June 10, 2019
Experts say the United States is in the throes of an Opioid epidemic as more than two million Americans have become either dependent on or abused prescription pain pills and street drugs such as Heroin. People who become dependent on prescription painkillers, but cannot obtain them legally, often switch to heroin. They are seeking both the euphoric high associated with Opiates and pain relief.
Opioids are drugs formulated to replicate the pain-reducing properties of opium. They include both legal painkillers like Morphine, Oxycodone, or Hydrocodone prescribed by doctors for acute or chronic pain, as well as illegal drugs like Heroin or illicitly made Fentanyl. The word “Opioid” is derived from the word Opium. These drugs are potent respiratory depressants and can stop respiratory function when used with higher than normal dosages.
US history takes us back as far as the Civil War when medics used Morphine on the battlefield leaving many soldiers dependent when returning home. After that, Heroin emerged in 1898, being first produced commercially by Bayer for Morphine addiction. In 1914, Congress first addressed Opiate addiction by passing legislation requiring written prescriptions for all forms of Opiates.
Fast forward to 1980 when the New England Journal of Medicine published a letter purporting that narcotics were a safe treatment for chronic pain with a low risk of addiction if monitored closely. For 15 years, obtaining a prescription for painkillers was relatively easy. Refills weren’t normally a problem either. Then came 1995, when Oxycontin was produced and marketed aggressively as a safe, long-acting Opioid slowly released over 12 hours. This was advertised as a “break-through” for those suffering from chronic pain.
Almost 12 years later, in 2007, criminal charges were filed against Pharma, the manufacturer of Oxycontin, for false and misleading information on this powerful and addictive painkiller. Since then, a steady increase in Opiate addiction has resulted in new legislation and restrictions on prescription Opioids.
In 2015, there were 52,404 overdose deaths in the United States, including 33,091 (63.1%) that involved an Opioid. That’s an average of 91 Opioid overdose deaths each day. The number of Opioid prescriptions dispensed by doctors steadily increased from 112 million prescriptions in 1992 to a peak of 282 million in 2012, according to the market research firm, IMS Health. The number of prescriptions dispensed has since declined, falling to 236 million in 2016. On October 26, 2017, President Trump declared Opioid/Opiate Abuse a National Public Health Emergency. Across the country, many local law enforcement and EMTs carry Naloxone, which temporarily blocks or reverses the effects of an Opioid/Opiate overdose.
Where do we go from here? Education on the dangers of these powerful painkillers and careful monitoring by prescribing physicians is vital. Employers and families must recognize this is a real problem that cannot be ignored.