Addiction is known to affect a large population worldwide. Though there are various causes of addiction, abusing prescribed medications has become a global issue. Many patients who consume prescribed medications such as opioids continue to use them even after the treatment has ended. This poses a great problem among the medical community as the very drugs which are meant to direct the health of an individual to betterment are being misused to further degrade their health.
One of the most common and primarily abused prescription drugs by people is opioids. This class of drugs includes painkillers and illegal substances such as heroin which is highly addictive. While natural opioids such as morphine and heroin are derived from poppy, which is opium, synthetic ones like carfentanil and fentanyl are produced in illicit labs.
Opioid Abuse – A History
The dangers and addictive nature of opioids have been known since ancient times. The history of opioids dates way back to the 1800s when the drugs were used solely as painkillers and to help people feel relieved from the stress. The effects of the drugs on people’s bodies encouraged many to keep abusing them, thereby forcing them to develop an addiction to them.
The timeline of opioid use and misuse:
1775 – The year when opioids entered into the United States.
The 1860s – Opioids were started to be used to treat soldiers in the Civil War. Around 400,000 soldiers who were given morphine to ease their pain became addicted to the drug.
The late 1800s – A steep increase in opioid addiction primarily due to over-the-counter availability of these drugs. The use also increased because companies like Bayer brands started selling heroin for coughs and pain relief.
The 1900s – Morphine was related to pain management. Many Americans started crushing and inhaling opioid pills just for the sake of pleasure.
1914 – An act was brought in to limit the recreational use of opioids. Harrison Narcotics Act made them available only through a valid prescription.
1920 to 1950 – To avoid problems related to addiction and opioids, the drugs are only prescribed to patients with acute pain rather than chronic pain.
The early 1970s – Rapidly increasing stigmas and fear around opioid addiction caused various doctors to turn to surgeries and other nerve-blocking operations to relieve chronic pain. Opioids were less prescribed.
1970 to 1990 – Pain relief benefit of opioids was advocated by the American Pain Society. They stressed on non-addictive treatment for cancer-related pain.
1986 – The World Health Organization issued guidelines for prescribing opioids to curb cancer-related pain and other conditions, only if no other alternative is available.
1997 to 2002 – The scariest period of opioid abuse. Prescriptions related to morphine increased by 73 percent and for hydromorphone, it increased by 96 percent. Shocking figures for fentanyl and oxycodone were recorded where the prescription increased by 226 and 402 percent respectively.
2001 and Mid 2000s – Medical centers were required to examine the patient’s pain levels. In the mid-2000s, teenagers using their parents’ prescribed medications for fun and personal use was first reported.
2010 – The year of transformation from drugs to common abuse of heroin.
2013 – More than 27,000 newborn babies were diagnosed with a drug dependency. The condition is known as Neonatal Abstinence Syndrome, where the baby withdraws from the drugs he was exposed to when in the womb. The commonality of opioid abuse in women resulted in this.
2015 – The United States witnessed record 52,404 opioid-related deaths.
Today – there are, on average, 142 opioid-related deaths a day in the United States. This means, every three weeks, the death toll is equivalent to what the country suffered on 9/11.
The stats have grown to become horrific over the past few decades, and the condition is only becoming worse. In 2015, the average life expectancy entered a phase of constant decline. The World Bank Group stated that life expectancy decreased from 78.8 in 2014 to 78.7 in 2015, which further reduced to 78.5 in 2016 and 2017. However, in high-income countries, life expectancy has shown a slow and steady increase over the last few decades.
The Opioid Epidemic and What Caused It
There are three waves in which the opioid epidemic impacted the United States and caused a high number of casualties. The first wave began in 1991 when opioid-related deaths increased due to the rise in prescriptions of opioids and related medications for the treatment of pain. This increase in opioid prescriptions was a result of reassurances made by various medical societies and pharmaceutical companies claiming that the risk of addiction rooted by opioids is very less. The pharmaceutical companies also promoted them for use in non-cancer-related pain, even when the data wasn’t sufficient enough to back this claim. Places, where opioids were readily available and used liberally, were the first epicenters of opioid diversion and abuse.
The second wave started around 2010 when heroin-related deaths began to rise. Along with the efforts made to decrease the opioid prescription, the focus was now stressed more on a highly addictive and illegal drug called heroin, which is a cheap, widely available, and is extremely powerful. The misuse of heroin was noted irrespective of gender, age groups, and economic background. It deepened so much into the country, that the casualties related to heroin overdose increased by 286 percent from 2002 to 2013. Also, more than 80 percent of heroin users accepted to have misused prescription opioids before turning to heroin.
The third wave of the opioid epidemic was caused mainly due to the misuse of synthetic opioids such as fentanyl and carfentanil. Beginning in 2013, this wave brought the steepest rise in drug-related fatalities that occurred in 2016. Over 20,000 deaths involved the use of fentanyl and other related drugs. A majority of fentanyl-related deaths are said to have sourced from the use of fentanyl produced in illicit labs.
Opioids occupy a majority of cases related to prescription drug overdose globally. Although restrictions are constantly being imposed on proper and guided use of prescription drugs, some people misuse the drug for the sake of their pleasure. Proper education and knowledge about the harmful effects of opioids are required so that each one of us is aware of the drastic and long-term consequences this drug can have on our physical, mental, and emotional health.
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