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Current Drug Issue: Opioids by Adila Salkic

One of the biggest drug issues of today is the opioid epidemic. As defined by the

National Institute on Drug Abuse, opioids are a class of drugs that include, heroin, fentanyl, and

prescription pain killers like OxyContin, hydrocodone, codeine, and morphine. More than

72,000 people have died as a result of opioid overdose in the United States in 2017. With that

number rising more and more each year, society is eager to find help to stop the epidemic once

and for all.

From the beginning of time, society has been faced with the issue of balancing opiates in

treating pain and the “euphoric” effects induced by abusing the drug. The earliest source of

opium dates back to 3400 B.C. Opium is the natural origin of opiates. Poppy plants were grown

in Mesopotamia. Between 460-357 B.C., the “father of medicine”, Hippocrates discovered that

the opium was a narcotic. In the 15th through 16th centuries, traders from the Middle East

brought opium to the far east, then it was brought into Europe. In Europe, opium was used as a

curative for many illnesses and psychological problems.

Friedrich Wilhelm Adam Serturner, a German chemist in 1806, removed a substance

from opium which he called morphine. This became huge for doctors around the United States.

Doctors used morphine to treat anxiety, pain, and respiratory problems. Morphine was the most

popular pain killer used in the Civil War. Soldiers were using the drug so much that they started

to become dependent. The post war morphine addiction was called “soldier’s disease”.

Morphine was started to be used in surgical procedure in 1853 when the hypodermic needle

was invented. They used morphine to treat neuralgia, which is intense pain along the course of

a nerve, especially in the head or face. This started the medicalization of opioids.
In 1898, Heroin was created as a derivative of morphine in 1898. Bayer, a German

company offered heroin as a cough suppressant. Heroin was said to be a non-addictive

substitute for morphine. The United States focus at the end of the 19th century was to end

opium abuse and that it should only be used for medical purposes. The Opium Exclusion Act

made the importation and distribution of opium for the purpose of smoking illegal in 1909.

Many states that this legislation was the official start of the was on drug in the United States.

Next, the Harrison Narcotics Tax Act of 1914 put a tax on all opiate and made it mandatory to

have physician and pharmacist for its disbursement. Next, Bayer stopped producing heroin as a

cough suppressant because of the addiction it created in 1916. Following this, The Heroin Act of

1924 was passed and it completely stopped heroin sales. At this point many people we skeptical

about opiates and there were many different views on the drugs. To keep the public safe from

dangerous chemicals and drugs, the FDA was granted power to regulate the safety of food,

drugs, and cosmetics. They made sure that drugs and other substances needed to be proven

safe to be sold.

In the 1960s, opioids that contained oxycodone were becoming the concern of the

United States. To make the public aware of the dangerous drugs, the Controlled Substances Act

was passed in 1970. This act put all drugs on a “schedule” that ranged between 1-5, one being

the most dangerous and five being the least. At this point, opioids were becoming a huge

problem in our nation. President Regan urged Americans to not tolerate drugs for any reason.

This quickly came to a fall because opioids were in need for pain management, but the problem

was that the opioids were being prescribed for all types of pain.
Coming into the 21st century, the controlled-release opioid names OxyContin hit the

market. This pill was deemed safe and non-addictive because of its time release feature. This

didn’t last long because drug abusers quickly learned that crushing the pills removed the time

release, making it easy to get high. Finally, in march 2016, the Centers for Disease Control

created a set of guidelines for prescribing any opioids for pain.

Even though there are plenty of laws and regulations against opioids, that hasn’t

stopped the epidemic. Today there are on average 142 overdose deaths a day in the United

States. The states with the highest overdose death rates from opioids were West Virginia,

Maryland, Maine, and Utah.

