The U.S. Opioid Crisis: Explained

Written by Ren on Friday May 3, 2019

It’s no secret that the United States is broiling in the midst of an opioid epidemic. Even though it took until 2017 for the US Department of Health and Human Services to officially declare the opioid crisis a public health emergency, the escalating overdose risk has been going on since the late 1990s. 

Patients want to trust their physicians when it comes to prescribed medication, but for decades, doctors have been pressured by big pharmaceutical companies to over-prescribe opioid painkillers. Pharmaceutical companies with profits in mind over patient wellness guaranteed that opioid painkillers were non-addictive and safe for use. With no other affordable pain relief options at their disposal, doctors became reliant on prescribing economical opioid painkillers for patients with chronic pain, acute muscle soreness, and for those in recovery after surgery. 

When it comes to chronic diseases like cancer, even stronger opioids are needed to help patients manage pain. The synthetic opiate fentanyl was created for this express purpose. Fentanyl is 50 to 100 times more potent than morphine, which makes it incredibly dangerous if abused. Because it produces a more powerful psychoactive effect and requires less product for the same high, fentanyl is much cheaper to manufacture and distribute than traditional opioids. While fentanyl is an economic boon for illegal drug manufacturers looking to ship more product, it has led to a market saturated in heroin, cocaine, and other opiates that have been mixed with huge portions of fentanyl, often unbeknownst to the user. Fentanyl overdoses present a unique challenge to treat because of the drug’s strength, and oftentimes multiple doses of the rescue medication naloxone are needed to reverse them. 

So who is most at risk for opiate overdose? 

Nearly 80 percent of opioid overdoses in the United States can be attributed to white, low income Americans, and are especially prevalent in the Appalachian “Rust Belt” region of the country. There are a variety of socioeconomic factors at play here, but the lack of available jobs has certainly been a major contributor to the widespread depression of the region. Low income Americans that are unable to afford the tuition costs associated with a college degree are less likely to be able to find work, integrate, and uplift, and thus more likely to turn to illicit drugs as a kind of emotional salve. Military veterans are another demographic where opioid abuse is rampant. Without access to necessary therapeutic treatments for chronic pain or PTSD that developed as a result of military service, many veterans account for a disproportionately high number of opioid-related deaths. 

To really drive home the scale of the epidemic, consider that more than 130 people in the United States die every day from opioid overdoses, and that in 2017 alone, there were 47,000 opioid-related deaths. The economic burden of the opioid crisis is over $78 billion a year, including the tallied costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. With 1 in 3 Medicare beneficiaries receiving a prescription of an opioid painkiller in 2016 and 30 percent of patients misusing their opioid prescriptions, overdose fatalities are only projected to rise. 

While the news certainly seems dire, there are a variety of things that can be done to combat the epidemic. 

First and foremost, it’s important to ensure that proper justice is dealt to pharmaceutical companies who were well aware of the dangers of their painkillers and continued to aggressively market them to medical professionals anyway. Next, it’s essential to create infrastructure to provide long term support for those suffering from opiate addiction. Safe injection clinics destigmatize addiction and simultaneously provide around-the-clock nurse supervision and naloxone treatment in the instance that an opioid overdose were to occur. If implemented, safe injection clinics can provide sufferers with informed options moving forward to treat addiction. Lastly, it’s critical to invest in new pain management research to find other methods of management that don’t rely on addictive medication. With these three key avenues funded and in place, physicians, politicians, and healthcare advocates will be able to create a safer place for vulnerable groups of people suffering not just from the effects of opiates, but from addictions of all kinds.