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Theresa Burton

English 1201

Professor Colvin

7 April 2019

Opioid Epidemic

As a person who has dealt with addiction second hand for their entire life, the idea of the

opioid epidemic sweeping through our nation was very interesting and alarming to me. We see

the effects of the epidemic on the news almost every day. But who is to blame for the epidemic

getting so out of hand and out of control? People need to become more knowledgeable of the

negative effects of prescription drugs and the epidemic because if they remain aloof about the

issue, medical professionals as well as pharmaceutical companies will continue prescribing

addictive opioids.

“Curtailing the use of opioids in the treatment of chronic pain may prove difficult;

however, there is compelling evidence that the routine use of these drugs could be decreased

exponentially…”(Nash.) When being introduced to a highly addictive supplement, chances are

that without control of the substance as a whole, the recipient will become addicted to the drug. 1

in 15 people who are prescribed opioid pain relievers will become long term drug abusers.

Beyond its risks to public health, the threat of the opioid epidemic is breaching the

security of our nation. Analysts say that the problem all started with the over prescription of legal

pain medication, then later evolved into the opioids supplied by foreign-based drug cartels. Such

as heroin and fentanyl. An average of 130 people a day die from overdosing on opioids.

Knowing of addictive effects of the prescription drugs, and still prescribing them brings the

practices of the physicians and pharmaceutical companies to question.

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In this image, the major cities affected by the opioid crisis are displayed. The red displays

where the most heroin and synthetic opioid overdoses occur. As you can see, New York and the

surrounding area is a very active and deadly spot for heroin and synthetic opioids. The blue area

displays the most overdoses through prescription opioids. North east of America is the most

active and most deadly in reference to the opioid crisis. The tan displays the overdoses by

unspecified substances. As you can see, the effect of heroin and other synthetic opioids are more

deadly and effective in major cities.

Prescribed opioid medications include oxycodone, hydrocodone, and morphine. These

drugs are commonly prescribed to treat pain. The origin of prescription opioids stems from the

1990s, when patients who have undergone surgery or cancer treatment but the prescription of

opioid pain relievers has been increasing since. While having a sense of relief is a great thing, it

is likely that over time of consistent use you will become addicted. After becoming dependent on
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the prescribed drugs then them being taken away, people resort to whatever they can find. Such

as heroin and fentanyl which has been labeled “manufactured death” because of its cost and is up

to 50 times more potent than heroin.

At some point, we are going to have to look at the source of the prescription overdoses in

America. It has been known for a long time that the aggressive marketing and the drug company

payments to doctors influence the amount of opioids prescribed to patients. Money plays a huge

role in any problematic situation. “When drug companies fund research published in prestigious

medical journals or give money to physician or PhD speakers at medical meetings or at upscale

restaurants, practicing physicians should be very skeptical and hyper-critical of their findings and

recommendations”(Gale.) The drug companies give more incentive to doctors who prescribe

highly addictive supplements because of the amount of money they receive. It is completely

unfair to the general public to be the victims of even a slight possibly to being exposed to

addiction. This should be a more topical situation we talk about in order to prevent the possible

outcome of being an addict.

So why is the epidemic only getting worse? This crisis has had our government

scrambling for ways to prevent and treat addiction and to punish those responsible for the

increasing amount of victims. Since the epidemic was brought into more light recently, there has

been lawsuits filed against some companies in order to try and prevent the growth of the crisis.

For instance, the states have filed a lawsuit against Purdue Pharma, which makes the powerful

drug oxycontin. “But efforts to rein in the abuse of prescription drugs have had a limited effect

because users have turned to cheap, readily available and dangerous street drugs such as heroin

and fentanyl. Overdose deaths from prescription opioids decreased slightly in 2012, but deaths

from heroin and synthetic opioids have soared.”(Smears.) The effect of prescription drugs can be
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so heavy that the users feel a need to an alternative or even stronger relief. The growing crisis in

the United States is more deadly than we’ve ever seen.

