The Opioid Epidemic – A National Crisis
According to the CDC, the opioid crisis that is currently gripping the nation has claimed nearly half a million lives over the span of two decades. On average, 130 Americans a day die from opioid overdoses, with prescription pain killers as the driving force behind these addictions. It’s the leading cause of death for Americans under 50 years of age and in 2017, it was declared an official public health crisis, as the overall life expectancy for Americans dropped for the first time in decades. The opioid crisis has been described as a “uniquely American problem” for all demographics because the healthcare system in the United States favors writing out prescriptions for those who don’t qualify for health care or have to buy their own rather than explore other therapies that are more expensive.
The opioid epidemic can be traced back to the pharmaceutical industries alleged deceptive marketing practices that not only downplayed and denied the highly addictive nature of these drugs, but also encouraged doctors and healthcare professionals to prescribe these painkillers liberally. Drug manufacturers such as Purdue Pharma LP and Janssen Pharmaceuticals Inc. now face hundreds of civil litigation lawsuits that claim they unlawfully increased sales to increase profits, committed gross negligence, and have used misleading marketing tactics; all of which has generated a public health emergency.
What Are Opioids?
Opioids are commonly prescribed as pain relievers used to treat severe and chronic pain due to various circumstances such as recovery from surgery, pain from illness, or pain caused by a traumatic event like an auto accident. Opioids function by attaching themselves to opioid receptors, which are proteins located in the brain, abdomen, and spinal cord. The three opioid receptors – mu, delta, and kappa – are part of the opioid system; a neuropeptide system responsible for controlling pain and is the reward center for addictive behaviors. The mu receptor triggers the brain reward system, initiating the feeling of euphoria and addictive behaviors. In a non-medical setting, opioids are used to produce that feeling of euphoria or to prevent withdrawal.
Opioid vs. Opiate, How the Addiction Occurs
Opioids and opiates are derived from the opium poppy; a flowering plant whose seed pods produce a liquid “gum” or “latex” that is dried and cultivated. Opiates are alkaloids such as opium and morphine. Opioids are semi-synthetic, or synthetic drugs either derived from morphine or fully grown in a lab. Both have the same effect on the central nervous system and brain function by blocking the feeling of pain and triggering a rush of dopamine, which is the chemical responsible for reward, pleasure, euphoria, and motivation in the brain. This rush of endorphins that create this euphoria, or high, does not last and since it is only achievable through artificial means (taking actual opioid drugs), the only way a person can experience that feeling again is by taking the drug again. Over time, the brain builds up a tolerance to opioids and either a higher dosage is needed to achieve that same feeling of euphoria or the brain becomes completely dependent on the drug to produce dopamine and function normally. Even though opioids are often prescribed by a doctor, there is still a risk of tolerance and dependence, which can occur after just a few uses.
The Opioid Crisis – Three Waves of Abuse
From over prescribing, to addiction, to misuse and eventual death, today’s opioid epidemic can be traced back to the 1990s, when the number of prescription painkillers tripled.
Opioid Litigation – The Fight Against Pharmaceutical Companies
By downplaying the addictive and ultimately lethal nature of opioids, opioid companies were able to increase their profits along with addiction and overdose deaths. In 2016, Pennsylvania saw nearly 5,000 opioid deaths.
Sources:
Rachel N. Lipari, Ph.D., Matthew Williams, Ph.D., and Struther L. Van Horn, M.A. “Why Do Adults Misuse Prescription Drugs?” The CBHSQ Report (July 27, 2017). [Link]
Mark R. Jones, et. al “A Brief History of the Opioid Epidemic and Strategies for Pain Medicine,” US National Library of Medicine National Institutes of Health (April 24 ,2018). [Link]