The opioid epidemic in America is one of the worst health crises that has ever rocked the country. The roots of the epidemic go back to at least 1914, which has led to the crisis to bloom as it is today.
The Timeline
In 1914, the Harrison Narcotics act was passed, which required that doctors write prescriptions for narcotic drugs.
In 1924, the sale and production of Heroin was banned by the Anti-Heroin Act.
In 1970, the Controlled Substances Act was passed. The law establishes groupings of drugs according to varying potential of abuse. Heroin is allocated to Schedule 1, while fentanyl, oxycodone, methadone and morphine were classified as Schedule 2. Hydrocodone was classified as Schedule 2 as well.
In 1980, due to an article titled ‘Addiction Rare in Patients Treated with Narcotics’, the belief that narcotics are a safe treatment option became widely known.
In 1995, OxyContin was introduced as a safer pain pill by Purdue Pharma.
In 2007, Purdue Pharma pleaded guilty for misleadingly advertising OxyContin as the safer alternative to other addictive opioids.
In 2010, FDA approved an ‘abuse deterrent’ version of the OxyContin. But the general population still finds ways to misuse it.
In 2015, a sting, called Operation Pilluted, was carried out by the DEA. This was a prescription drug bust, centred around health care providers that dispenses massive amounts of opioids.
In 2016, the CDC published guidelines for opioid prescription to patients that have chronic pain.
On March 29, 2017, Trump officiated an executive order which called for the establishment of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
On July 31, 2017, Trump declared a national public health emergency regarding the crisis.
On September 22, 2017, CVS announced that new restrictions on filling prescriptions for opioids will be implemented.
On November 1, 2017, the final report was released by the opioid commission. The report has 56 recommendations, including the establishment of nationwide drug courts.
On February 9, 2018, Trump signed a budget agreement that allocates 3 billion dollars each for drug programs of 2018 and 2019.
On March, 19, 2018, the Trump administration detailed an initiative to halt opioid abuse. This includes three areas of focus, law enforcement, prevention and job seeking assistance.
On May 1, 2018, a study by the AMA finds that synthetic opioid causes 46% of deaths in 2016. Which is three times more than 2010.
On December 12, 2018, stats by NCHS indicates that fentanyl is most commonly involved in drug overdoses. The rate increased by 113% between 2013 and 2016.
On July 17, 2019, the CDC shows that there was a 5.1% decline in drug overdoses in 2019.
The Origins of the Epidemic
Jennifer Silva, a researcher and professor of Sociology and Anthropology at Bucknell university wrote a book called We’re Still Here, which researches the impact of the collapse of the coal industry on poor and working-class Americans. Amongst her subjects, she noticed a trend of opioid abuse and addiction amongst these people and their families.
This points to the connection between job loss and opioid abuse, a connection that has been made quite often by research. According to a study in the JAMA, nearly five years after assembly plans had closed in certain counties, the rates of opioid-overdose mortality increased by 85% compared to counties where plants had remained open.
The connection between job loss and addiction is underscored by many factors. For some, it may mean social isolation, hopelessness, a loss of purpose or access to health insurance. Atheendar S. Venkataramani, an assistant professor at University of Pennsylvania stated, “If you feel like the American dream is no longer accessible, then one may also feel that, Well, it’s not really worth investing in myself … because investing in yourself is one way to access the fruits of the American dream.”
Social and economic factors play a big role in the epidemic according to studies that have been conducted. Venkataramani’s study found that due declining life expectancies and life chances, Americans are being pushed towards drug abuse, suicide and alcohol.
Moreover, a study conducted by Brown et al, found that economic downturns like the Great Recession which lower the values and prices of houses contribute to the epidemic.
In addition, other factors have been tied to the increase in the epidemic. From the timeline above, it can be seen that misinformation and false advertising bolstered the opioid epidemic as big companies such as Purdue Pharma pushed opioid sales for their own personal gain. In addition, according to an exclusive by CNN, it has been found that the more opioids doctors prescribe to their patients, the more money they make.
On the subject, Dr Andrew Kolodny, the co-director of Opioid Policy Research Collaborative said, “It smells like doctors being bribed to sell narcotics, and that’s very disturbing.”
The Government
According to the National Institute of Drug Abuse’s website, the US Department of Health have put out a plan that focuses on five main areas:
- Improving access to treatment and recovery services
- Promoting use of overdose-reversing drugs
- Strengthening our understanding of the epidemic through better public health
surveillance - Providing support for cutting-edge research on pain and addiction
- Advancing better practices for pain management
Moreover, Trump’s drug policy and health care proposals could blow the current crisis out of proportions. His failure to address the problem can be seen in the overdose data, where the decline seems to stem from the efforts made to deter doctors and prescribes from making out opioid prescriptions.
In reality, his proposals like repealing Obamacare, cutting Medicaid, establishing a wall at the US-Mexico border and death penalty for drug dealers seem neither address the problem effectively or have a fruitful result.
Moreover, it can be seen from data that overdoses in other areas have been going up, for example, drug overdose deaths relating to synthetic opioids – in particular fentanyl have increased by 10%. In addition, deaths that involve stimulants that can be misused, specifically meth have gone up by nearly 22%. Cocaine overdose deaths have risen by 5%.
