The History of the Opioid Epidemic

Introduction

From 2019 to 2020, there were nearly 30 percent more people dying from drug overdoses, which is a quintuple increase from 1999. An opioid was involved in nearly 75% of the 91,799 deaths caused by drug overdoses in 2020 (Li et al.). There were significant shifts in opioid-related death rates from 2019 to 2020, for instance, the number of deaths caused by opioids rose by 38 percent (Li et al.). Furthermore, the number of deaths caused by prescription opioids rose by 17 percent (Li et al.). Moreover, the number of deaths caused by heroin decreased by 7 percent while excluding methadone, the rate of deaths involving synthetic opioids rose by 56 percent (Li et al.). The opioid epidemic is caused by the increase in deaths from overdose of prescribed opioids, heroin overdose since 2010, and synthetic opioid overdose since 2013.

Increase in Deaths From Overdose of Prescribed Opioids

The rise in deaths arising from opioid overdose can be described in three waves. Overdose deaths involving prescription opioids (methadone and natural and semi-synthetic opioids) have been rising since at least 1999 when the first wave began with an increase in opioid prescribing in the 1990s. In “Generational trends in US opioid-overdose deaths” Hall et al. describe the opioid epidemic as an unfolding predicament: “Deaths from opioid overdose in the USA have followed three distinct waves that have all affected baby boomers, generation X, and millennials” (651).

Doctors started prescribing more opioids in the 1900s and assuring patients that these drugs would not cause problems and that they would not be addictive. They even attempted to calm communities but opioids, like this false information, quickly. When people discovered that the drugs came with a feeling of euphoria, it did not take long for them to start abusing them. Even those who did not intend to abuse their prescriptions ended up physically dependent on the drug and were unable to stop using it.

OxyContin was approved by the Food and Drug Administration (FDA) in 1995. Purdue Pharmaceuticals is the manufacturer of OxyContin, an extended-release medication. Again, this drug was sold to the general public with false claims that it was not as addictive as other options, which was also incorrect. The “pain as the 5th vital sign” campaign was launched shortly thereafter. Along with temperature, pulse, respiratory rate, and blood pressure, this campaign promoted pain as a vital sign. This was a problem because pain is subjective and cannot be measured the same way. More patients started taking opioids to lessen their pain as a result of this campaign.

Heroin Overdose

During this time, many people began to scrutinize doctors for their opioid use, and prescriptions decreased. Unfortunately, many addicts turned to heroin because they needed a prescription for their addiction. They were able to control their withdrawal symptoms and achieve the same effect as when they were taking prescription drugs by using heroin. According to Gardener et al., “the US opioid crisis came in three waves – prescription opioids, heroin, and illicitly manufactured fentanyls – Centers for Disease Control and Prevention Centers for Disease Control and Prevention resulting in the deaths of nearly 500,000 people from 1996 to 2019” (43). It is unfortunate that heroin is known to be even more addictive than other opioids and can be mixed with other substances thereby increasing its danger.

Drug overdose deaths in the US outnumbered automobile-related fatalities in 2009. Narcotic excess deaths added to the reduction in life expectancy for Americans from 78.8 to 78.5 from 2014 to 2017 (Gardener et al.). Pharmaceutical companies promoted the growing perception that pain was an undertreated condition, which led to an increase in the overprescribing of schedule II prescription opioids. The number of prescriptions for opioids reached a peak of 255 million in 2012, and there were more than 11,000 annual deaths (Gardener et al.). Prescription opioid abusers were typically white, male, and between the ages of 45 and 55. Appalachia and the Northeast were the states that were hit the hardest.

Users turned to heroin after OxyContin, the most popular prescription opioid, received a formulation that was resistant to abuse. Gardener et al. acknowledge that: “Heroin the primary opioid of abuse and only a few countries – including Canada, Germany, Austria, and Belgium – have experienced a significant increase in prescription opioids” (44). Beginning in the early 1980s, a new Mexican method of trafficking black tar heroin via pizza delivery began to spread to many of the states that had been hardest hit by prescription opioids.

Synthetic Opioid Overdose

The synthetic opioid fentanyl was the focus of the third opioid epidemic wave that began in 2013. Due to the strength of fentanyl, the third wave of the opioid epidemic is frequently cited as the most dangerous. Fentanyl is extremely potent even at low doses because it is 50 to 100 times stronger than morphine. Fentanyl is frequently used to treat severe pain, particularly cancer-related pain. It is mostly used in hospitals rather than being prescribed.

