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Maggie Roalef

English 1201

Dr. Cassel

17 April 2019

Opioid Epidemic

When most people think of drugs they tend to think of cocaine, heroin, and maybe even

LSD. I know that I used to only think of those when I thought of drugs, and I only thought of

people who took those kinds of drugs as drug addicts. Growing up my older brother struggled

with drugs, he took the ones that are the most common. It started with weed and then grew to

heroin and cocaine. When I was sixteen years old, my brother Jon passed away due to a drug

overdose. Since then I have been more interested and also a bit more sensitive to the idea and the

talk of drugs. I realized that if my brother could become a drug addict then anyone could be

affected by the tortuous disease known as addiction. I also began to realize that not only were the

core drugs that I had thought of my whole life the only problem. More than 11.5 million people

in the United States over the age of 12 misused prescription opioids in the year 2016 (Romberg

et al). The same year that my brother had died.

Prescription opioids are highly addictive and are given to people by doctors for different

kinds of pain. According to an article done by ​American Journal of Public Health;

“Opioids were once focused on being used for post surgery, traumatic injury, and

terminal illness. Opioid prescribing in recent decades broadened to treatment of chronic

noncancer pain, including for conditions for which opioids have no evidence of benefit.

Increased prescribing has produced iatrogenic opioid use disorder (addiction) in some
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patients and large-scale diversion of opioids to others for whom they were not intended”

(Pitt et al).

This means that doctors began to prescribe these drugs to patients who really did not need them.

What caused the opioid epidemic? The idea that pain for patients needed to be stopped began the

search for a drug that could do that. The physicians and pharmaceutical companies that created

the drug OxyContin in the early 1990’s can thank master marketing campaigns and false research

for the reason why millions of Americans had access to this incredibly addictive drug.

Opioids are drugs that are actually used to create other drugs such as morphine and

heroin, opiates are the synthetic version of this drug such as oxycontin. These are both used

interchangeably when talking about narcotic drugs. Opioids block the pain messages sent to the

brain and the pain threshold is lowered. They are dangerous and deadly because the opioid

receptors are linked directly to the brain stem which is where the body's automatic functions are

held. This includes the body's heart rate and breathing, key factors in living. When there are too

many opioids affecting these two things the body’s heart rate slows and breathing becomes

difficult (Sievers). Since these drugs are addictive they have caused a huge national problem in

the United States and other parts of the world.

An article done by ​National Capital Poison Center ​explains that the first wave of the

opioid epidemic began in the early 1990’s, the increase in opioid prescriptions was influenced by

reassurances given to prescribers by pharmaceutical companies and medical societies claiming

that the risk of addiction to prescription opioids was very low (Liu et al). This can very well be

considered false advertising. Pharmaceutical companies were stating that there was a very low
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risk for becoming addicted to these new found drugs, when we now know that is not the case.

According to ​National Institute on Drug Abuse​:

“​Pharmaceutical companies reassured the medical community that patients would not

become addicted to prescription opioid pain relievers, and healthcare providers began to

prescribe them at greater rates. This subsequently led to widespread diversion and misuse

of these medications before it became clear that these medications could indeed be highly

addictive.”

This all began because pharmaceutical companies decided to guarantee that these new drugs

were not addictive and that they could be prescribed to anyone. This created a large demand for

these drugs by doctors because they were non addictive painkillers that almost anyone could take

home with them, at least until they realized they were addictive painkillers.

The article done by the ​National Capital Poison Center ​also states that the second wave

of the opioid epidemic occurred around 2010, but this time there was an increase in the amount

of heroin overdoses. As early efforts to decrease opioid prescribing began pharmaceutical

companies started making it harder to receive prescription opioids, the focus turned to heroin, a

cheap, widely available, and illegal opioid. Deaths due to heroin overdose increased by 286%

from 2002 to 2013, and about 80% of heroin users admitted to misusing prescription opioids

before turning to heroin (Liu et al). The pharmaceutical companies tried to fix their mistake by

making it harder to access prescription opioids. This backfired when people decided to turn to a

cheaper more easily accessed option, called heroin. It did not matter that they had finally realized

that these drugs were addictive, the damage had already been done and people were paying for it.

Many experts have researched and debated that the greater controls on prescription opioids and
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the reduction of them as well lead the already addicted individuals to seek another source

including heroin (Pitt et al). Opioids are not just a deadly drug because people can get addicted

and overdose off of them, they are also an addictive drug because they lead to people using other

sources of drugs. When people can no longer get the prescription drugs that they are craving they

reach out to other sources to get a similar high. This is why people who use opioids begin to take

drugs like heroin or cocaine. So even though these people did not overdose and die off of the

opioid, the drug itself did have an indirect effect on these deaths. Which means that the

pharmaceutical companies are also to blame for the thousands of deaths.

