The Evolving Epidemic
The opioid epidemic has been an ongoing issue since the 1990s. From 1999 to 2019, nearly 500,000 people died from an opioid overdose.
The epidemic started with prescription opioids, then moved to heroin, and is now fueled by fentanyl. Here we will break down each outbreak individually and see how they contribute to this ongoing epidemic.
Prescription opioids are used to treat moderate-to-severe pain. They typically get prescribed after an injury or surgery but can also be prescribed for health conditions like cancer. They became more accepted and were prescribed for back pain or osteoarthritis, even though health risks accompany the use. Over time, people become addicted and build a tolerance, meaning they need more to achieve the same effects. Those who become physically dependent on them experience withdrawals if they stop the medication. Their pain tolerance decreases, the result of which is that the person becomes extremely sensitive to pain.
Purdue Pharma admitted they would market and sell their opioids, such as OxyContin, to healthcare providers who were diverting them to well-known abusers. They also admitted they made payments to two doctors through their doctor speaker program to persuade them to write more prescriptions for their products. Purdue also fraudulently increased the amount of production they were permitted to sell. They also paid kickbacks to providers to encourage them to prescribe even more of their products. This resulted in more people becoming highly addicted to their products.
Between the mid-1990s and 2010, there was no infrastructure for prescriptions to be shared between different pharmacies. This meant that users could go from state to state and accumulate excessive pills and then turn around and sell the rest. After that, the US state and federal agencies cracked down on the distribution and availability of opioids. Heroin’s popularity increased because it was easier and cheaper to get than prescription opioids.
Heroin became the quick, cheap fix to the lack of prescription opioids. Heroin is a highly addictive opioid derived from morphine. When heroin is injected, it enters the brain and causes a fast and intense high. The longer someone uses heroin, they develop a tolerance to it, causing them to use more to achieve the original high. When someone is withdrawing from heroin, they can experience highly uncomfortable and painful symptoms, causing it to be even more challenging to quit. They can have muscle and bone pain, cold flashes with chills, diarrhea, vomiting, restlessness, trouble sleeping, and intense cravings for heroin. When people fear withdrawal and have a high tolerance, the risk of overdose increases. Heroin continues to be an ongoing issue, but the newest opioid problem is now fentanyl.
The latest wave in this epidemic is fentanyl. Fentanyl is causing an uproar because of its potency and its deadly effects. Fentanyl is 50–100 times more potent than heroin, and it is also 90% cheaper than heroin. There are two types of fentanyl; pharmaceutical fentanyl and illicitly manufactured fentanyl. They are both considered synthetic, but the illicitly manufactured fentanyl is the cause of the most recent cases of fentanyl overdoses. One kilogram of fentanyl has the ability to kill 500,000 people, and 2mg of fentanyl is considered a potentially lethal dose. The other issue fentanyl is causing is that it is being used to lace other drugs such as heroin, methamphetamine, and cocaine because it is so cheap. This way, dealers can extend their supply and make more money. Pills are also being made to look as if they are one thing, but they really contain fentanyl. Because fentanyl is so potent and people are uncertain about what they’re buying on the streets, people are overdosing and dying, which is continuing this epidemic.
If you or a loved one are struggling with opioid addiction, reach out before it’s too late. There is a way to end this, and it starts by getting help.