In this image provided to us by Elsevier, the potential threat that opioids provide to

everyone is brought to light. For instance, almost 30% person of people who will be prescribed

opioid medication in their life will misuse them. This will lead to a great deal of opioid disorders,

then moving on to heavier more lethal drugs such as heroin. 80% of people who resort to heroin

have had history of misuse with their prescribed opioid painkiller. With these substances more

readily available than ever, we need to be taking more steps to prevent the cause of addiction in

the first place.

There are plenty options for addicted users. When it comes to treatment and guidance,

there is no shortage in given opportunities for assistance. There are medicines used to treat

opioid abuse and addiction. Some medications issued for treatment are methadone,

buprenorphine, and naltrexone. They can decrease the amount of withdrawal symptoms and

cravings. These drugs work by acting on the same targets of the brain as the opioids do but they

do not make you high like the opioids. They also restore balance to the brain that the opioids

may have effected. Another source of treatment for addiction is counseling. With counseling

options ranging from individual counseling, cognitive-behavioral therapy, motivational

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enhancement therapy, contingency management and many more. In a situation of addiction, you

are never alone. There are so many individuals that become subject to the pressure of addiction.

There are family counseling groups and peer support groups so you are never alone in the

struggle of addiction. There are residential and hospital based treatments. These programs can

provide housing and treatment services for those in need. You can be living with your peers and

be supporting each other throughout the same struggles you’re all experiencing.

So what are the socioeconomic consequences of the epidemic? The epidemic has

devastating disadvantages to public health. Including the causing of high rates in hepatitis C,

HIV and other diseases through the use of syringes. There is also the chance of passing opioid

dependency to children if the use were to continue under the effect of pregnancy. The increased

use of opioids can also increase the amount of children that are implemented into foster care

systems.

“Efforts to halt the opioid epidemic have varied across the countries in North America. In

Mexico, the government placed access to medication-assisted treatment (MAT) at the center of

their policy response, while in Canada there have been multiple successful efforts to expand

access to treatment for marginalized populations”(Mittal.) The epidemic has become more than

just a crisis in America. Surrounding countries have also been affected greatly by the addictive

effects of prescription and non-prescription drugs. Countries like Canada have implemented

several successful ways to deal with the crisis. America has plenty of ways to prevent and treat

the route of addiction, however, the problem is that if people want to obtain the drug then they

have more than just one way to do that. It is very easy to obtain drugs like heroin and fentanyl in

today’s day and age. The problem with neighboring countries like Mexico, the drug flow coming

into the country is at an all time high with up to 8 cartels controlling distribution.
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When asking a good friend of mine, who now lives in Canada, about the epidemic in his

country compared to the U.S., he made it clear that the difference is very noticeable. How the

epidemic in Canada is widespread as well, he finds it to be much more apparent and visible in

the U.S. He’s moved from Ohio, to Louisiana, to Toronto and throughout all that travelling, he

found that the appearance of drug abuse was much more visible in Louisiana than anywhere else

that he’s lived. “In New Orleans there was a lot of users in the downtown area, and you can just

smell it in my apartment building.” Everyone needs to recognize the effect of the epidemic

worldwide and take necessary steps to avoid contact and addiction through prescribed

medication.

In the USA, the use of pharmaceutical advertising and prescription practices have

undoubtedly increased the craving and use of opioid drugs. It’s hard to believe in some cases that

a lot of people will intentionally harm themselves in order to obtain prescription pain relievers to

feed their ongoing addiction. We see commercials every day of a new prescription that will

supply you with the relief you’ve been struggling to obtain. “Pharmaceutical companies and

academic research institutions should be further engaged in developing novel pharmacotherapies

for OUD accessible to a range of populations”(Werb.) When prescribing particular opioid pain

relievers, everyone involved should further their knowledge about the drug being brought into

question and make sure it fits their needs while also not being so high risk.