In “Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017″ Scholl et al. say, “…the current wave of the opioid overdose epidemic has been marked by increases in deaths involving synthetic opioids…” Sadly, a lot of drug dealers will cut their drugs with fentanyl to get a stronger effect without spending a lot of money. As a result, an increasing number of people are being overdosed. Overdosing greatly increases when a person is unaware that a drug contains fentanyl. This is because even low doses of fentanyl are potent and it quickly leads to overdose if taken in large quantities.

Over 20,000 people died from fentanyl and other drugs in 2016, the greatest increase in drug-related deaths. Illicitly manufactured fentanyl—not diverted medical fentanyl—used to replace or adulterate other drugs of abuse has been linked to the rise in fentanyl-related deaths (Scholl et al.). The US CDC issued comprehensive guidelines for prescribing opioids for chronic pain outside of cancer treatment, palliative care, and end-of-life care to minimize risk and maximize the benefits of available pain treatment options. According to these prescribing guidelines, non-opioid treatments should be used first to treat chronic pain (Scholl et al.).

Opioid medications should only be added after careful pain management evaluations and ongoing assessments of their necessity. The pharmaceutical industry has used lobbying and advocacy groups to indirectly intervene against efforts to alter opioid prescribing patterns (Scholl et al.). These efforts include attempting to thwart efforts to hold prescribers and pharmaceutical companies accountable, attempting to undermine the CDC guidelines, and attempting to halt measures to restrict opioid overprescribing.

Counter-argument

There has been a significant increase in deaths resulting from opioid overdose since 1999. However, the Centers for Disease Control and Prevention (CDC) is committed to eradicating the opioid overdose pandemic and assisting states and communities in their ongoing efforts to identify outbreaks, collect data, respond to overdoses, and provide medical attention to residents. Overdose Data to Action (OD2A) is a four-year cooperative agreement in which the CDC provides funding for surveillance and prevention efforts to health departments in 47 states, Washington, D.C., two territories, and 16 cities and counties. As by Shoemaker-hunt et al., there are actions underway whose: “Research objective to address the opioid overdose epidemic, the Centers for Disease Control and Prevention (CDC)…” (57).

These endeavors incorporate more ideal following of nonfatal and lethal medication gluts, and further developing toxicology to all the more likely track polysubstance-involved passing. Furthermore, upgrading linkage to focus on individuals with narcotic use problems and the chance for narcotic excess and further developing physician-endorsed drug-checking programs. Lastly, carrying out well-being framework mediations, collaborating with public security, and executing other imaginative reconnaissance and anticipation exercises.

Conclusion

The increase in the deaths from overdose of synthetic opioids since 2013, prescribed opioids, and heroin overdose since 2010 are the main causes of the opioid epidemic. The above-mentioned reasons are also identified as the three waves of the opioid epidemic. Despite the many deaths arising from this predicament, the Centre for Disease Control and Prevention is having plans underway to ensure that the millennials and generations to come will be saved from this ordeal. Therefore, the CDC focuses on monitoring trends, advanced research, building tribal, state, and local capacity like OD2A, supporting payers, providers, and healthcare systems, and increasing public awareness. Ultimately, the epidemic will be dealt away with by creating more awareness among the people and avoiding misinformation.

Works Cited

Gardner, E. A., et al. “The Opioid Crisis: Prevalence and Markets of Opioids.” Forensic Science Review, vol. 34, no. 1, 2022, pp. 43–70.

Hall, Wayne, et al. “Generational Trends in US Opioid-Overdose Deaths.” Nature Medicine, vol. 26, no. 5, 2020, pp. 651–652. Web.

Li, Zehang Richard, et al. “Suspected Heroin-Related Overdoses Incidents in Cincinnati, Ohio: A Spatiotemporal Analysis.” PLoS Medicine, vol. 16, no. 11, 2019. Web.

Scholl, Lawrence, et al. “Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017.” MMWR. Morbidity and Mortality Weekly Report, vol. 67, no. 5152, 2018. Web.

Shoemaker‐Hunt, Sarah, et al. “The Effect of Health Systems’ Opioid Quality Improvement (QI) Efforts on Prescribing Practices: Findings from the CDC Opioid QI Collaborative.” Health Services Research, vol. 56, no. S2, 2021, pp. 57–58. Web.

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