No one can deny the opioid addiction epidemic that is going on in the United States today. Thousands are dying every year, and it seems to be only getting worse.
According to the CDC, the rate of overdose deaths rose significantly from 2015 to 2016 by 21 percent.
It appears that some states are getting hit harder than others, notably states in the northeast and midwest including West Virginia, Ohio, New Hampshire, and Pennsylvania.
This increasingly widespread use of opioids has led to a public health crisis. Pregnant women are using these drugs resulting in their babies being born addicted and going through withdrawal. This heartbreaking phenomenon is known as neonatal abstinence syndrome. Injection of opioids, like heroin, is leading to an increase in bloodborne infections like HIV and hepatitis C.
It's also important to know that drug addiction is not just an inner city problem or a poor people's problem. It could be your next door neighbor or the girl you went to high school with. It's the celebrities you love. Drug addiction doesn't discriminate.
Where did this all come from? This epidemic didn't just come out of nowhere. It all started with the pharmaceutical industry.
How did this happen?
The opioid epidemic can be traced back to the 1990s.
During this time, pharmaceutical companies, most notably Purdue Pharma, who is the maker of OxyContin, created a big marketing push to get doctors to prescribe opioids and patients to ask for them.
We know now that opioid drugs are powerful and meant for acute, severe pain such as post-surgery pain and cancer pain.
Purdue Pharma downplayed the risks of becoming addicted to OxyContin because it was a long-acting, extended-release medication; therefore, it was probably safe.
What they don't mention is that people could crush and snort extended-release pills getting them high very quickly.
People also latched on to this five sentence letter to the editor in a medical journal that said that addiction is rare in patients using narcotics. We see now, however, that the proof wasn't really there.
As a result, opioids were being prescribed fast and furiously for every little complaint. Had a tooth pulled? You get a narcotic prescription. Bumped your toe? You get a narcotic prescription.
Pretty soon, there were more narcotic prescriptions than people in some states. And some drug distributors, such as McKesson, had some shady practices involving things like sending millions of pills to only one pharmacy. This also begs the question, did McKesson have the proper regulatory practices in place or is it possible that people working in the pharmacy were up to no good?
People started to become addicted to these pills with some turning to cheaper alternatives like heroin. Thus, the epidemic begins.
Why are opioids so addictive anyway?
Well, using opioids tends to make a person feel good by activating the reward centers in the brain.
Opioids trigger the release of endorphins, your feel-good neurotransmitters. Normally, we get a rush of endorphins with natural rewards like food and sex.
However, opioids produce a more powerful sense of well-being. When it wears off or when a person eventually builds tolerance, they will want to try higher doses of the drug. That's where people run into problems.
Research also suggests that memories are associated with both positive and negative opioid experiences and play a role in the continued use of opioids and relapse.
Here comes trouble
Pharmaceutical companies were profiting hard from opioids. They were making billions.
Also, doctors were being bribed with money and incentives from these companies to prescribe opioids. Doctors could receive more money or other incentives like meals and travel expenses for prescribing opioids.
There have even been doctors who played it dirty and sold opioid prescriptions to people or just gave them out to friends and family. Just recently, 5 doctors in New York were charged for prescribing millions of oxycodone pills to people who didn't really need them.
People started to catch on to the fact that opioids were falsely advertised as being safe. We began to see how addictive they can be leading to people dying from their use.
In 2007, Purdue Pharma paid more than $630 million in fines for their deceptive marketing. In fact, three of their top executives faced criminal charges and were sentenced to probation and community service. Unfortunately, the money they paid is only peanuts compared to the profit that has been generated.
Now, there have been more than 1,000 lawsuits brought on by states and Native American tribes against pharmaceutical companies like Purdue Pharma. These lawsuits claim that these companies did not disclose the truth about opioids being addictive in their marketing efforts. These groups are just trying to regain the money lost at the governmental level to pay for the cost of addiction. These suits also target drug distribution companies who didn't exactly monitor shipments of opioids to pharmacies.
Most recently, President Trump has called for a lawsuit at the federal level against pharmaceutical companies to pay for what they've done. He is also calling for an investigation into shipments of fentanyl, a very potent synthetic opioid, from places like China and Mexico. Stay tuned.
What is being done now
We have seen some changes implemented over the years as a result of this growing problem.
At the national level, the Food and Drug Administration (FDA) regulates prescription drug advertising. If an advertisement is public and they feel that it is misleading or inaccurate, they can ask the drug company to remove it. If they don't remove it, the situation escalates higher.
Other government-based entities are also playing a part in curbing this epidemic.
The Centers for Disease Control (CDC) released a comprehensive guideline in 2016 which details 12 recommendations for doctors as to when to begin or continue opioid painkillers for chronic pain.
Trust me on this, healthcare providers are receiving a lot more education about the appropriate use of opioid medications. This is typically mandatory for recertification purposes.
Additionally, many states have implemented Prescription Drug Monitoring Programs which shows you when a person has received an opioid prescription, who prescribed it, and what pharmacy dispensed it. This really helps detect those people who 'shop around' at different doctor's offices, emergency rooms, and pharmacies to get their fix.
The U.S. Department of Health and Human Services and the National Institutes of Health are focusing their efforts on improving access to addiction services, increasing the use of opioid-reversal drugs, providing support for research on pain and addiction, and advocating for safe, non-addictive methods to treat chronic pain.
Do the drug companies care?
Recently, Purdue Pharma has patented a new drug to help curb addiction disorders.
This new drug is a fast-acting form of buprenorphine, which is a weak opioid that helps combat drug cravings. It is better known as Subutex or Suboxone.
Well, look at that. The people who made OxyContin have made a new drug to help you get off of it after you become addicted. They must really care.
Just kidding. They are most likely in it for the money.
The pharmaceutical companies and drug distributors will continue to deny any wrongdoing and deny the fact that they have contributed to the opioid crisis.
It seems now that things are starting to move in the right direction to force the industry to follow the law and monitor the availability and use of opioids. Access to addiction services also seems to be improving.
Let's hope that this epidemic ends soon.
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