The United States is said to be in an opioid epidemic because more than 2 million Americans are now abusing or have become dependent on street drugs or pain pills. But what are opioids? First of all, ‘opioid’ is a term that originates from the word ‘opium.’ Opioids are drugs designed to work like opium to replicate its pain reducing properties. These drugs include legal painkillers like hydrocodone, oxycodone, or morphine that is prescribed by doctors for chronic or acute pain. They also include illegal drugs like fentanyl which is illicitly made, and heroine.
In 2016, there were more than 63,600 deaths in the USA due to a drug overdose. Of that number, 42,249 or 66.4% were involved with opioid overdose. On average, that translates to 115 opioid deaths each day.
According to IMS Health research done in 1992, the number of prescription dispensed by doctors on opioid was at 112 million. In 2012, the number increased to 282 million. In 2016, the number declined to 236 million.
More about opioids
Opioids work by binding to the spinal cord and the brain receptors to disrupt the pain signals. They also activate the brain’s reward areas by releasing dopamine to create the “high” feeling. Opioids like codeine and morphine are derived from the opium poppy plant that is grown naturally in Asia, South America and Central America. The synthesized product of morphine is heroin.
Oxycodone and hydrocodone are semi-synthetic opioids that are manufactured in the lab with synthetic and natural ingredients. Hydrocodone (Vicodin) was the most widely prescribed opioid between 2007 and 2016. To paint a better picture; there was a nationwide distribution of 6.2 billion hydrocodone pills in 2016. Second to Hydrocodone was oxycodone(Percocet) where 5 billion pills were distributed in the US.
In 2015, Americans were 99.7% of the world’s population in the consumption of hydrocodone, according to the International Narcotics Control Board.
Fentanyl was developed to be a powerful anesthetic for surgery. It was also used to help patients alleviate extreme pain caused by terminal diseases like cancer. A small dose of fentanyl is deadly because it is 100 times more potent than morphine. The illicit version of the drug is what has caused most of the overdose deaths.
Fentanyl and methadone are fully synthetic opioids; Methadone is offered to addicts of heroine who are recovering to help them with withdrawal symptoms.
Addiction to opioids
Opioid abuse is clinically referred to as opioid use disorder. People who become addicts of opioids experience withdrawal symptoms when they decide to stop taking the pills. Tolerance is often coupled with dependence, meaning that users of opioids need to take more doses to have a consistent effect.
According to the Substance Abuse & Health Services Administration, 11.5 million teens from the age of 12 and older misused prescription pain medicine in 2016. In the same year, kids from the age of 12 and above who represent about 0.3% or 948,000 of the U.S population used heroin.
Users of pain pills tend to switch to heroin because it is easily affordable compared to prescription drugs. According to the National Institute of Drug Abuse, it is estimated that half of the youth who inject heroine ended up using street drugs. The same institution also says that 3 in 4 new heroin users started by abusing prescription drugs.
Between 2002 and 2016, the number of deaths related to heroin overdose increase by 533%. In 2012, the estimations stood at 2.089, and in 2016, the estimations stood at 13,219. For responders to reverse or block the effects of opioids, they carry a drug called naloxone which can be administered by injection or as a nasal spray.
Regulation and funding
According to the journal Medical Care, an estimated $78.5 billion was the cost of medical care and treatment of opioid addiction and overdoes in 2013. In 2016, the 21st Century Cures Act allocated $1 billion to be spent in two years in different states as grants for the opioid crisis to provide funding for prevention programs and treatment.
In 2017, Tom Price, the secretary of Health and Human Services announced $485 million distribution to all 50 states in the U.S. AG Jeff Session in August 2017 announced the start of an Opioid Fraud and Abuse Detection Unitwhose mission is to prosecute people who were associated with opioid-related health care fraud. Measures are also being introduced by the state legislatures to regulate the dispensation of opioid in pain clinics