It is very important that before prescribing addictive medication, it is important that the

prescriber knows the patient’s past history of drug abuse. Family history of drug addiction is

important when analyzing if the prescription is right for them. “New research shows that when a

teen is prescribed an opioid painkiller after minor surgery, his or her odds for long-term abuse

nearly doubles if someone living at home already has an opioid use problem”(Mundell.)
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Research shows that a family history of substance abuse is a very high risk factor for opioid

misuse in relatives. “The hospital I was at forced them onto me, after I refused them given my

family's history of addiction. It literally only took one pill for me and I was making up excuses to

take them. My body then became dependent of them and recovery, on my own, was hell. I

refused to see a specialist or seek professional help because I didn't want to be like my parents,

one of my aunts or one of my uncles.” A close friend of mine reveals the harsh reality of the

likely chances of becoming addicted to opioid medications if the family has a history of also

being addicted to any substance.

The misdiagnosing of patients is a huge issue in today’s society. Personally, I have had

family members had their addiction fed by the lack of research and background check ups on

them. My cousin who is still addicted to opioids, would go into the doctor very often stating how

bad his back was hurting. His doctor would continue to prescribe him opioid pain medication to

help relieve his pain that he had. Recently, he has been cut off as his doctor had suspected his

addiction the the medication. After being cut of from the prescription, he started receiving

anxiety attacks from the withdrawal symptoms he was experiences and now resorted to the cheap

resolution of heroin found on the street, to feed his addiction. My family has had a strong history

of drug and alcohol abuse.

I have previously discussed the use of methadone in my paragraph about treatment

options. However, methadone is the cause of 1/3 of opiate pain reliever overdose deaths. What

happens is, doctors will take in the information of you being addicted to opioids, then raise you

another supplement to get reliant. In most cases, you need to go to your doctor or treatment

center everyday to receive the dosage of replacement medication. Say that you’re addicted to

heroin and you go to your doctor to seek help and relief. He may prescribe you methadone as a
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replacement to wean you off of the more lethal drug, but the drug he prescribed you is just as

addictive, if not more. Because methadone is so easily obtainable to patients struggling with

addiction by physicians and seen as a better alternative. But these replacement drugs are just as

deadly as the prescription opioids that caused the addiction in the first place.

A huge issue within the realm of addiction is the amount of veterans introduced to the use

of opioids. Veterans have been coming home long before we were alive only to result in being

heavily medicated by opioids. After dealing with the effects of PTSD, veterans are one of the

largest groups of individuals to be victims of imperfect prescription. After coming home and not

knowing how or having the appropriate tools to deal with your experiences from combat, a

veteran’s first instinct is to seek help and attention from the VA. The VA is a government

facilitated hospital and housing for veterans in need of assistance. If wounded, the VA will

prescribe opioids in extreme cases to deal with the effects of the pain. However, in most cases

the VA will not prescribe highly addictive opioids to deal with the effects of PTSD. They will

refer you to a health clinic and that clinic will most likely distribute the opioid. When their

wounds are then healed, they are immediately cut off of the prescription. The veterans will then

resort to cheap replacements, such as heroin. When walking in to the VA they will almost always

prescribe you something to help you deal with your PTSD. The only problem with this is that the

amount of anxiety and depression will experience will draw you to abusing drugs like Xanax. In

most cases of addiction in veterans, they will resort to the abuse of alcohol and drugs. My father,

who is a retired Navy Seal, was telling me all be about his experience with the VA. “PTSD is an

everyday thing, it doesn’t just happen 2 days a week. It’s an everyday battle that we have to deal

with,” he tells me. When first consulting with a doctor through the VA, they give them a month

trial of supplements to assist you through your anxiety and sleep deprivation. Chances are that in
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that month they will resort to the abuse of the medication prescribed, alcohol, or even suicide.

Studies lean heavy into the notion that you are more likely to become addicted to prescriptions

and other supplements if you have a past family history of drug or alcohol abuse. My father’s

family has had a strong family past abuse of drugs and alcohol. He explained to me that before

he ever went to the VA, he went to a normal family physician who just prescribed him a highly

addictive opioid to deal with his anxiety and PTSD from his experience in the military. My

father who also now works as a maintenance man had recently cut his arm very severely on the

job. He was taken to urgent care and the first thing that was offered to him was a highly addictive

pain medication. Of course he refused, but it shows that in times of urgency, the history of

addiction is not made clear to the nurses in doctors if they have never dealt with the patient in the

past.

