The abuse of opioid prescription pain medication, opium derivatives, and illicit drugs such as heroin is a problem the United States has struggled with since the late 1800’s. Recently the issue has gained the attention of public officials and the media due to the devastating effect that opioid abuse is having on society. The balance between the medicinal value of opioids and their addictive nature has been a struggle for cultures throughout history, and the current epidemic has affected every community in the country.
History of Opioids in The USA
Opium, made from the sap of the opium poppy, has been a part of society for thousands of years with the earliest reference to its cultivation and use dating to 3,400 BCE. Hippocrates, the “father of medicine,” declared around 400 BCE that opium was useful as a narcotic as well as in the treatment of internal diseases epidemics, and even diseases of women.
Opium use first gained a foothold in American society in the mid-1800’s when thousands of Chinese immigrants poured into the U.S. seeking work on the railroads and in the California gold fields. With them came the practice of smoking opium and Chinatown opium dens became popular with many Americans. So popular that by 1875 San Francisco passed an ordinance making it a misdemeanor to visit or operate an opium den.
German chemist Friedrich Wilhelm Adam Sertürner first isolated the active narcotic ingredient in opium in the early 1800’s and called it morphine, after Morpheus, the god of dreams. Throughout the 1800’s, morphine became a favored medical treatment, prescribed for anxiety, consumption, and pain, by the U.S. medical community. During the Civil War morphine was regularly used to provide pain relief to soldiers injured in battle, addicting enough soldiers to the potent drug that their addiction was known as “Soldier’s Disease.”
The addictive nature of morphine caused pharmaceutical companies to seek alternative painkillers and in 1898 heroin was synthesized from morphine, and marketed by Bayer as a non-addictive alternative. Over the next century, heroin proved to be as addictive as morphine and the pharmaceutical industry responded by creating other powerful synthesized painkillers such as oxycodone, dilaudid, and hydrocodone.
Opioid Uses
The administration of opioids became one of the most common treatments for patients suffering from terminal illnesses such as cancer, and the associated chronic pain, in the 1970’s. During this period, the medical community investigated the use of prescription narcotics and opioids for treatment of chronic pain not connected to a terminal illness as well. While chronic pain linked to cancer is different from musculoskeletal or functional pain, opioids became the standard treatment for individuals suffering from any chronic pain.
While many experts warned of the addictive nature of opioids during this period, there were others who believed the benefits far outweighed any dangers associated with them. Dr. Hershel Jick stated in a 1977 interview with the Washington Post that his research showed that less than 1% of patients had an adverse reaction to the drugs. In a 1980 letter printed in the New England Journal of Medicine, Jick further dismissed fears of addiction to opioids stating that his study of nearly 12,000 patients treated with narcotics showed that “the development of addiction is rare in medical patients with no history of addiction.” A few years later pain-management specialist Dr. Russell Portenoy analyzed the treatment of 38 patients treated with opioids for pain not caused by a terminal illness. He reported that only two patients showed signs of addiction and concluded that “opioid maintenance therapy can be a safe, humane alternative to surgery or not treating a patient suffering from chronic pain.
In spite of these reports and endorsements by the medical community, many doctors in the 1980’s were hesitant to treat their patients with opioids. During this same period then-President, Ronald Reagan enacted a war on drugs which called for harsher and stricter sentencing for individuals arrested for crimes linked to drugs. The war on drugs became a nationwide movement spearheaded by First Lady Nancy Reagan who popularized the phrase “Just say no” and asked Americans not to tolerate drug use by anyone, anytime and anyplace
Abuse Statistics
The cost of the opioid crisis in the U.S. is staggering both in financial loss and lives affected, with no immediate sign of improving. In 2016 the number of Americans estimated to be abusing opioids, including prescription painkillers, heroin, and other illicit drugs, was 2.4 million. Drug overdoses accounted for 50,000 deaths in 2015, with 33,000 or 63% of them caused by opioids. In spite of stricter drug policies, increased awareness of addiction issues and the dangers of opioids, death rates due to overdoses nearly doubled from 1997 to 2012, and continue to rise. While the overdose death rate has leveled off and the rate of abuse among teens has dropped in the last few years, there has been a significant increase in opioid poisonings, notably among preschool children and adolescents.
In addition to the loss of life, research shows that opioid abusers use more health care resources than the average American, as well as increase costs to the criminal justice system. A review of children’s hospital records shows that pediatric intensive care unit (PICU) admissions for opioid overdoses almost doubled between 2004 and 2015. Methadone, an opioid used to treat addiction, but also abused, was responsible for 19.5% of the opioids ingested by children under five. These staggering statistics demonstrate the severe risk that opioids and the drugs used to treat addiction pose to children that have a family member being treated for opioid dependence or abusing methadone.
In calculating the financial cost of opioid addiction, the Council of Economic Advisers found that previous estimates grossly underestimated the high cost of addiction. The council used a method commonly used by federal agencies known as the “value of a statistical life” (VSL) analytic method. The VSL method considers not only work productivity and earnings but also the value of life activities, such as volunteering and family activities. Using the VSL method, the council calculated the actual cost of addiction to be about $504 billion, or about 2.8% of the U.S. gross domestic product in 2015.
Designation as a Health Crisis
In August of 2017, President Donald Trump addressed the current opioid epidemic, stating that as a country we need to “liberate our communities from this scourge of drug addiction.” Trump officially declared the opioid crisis a national health emergency, which received support from health officials as being a positive step, but also received criticism for not adequately addressing the issue. The U.S. medical community prescribes opioid painkillers at a higher rate than any country in the world, and their availability has contributed to the current situation. Finding a solution to the opioid epidemic will require adequate funding and resources for treatment programs, facilities, and qualified professionals
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Posted 5th April 2018 by DeVore Criminal Defense