The opioid crisis in the United States is a tragedy that has negatively impacted the lives of millions. The prescription of legal and highly addictive drugs has effectively caused dependency and addiction among people seeking safe pain relief.
In this article, we’re taking a closer look at one of the most common questions we hear from the community – what is the opioid crisis?
What is the Opioid Crisis?
For years, the United States has been struggling with opioid-related deaths, from prescription medication and heroin alike. Despite having the world’s third-largest population, the US consumes almost all the global opioid supply. The result is an absolute tragedy – with about 4 percent of the world’s population, we struggle with about 27 percent of the world’s total drug overdose deaths.
Heroin is doubtlessly playing a big part in this, but legally-distributed medications have their own way of ending up on the black market or being abused by addicted patients.
America’s Prescription Addiction
In general, drugs have always been a bigger problem in the United States than in most of the rest of the world – more disposable income for individuals meant that more people had the financial capacity to buy both homegrown and imported drugs, versus the populations in much poorer countries. However, the issue is more complicated than that. General inequality in the US is higher than in most other developed countries, and lack of a social safety net means more people in poverty end up turning to drugs to soothe personal woes.
Another problem is America’s penchant for prescription medication. Americans are prescribed about six times as many opioids per capita than the French and the Portuguese, despite having arguably worse access to health care. Statistics related to aging or other potential causes of chronic pain don’t effectively reflect this massive difference – in other words, Americans aren’t consuming more prescription drugs because they need them more, but simply because that is the way the industry works.
Pharmaceutical companies in the US have a much easier time aggressively marketing their products to the populace, and the medical industry has a close-knit relationship with representatives in pharma manufacturing. A highly-competitive, profit-driven health care environment might theoretically promote better medicine, but it also promotes tactics that result in higher sales. Higher sales require higher consumption. Simply put, other developed countries have a habit of stringently regulating pharmaceutical companies – the US doesn’t.
This isn’t a recent issue, although it has become worse than ever. But with so many threads, it’s important to take a step back and more meticulously examine why the opioid epidemic came about, and what steps we can take to limit its growth and eventually push back against it.
Drugs and America
Snake oil salesmen are as old as commerce itself, and it wasn’t until sometime in the last century that Western society began to actively regulate and ban outlandish claims of unproven medical potency. Products made with medically ineffective or even toxic contents were advertised as panaceas on all forms of public media, until around 1906 when laws began to go into effect banning the sale and marketing of ineffective and dangerous “medicines”. By 1938, a doctor’s prescription became mandatory for powerful drugs.
While advertising growth exploded in the 60s with the rapid rise of the television and the ad industry, it wasn’t until the 80s that the relationship between mass media and pharma companies grew. Over time, the restrictions originally imposed on these companies grew smaller and more insignificant, and today, the US is one of only two developed countries that allow pharmaceutical advertisements.
At the root of the opioid epidemic is an attitude towards medication found nowhere else on the planet. Most evident in today’s heated debates surrounding health care, the health care situation in the US is broken. A profit-driven industry with few regulations is more concerned with drug profits than drug benefits – and pharmaceutical companies learned to take advantage of that in the 90s when the medical attitude towards chronic pain shifted to treating it as a serious condition. The result was the rise in the usage of opioids like Percocet and OxyContin.
This rise led to a few side-effects, notably abuse of prescription medication. While the government was concerned mostly with the consumption of marijuana and cocaine, it neglected to address the fact that prescription medication also led to long-lasting and difficult-to-treat addiction, and in an environment where addiction was heavily stigmatized and treatment had a brief history of success to begin with, the epidemic grew.
A Growing Problem
It didn’t stop there, obviously. Once the problem was recognized, the government took measures to crack down on overzealous prescriptions and punish doctors for flooding the market with opioids. The result, however, was that existing addicts began to seek alternatives, going to extreme measures such as illicit drugs to get a fix. With addiction left untreated and misunderstood, the temporary influx of easily-abused medication created a ripple effect. Heroin and fentanyl abuse grew rapidly, both of which are manufactured and abused non-medically.
About 75 percent of heroin users started with painkillers, according to a 2015 analysis. Someone struggling with painkillers is 40 times more likely to start using heroin than the average person.
Struggling for a Solution
The answer to America’s problems doesn’t lie in time travel, sadly. But undoing the mistakes of the past isn’t impossible, even if it is difficult. While cracking down on painkiller prescriptions and more strictly regulating drug companies is one way to combat the issue, the reality is that making drugs harder to get does not magically erase the addictions of millions of Americans struggling with already illicit substances. The focus now needs to be on treating drug addiction itself, and finally addressing the problem as a medical one on a wide scale. People in general – not just the medical and psychiatric community – need to understand that addiction is not just a social problem, but an individual medical issue. In the past few decades, the country’s reaction towards drug use has been to clamp down hard and punish both dealers and users with prison sentences – but that hasn’t worked.
Instead, we need to fix our health care and make treatment more easily available. There are many, many ways to help people get off drugs, including work and sober living programs, 12 step programs, individual therapy, art and sports programs, and better education on the long-term effects of drugs.
The time for opioid painkillers must also come to an end. Research has proven again and again that opioids are highly effective as short-term analgesics, but struggle to be effective in the long-term treatment of chronic pain. Alternatives exist and have a much lower potential for damage and misuse. However, the road ahead is tough. For individuals seeking treatment and families helping their loved ones, the priority should be to treat addiction and seek alternatives to prescribed opioids – and thankfully, there are plenty of options for both.