The last element of opioid addiction I would like to discuss is the harsh reality of the

latest trends in teen culture. When I was in high school, as i’m sure you all experienced similar

encounters with your peers, there was a lot of drug culture being pushed into my school. Every

day there would be a new poster on the wall about how to avoid the use of now very popular and

very addictive supplements. “Abusing prescription opioid pain relievers is a major problem

among young people, and a new study shows users are combining those drugs with other

substances”(NIH.) A huge issue in my community that contributes to the opioid epidemic in

America, is the use of laced marijuana with fentanyl circulating through the area. I have recently

discovered a post revealing ways to know whether or not the marijuana you’re smoking has been

laced with something unfamiliar. I personally have never smoked marijuana, so I have never

been worried about being subjected to foreign substances. However, that does not mean I am not

concerned with the effect it may have on our youth. A recent study also reveals that 1 out of 8
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high school seniors are now mixing prescription opioids with at least one other substance.

“Teens who mix prescription opioids with other drugs are four times as likely as non-users to

report frequently getting drunk and are eight times as likely to be marijuana users”(NHL.) Not

only is becoming addicted to these supplements a high risk factor, but also the use of gateway

drugs is heavily implemented into these teens lives if exposed to the use of prescription opioids.

In conclusion, the opioid epidemic is increasing its negative effects on society every day.

It is important that as a community and as a society, every one be well aware of the effects that

opioids and other gateway supplements can have on your system, a possible diseases it can

cause. In a case of addiction, no one person is ever alone. We need to all increase our awareness

of the opioid epidemic as a whole and be aware of the physician prescription power and past

family history. People need to become more knowledgeable of the negative effects of

prescription drugs and the epidemic because if they remain aloof about the issue, medical

professionals as well as pharmaceutical companies will continue prescribing addictive opioids.

Works Cited:

Clarke , Janice. “The American Opioid Epidemic: Population Health Implications and

Potential Solutions. Report from the National Stakeholder Panel.” Mary Ann Liebert, Inc. |

Home, 2016, www.liebertpub.com/doi/full/10.1089/pop.2015.0144.

Felter , Claire. “The U.S. Opioid Epidemic.” Council on Foreign Relations, Council on

Foreign Relations, 2019, www.cfr.org/backgrounder/us-opioid-epidemic.

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Kommenda, Niko, et al. “Why Are More Americans than Ever Dying from Drug

Overdoses?” The Guardian, Guardian News and Media, 2017, www.theguardian.com/us-

news/ng-interactive/2018/nov/29/usdrug-overdose-epidemic-opioids-crisis-getting-worse.

Mundell, E.J. “Family Dinner Frequency an Indicator of Teen Drug Use Likelihood.”

PsycEXTRA Dataset, 2006, doi:10.1037/e426592008-016.

National Institute on Drug Abuse. “Opioid Overdose Crisis.” NIDA, 22 Jan. 2019,

www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.

“Opioid Abuse and Addiction Treatment.” MedlinePlus, U.S. National Library of Medicine, 30

Nov. 2018, medlineplus.gov/opioidabuseandaddictiontreatment.html.

“Opioid Epidemic.” The Practice Doctorate in Nursing: An Idea Whose Time Has Come,

www.nursingworld.org/practice-policy/work-environment/health-safety/opioid-epidemic/.

“The Opioid Crisis in America: An Overview | Calvary Healing Center | Phoenix Drug and

Alcohol Rehab.” Calvary Healing Center, 2 Oct. 2018, calvarycenter.com/opioid-crisis-america-

overview/.
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Patrick , Stephen W. “Figure 2f from: Irimia R, Gottschling M (2016) Taxonomic Revision of

Rochefortia Sw. (Ehretiaceae, Boraginales). Biodiversity Data Journal 4: e7720.

Https://Doi.org/10.3897/BDJ.4.e7720.” Prescription Opioid Epidemic and Infant Outcomes,

2015, doi:10.3897/bdj.4.e7720.figure2f.

Vashishtha, Devesh, et al. “The North American Opioid Epidemic: Current Challenges and a

Call for Treatment as Prevention.” Harm Reduction Journal, BioMed Central, 12 May 2017,

harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-017-0135-4.