The last wave of the opioid epidemic was in 2013 when this time instead of getting

heroin, the opioid addicts were getting a synthetic opioid called fentanyl. The sharpest rise in

drug-related deaths happened in 2016 when there was over 20,000 deaths from fentanyl and

other close related drugs (Liu et al). This is another example of the pharmaceutical companies

trying to fix their mistake by just making the problem worse. This causes people to wonder if

what they did was even a mistake, it may have been on purpose.
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Figure 1: This image shows the increase in deaths due to the different types of drugs that were popular at

that time. Showing the Waves of the Opioid Epidemic in order (Seivers).

Others may argue that pharmaceutical companies are not to blame, or at least that they

did not do it on purpose. These people think that the drug was approved because pharmaceutical

companies truly believed it was not going to be as addictive as it ended up being. Others believe

that the doctors are more to blame for the epidemic because they were the ones prescribing the

drugs to people who may not have even needed them. For the most part the the majority of the

U.S. population either believes that pharmaceutical companies are to blame or they do not pay

attention to the problem and do not care who is at fault.

People should care though, because opioids do not target any specific race, gender,

education, or financial situation. Anyone and everyone could become addicted to this drug. Yes,

anyone could get addicted to any drug, but this drug was supplied to people who believed that

they were just taking an ordinary medicine. Most people who become addicted to opioids are

people who have had no desire to take drugs in their life. Low-risk teens or young adults who did

not have a positive view on drugs or who had never taken any changed their attitudes towards

drugs when they were exposed to opioids through medical treatment (Romberg et al). This would

mean that the use of any opioid or even heroin became more likely now that they have been

exposed to drugs. Even though these young adults were planning on living their lives drug free,

one use of a medical drug prescribed to them made them an addict for the opioid high. Now

these young adults who were not originally intending to become addicted to drugs are addicts. It

did not matter who or where they came from, their lives were changed completely because of the

use of a prescribed opioid.

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Figure 2: This chart shows the percentages of different characteristics of people addicted to opioids

(Romberg et al).

The one main attempt to solve the problem of the opioid epidemic was to limit the

number of opioids prescribed or to not prescribe them at all anymore. This still is not working

because of what was mentioned earlier, people are turning to different kinds of drugs for their
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high. According to an article done by ​AJPH​ these efforts to curb prescribing rates to reduce the

risk of addiction and also decreasing a risk of people getting opioids include monitoring

programs and practice guidelines to recommend more judicious prescribing. Other policies in

place are being used to focus on reducing the risk of the potential misuse of the prescribed

opioids (Pitt et al). But any kind of limitation on opioids will lead to some negative reaction, it is

to be expected.

The opioid epidemic has been going on since the early 1990’s with very little

improvement. Pharmaceutical companies are to blame for the false fact that opioids do not have

a risk of addiction. All of this leading to thousands of people dying from overdoses, from the

opioid itself or heroin. Either way this three wave epidemic has caused many families in the

United States unspeakable pain and will continue to do so if something is not changed and if

pharmaceutical companies are not punished.

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Work Cited

Joyce, Theodore. “Perspectives on the Opioid Epidemic: Causes, Consequences, and

Responses.” ​Journal of Policy Analysis & Management,​ vol. 37, no. 2, Spring 2018, p.

430. ​EBSCOhost​, doi:10.1002/pam.22045.

Liu, Lindsy, et al. ​History of the Opioid Epidemic: How Did We Get Here?,​ National Capital

Poison Center, 12 Feb. 2018,

www.poison.org/articles/opioid-epidemic-history-and-prescribing-patterns-182​.

Pitt, Allison L., et al. “Modeling Health Benefits and Harms of Public Policy Responses to the

US Opioid Epidemic.” ​American Journal of Public Health,​ vol. 108, no. 10, Oct. 2018,

pp. 1394–1400. ​EBSCOhost​, doi:10.2105/AJPH.2018.304590.

Romberg, Alexa R., et al. “Young Adults’ Opioid Prescription History and Opioid Misuse

Perceptions.” ​American Journal of Health Behavior,​ vol. 43, no. 2, Mar. 2019, pp.

361–372. ​EBSCOhost​, doi:10.5993/AJHB.43.2.12.

Sievers , Kristin H. ​SHATTER PROOF​, 20 Feb. 2019,

www.shatterproof.org/blog/10-things-you-need-know-about-opioid-epidemic?gclid=Cj0

KCQjwhuvlBRCeARIsAM720HrXEJeiQH7klzuJPjrdcrMGe1fuvcSuaq0W9pRpdlh-Yko

tMxjQiUkaAqa_EALw_wcB.

Terrell, Rebecca. “THE OPIOID EPIDEMIC: What’s the Solution?” ​New American (08856540),​

vol. 34, no. 9, May 2018, p. 10. ​EBSCOhost,​

search.ebscohost.com/login.aspx?direct=true&db=pwh&AN=129253122&site=eds-live.