Contributing to the opioid epidemic, heroin and fentanyl overdoses are at an all-time

high. Heroin is a form of an opioid, directly made from morphine. Prescription opioids like

OxyContin and Vicodin have very similar effects to heroin. Studies show that prescription opioid

abuse can lead to heroin use. Heroin is used by injecting, sniffing, and smoking. The effects of

heroin are “euphoria”, pain relief, calmness, and disorientation. The high changes feelings,

thoughts, and sensations. Users of heroin have stated that they feel sensations of warmth and

safety when they are high. The use of heroin comes with many dangers. Heroin is often sold

with fillers, which are other drugs mixed in with it therefore making it impossible to know how

weak or strong the hit will be. Due to the fact of uncertainty, chances of overdose are

significantly increased. The long term effects of heroin include dependence, infertility in

women, intense sadness, cognitive impairment, and damage to organs.

Fentanyl, a synthetic opioid is also to blame for the current epidemic. Pharmaceutical

fentanyl was main for pain management for terminal cancer patients, but because of its strong
opioid properties, it is redirected for abuse. Fentanyl is one of the most dangerous drugs in the

opioid family. It is anywhere between 80-100 stronger than morphine. Often, fentanyl is mixed

with heroin to increase the potency of the heroin. This results in many overdose deaths.

Fentanyl is typically crushed and snorted, taken as a pill, smoked, and injected. There is no safe

level of fentanyl. A fentanyl higher is similar to the short, “euphoric” high that heroin creates.

Fentanyl in especially dangerous because it is lethal in small amounts. Abuse can completely

cause breathing to stop, which will lead to death. It is also an extremely addictive drug, studies

state that negative withdrawal effects can happen after just one use of it, creating the craving to

get more. Like heroin, fentanyl has similar side effects like dependence, damage to organs,

unconsciousness, coma, and death.

Since opiates cause dependence quickly, withdrawal makes it even harder to stop, this is

called physical dependence. Withdrawal from opiates come in flu like symptoms. Signs include

insomnia, muscle aches, nausea, fever, sweating, vomiting, diarrhea, anxiety, and abdominal

cramping. Withdrawal in severe cases can even cause death. Persistent diarrhea and vomiting

can result to dehydration, elevated blood sodium levels, and resultant heart failure if they go

untreated. Withdrawal is very taxing on the body and doing it without medical support can be

especially dangerous. Treatment often involves medicine and counseling. Withdrawal can be

done in three different settings, those are, at home, in a facility, and a hospital. Deciding to

undergo withdrawal at home is the most difficult but can be done with a strong support system

and the use of medicine. Facilities are set up to help people detox and hospitals are an option

for those who have severe symptoms.

These types of drugs are on the streets virtually everywhere you go, but how are opioids

obtained so easily? Addiction can start if one suffered a great injury which caused chronic pain

or if they had a serious surgery and were prescribed pain killers to combat the pain. After their

pain subsides they continue using the drug not for pain management but now for the high that

comes with it. Anyone who takes opioids is at risk for addiction. Doctors state that addiction is a

condition which started as pleasurable now feels like something the users can’t live without.

Opiates are typically received by prescription then distributed, thy can be made in a lab to be

distributed, and some will go to the lengths of robbery to steal from anyone to get what they

need. There are also many legal repercussions for individuals who engage in illegal behaviors

involving drugs. Some consequences are, time in jail or federal prison, fines, community service,

probation, and a criminal record that can affect the ability to get or maintain a job, vote, own a

gun, or even join the military. Selling illicit drugs has much more penalties than drug possession.

In the united states, the consequences depend on the state. In Wisconsin, if an individual is

caught with distribution of any drug they will get a felony along with a fine of $100,000 and 40

years of imprisonment. Depending on the severity of the situation, individuals can face charges

with even worse jail time and fines.

We know the detrimental effects of opioids, but they are continually abused all day,

every day. What can we do to stop the epidemic? Effective treatments are not utilized, and the

result is a cycle of drug use, inadequate treatment, and return to drug use. Breaking this cycle

will require a lot of individual and community effort. The epidemic is not only within the nation,

but it is worldwide. The World Drug Report of 2017 states that about 29.5 million people have

suffered from drug use and opioids were the most harmful drug type. Opioids accounted for
70% of the negative health impacts associated with drug use disorders. Research shows that 11

million people in the united states abused prescription opioids in 2017. The United States

government considers the opioid epidemic to be a public health emergency.