Our history with opioid addiction can be traced back centuries, to the very first instances of poppy extract. Opium had been spread throughout Arabia, India and China by the eighth century. Rome kept a steady supply flowing through its markets, where you could get the stuff on the cheap. It was a revered substance, with spiritual and historical meaning. Over the centuries, opioids have continued to be a part of the human experience, however it’s only recently that the opioid crisis developed.
Today’s opioid crisis in the United States is a beast of a different kind. It is a nationwide epidemic, a sweeping sickness that has spread throughout the Midwest, Appalachia and New England, devouring many counties between those regions as well. And it all began at some point in the 1980s.
Before we knew better, the potential for opioids as a force for good outweighed their risk for developing an addiction. The potency for prescription drugs to help victims of chronic pain encouraged the study and publishing of several influential studies promoting the use of prescription drugs in beating pain. The result was a monstrous influx in the production of prescription opioids and their advertising – drug companies began pushing the public to take pain meds for every ill, until tighter regulations forced those companies to turn to doctors to aggressively push for the drugs instead. For a while, opioids were sold more in the US than at any other point in history, anywhere in the world.
It didn’t take long for the effects to become apparent. An influx of opioids led to an influx of addiction – and a harsh reaction as the opioid crisis took hold. Opioid prescription medication became more harshly regulated, leading to thousands of cases of overdose as people stopped abusing prescription drugs and started abusing heroin instead.
Most chronic pain patients do not get hooked on their medication. But enough do that the opioid crisis came into full swing. The death toll for drug overdoses in 2015 was around 52,000, rising to about 60,000 by the next year. To understand this better, and to see where it’s gone and where it’s going, it’s important to take a step back and look at what an opioid is.
What Are Opioids?
Any substance that acts on the opioid receptors in the brain can be an opioid. Opioids bind to certain receptors in your brain cells and cause a massive release of dopamine, numbing the pain and creating a feeling of euphoria. Most who have experienced this might have had an injection of morphine in the ER. Heroin, which accounts for many of the more recent drug overdoses in the crisis, is about three times as powerful as hospital morphine.
Our history with opioids began with opium, the latex (or sap) of the poppy plant. Recently in human history, we began to derive drugs from opium, specifically substances like morphine and codeine. The prescription painkillers we know today – Vicodin, OxyContin, Percocet – are all opiates, in that they contain opioids.
Methadone and fentanyl are also opioids, yet are not derived from opium, or any other form of poppy. They are entirely synthetic, made in laboratories (much like synthetic cannabinoids have no direct connection to the cannabis plant).
The trouble with opioids is that while they provide incredible relief from pain and quite literally make us happy, they are also extremely addictive. The brain very easily grows used to the effects of opioids, making it hard to feel pleasure in any other form – while continuously making it harder to stay off the stuff. This high level of adictiveness if part of what turned the opioid crisis into a true epidemic. After a while, any attempts to stop taking opioids will cause you to undergo painful symptoms of withdrawal for anywhere between a few days to several weeks. For most long-term users of heroin and other powerful opioids, the cravings for opioids even after sobriety never truly end.
Here’s Why The Opioid Crisis Developed
It’s been mentioned that the crisis began with the influx of prescription medication, but it has changed form several times since that. Today, most opioid-related drug overdoses are through heroin and fentanyl use – fentanyl caused the biggest spike in nationwide drug use as the opioid crisis raged on. It is a synthetic opioid several dozen times more potent than heroin, and thus several dozen times more dangerous. Because of its potency, it became easy to mix into existing batches of heroin to sell on the black market, getting people hooked faster than ever before.
A sudden growth in prescription drugs was the origins for the opioid crisis, but the driving factor was the growth of the international heroin market. Heroin from Mexico and fentanyl from China can be attributed to most of the opioid crisis related drug abuse in the country nowadays, as prescription drugs are harder to get.
While the flow of prescription opioids has been massively decreased, the effect on the opioid crisis of hefty opioid regulations led to a jump in heroin usage, while still leaving enough prescription medication out there to contribute to the rising number of addicted patients and relatives. Fentanyl can be traced to the biggest increases in the use of opioids during the opioid crisis. However, the solution is not as easy as banning all opioids and cutting off every prescription for opioid-related medicine.
Finding A Solution To The Opioid Crisis
There is no easy answer to America’s opioid crisis. The United States consumes over 80 percent of the world’s supply of opioids, and much of that is owed to when the opioid crisis first began in the 80s and 90s. But despite both heroin and fentanyl being illegal, drug overdoses from these two substances continue to be on the rise. Prescription drug overdoses did not disappear, either – they only slightly diminished.
Incarceration is not a very good answer, and neither is simply pursuing a crackdown on the manufacturing and importing of these drugs. Fentanyl is problematic, as its synthetic nature means it is extremely hard to trace to an origin point.
The solution lies in finding alternatives for existing patients of chronic pain to help prevent the opioid crisis from spreading, while making mental healthcare and addiction treatments more available and affordable to all. Varied addiction treatment, from residential treatment to sober living facilities, will be needed to help patients cope with their situation in whatever way works best for them.
A greater public sympathy towards mental illnesses and addiction will be necessary to help those struggling with such conditions seek a place in society where they can be open about their problems without judgment, and find a way to overcome them. And finally, opioids will continue to be important in medicine. They are massively important in relieving acute pain in the ER and on the operating table, and can help people with cancer cope with the pain of their therapies.
This is just one answer, and there are many others with good points and solid logic. But one thing is universally true: we must all move forward and move past this crisis with a better understanding of addiction and public healthcare.