of illegal drugs into the United States (ProQuest). These acts did help cut down the amount of drug trafficking a little bit but did not stop it completely. Though there have been efforts made in the past to prevent the growth and popularity of legal and illegal opioids in the United States, none have been too successful, being that deaths due to any opioid have risen every single year since 1999 (NIDA). Opioid addiction is a huge problem in the US and unfortunately, not much progress has been made in the past to help put an end to this nationwide crisis.
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Present Day Problem
Opioids have made a very prevalent impact in today’s society, with the most amount of deaths per day due to opioids that have ever been recorded in history. In a study done by the Centers for Disease Control and Prevention, it showed that there are an estimated 115 deaths per day from opioids, with 40 percent of them being from prescribed opioids. Those deaths compared to the deaths in 1999 are four times as many per day (NEJM). This is partly due to the fact that patients in hospitals experiencing severe pain have incredibly easy access to legal opioids. Many doctors across the country are prescribing opioids to people who don’t necessarily need them, just so they can make quick money, and make their jobs easier by solving a person’s pain quickly, but not correctly. Some doctors are overprescribing opioids to patients which is dangerous because 20 to 30 percent of patients who have prescribed opioids from a doctor for chronic pain will end up misusing them (Melemis). Though opioids have been proven to be helpful to stop pain for people with chronic pain, and certain cancers, they are not a great long term solution for pain. Opioids cause extreme dependency for people because of its addictiveness, which is difficult for people to break free from. When people stop taking opioids they usually experience withdrawals which, fortunately, the systems are not life-threatening just uncomfortable. Many common side effects of a withdraw include vomiting, diarrhea, insomnia, and anxiety, which makes it even harder for people to try and stay clean (Melemis). Opioids are telling people’s bodies that they still need the feelings the drugs give them in order to function.
There are many efforts being made by both organizations and people to help put an end to the opioid crisis in the United States. One of the most notable efforts being made to decrease opioid deaths is Narcan. Narcan, also called Naloxone is a medication that fights the effects of an opioid overdose. It is estimated that Narcan has saved an estimated 27,000 lives since they have started being sold in pharmacies (CDC). Narcan sells a nasal spray that can be found at almost all pharmacies across the US and can be bought over the counter without a doctor’s prescription. Narcan is one of the best efforts made so far to help opioid addicts from dying due to an overdose. Different efforts to try and stop the opioid epidemic have made varying levels of success, and Narcan has been a leader in both help solve this problem and making it harder to solve. Narcan medication is an important part of saving peoples lives in an emergency situation, but not keeping them healthy after an overdose. A patient who has been recently discharged from the hospital after an overdose has a one out of ten chance of being dead within the next year (Weiner). After people use Narcan there are no cheap programs set in place for addicts to make sure they stay safe.
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Currently, in the U.S the opioid epidemic is far from over, there is an all-time high of deaths from opioid overdose in this country. Roughly 20 to 30 percent of people misuse their prescribed opioids, and because opioids are a gateway drug around five percent of users transition to heroin (NIH). Though those statistics are scary and overwhelming there are actions that can be made to help save people’s lives and put an end to the opioid epidemic.
Part of the solution to the opioid epidemic that anybody can help with, is purchasing Narcan nasal spray. Narcan nasal spray is sold at almost all local pharmacies such as CVS, or Walgreens, and can be bought without a prescription from a doctor. When somebody is overdosing the Narcan nasal spray is placed in their nostrils and a button is pushed that releases a drug into their nose that helps keep them alive by fighting the effects of the overdose. After Narcan is injected into the user who has overdosed they must immediately go to the hospital, because Narcan is just a short term solution. If more people were to carry around Narcan in their bag or buy it for somebody who is in a situation more in need, a lot more lives could be saved. Another big part of the solution to the opioid epidemic is the US Center for Disease Control otherwise known as the CDC. The CDC is trying to put a stop to the opioid crisis by helping spread awareness across the country, they meet with healthcare systems and opioid providers, and supporting states in the U.S. who have taken action themselves to prevent opioid overdoses and addiction (CDC). To support the CDC you can donate money to their foundation. The CDC and medications like Narcan are steps in the right direction towards ending the opioid crisis, but they are not the complete and only solutions to the opioid epidemic, there is still a lot more work and efforts to be made to help current addicts and prevent new users.
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