Opioid Epidemic in the United States

Opioid Epidemic in the United States

Opioid abuse is not a new in the United States. Opioid addiction can be traced back to the first European settlers who used poppy flowers to treat many common illnesses. During the Civil War, many soldiers developed addictions to morphine. Children were offered morphine in Mrs. Winslow’s Soothing Syrup to ease teething , resulting in a surge of infant deaths.

This wave of overdose deaths didn’t decline until 1914, with the passage of the Harrison Narcotics Tax Act, limiting doctor’s ability to prescribe opioids. Over a century later, however, the U.S. is in the midst of a major opioid crisis.

Opioid Crisis: Three Distinct Waves

The CDC states that the opioid crisis has three distinct waves where death rates have increased. The first occurred in the 1990s when overdoses primarily occurred with prescription natural and semi-synthetic opioids, in addition to methadone. It was at this time that pharmaceutical companies began influencing physicians to prescribe opioids even for non-cancer pain. Despite a lack of research into risks, pharmaceutical companies reassured physicians that the risk of addiction was low. Deaths from prescription opioids have now leveled off and are not increasing as rapidly as during the 1990s because of new knowledge into the true risks of prescription opioid addiction. However, the rate of deaths is still high.

In 2010, a second wave of deaths began, this time with heroin. When it became clear that prescription opioid medications were addictive, doctors began to decrease prescriptions. However, this resulted in people turning to heroin as a cheaper alterative. The second wave continued until about 2016, when the death rate began to level off. It is important to note, however, that the death rate from heroin is still high – it just isn’t increasing as rapidly.

The third wave of deaths began around 2013 with synthetic opioids, including Tramadol and fentanyl. This includes both synthetic opioids that are prescribed and those that are illicitly manufactured. Illicitly manufactured fentanyl (IMF) is often found in combination with cocaine, heroin, or counterfeit pills. This wave of deaths involved a sharp annual increase in deaths from 1 per 100,000 people in 2013 to 9.5 per 100,000 people in 2017. The rate continues to sharply increase today.

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Opioid Epidemic By The Numbers

Opioid use and abuse statistics in the United States are staggering. In the U.S., more than 11.4 million people misused prescription opioids during 2017. An additional 886,000 used heroin. Of these, more than 2.1 million met criteria for an opioid use disorder. It is estimated that more than 130 people die every day from opioid-related overdoses, with a total of more than 47,600 deaths in 2017. Nearly 28,500 died from overdosing on non-methadone synthetic opioids and nearly 15,500 died from a heroin overdose that same year.

These statistics are devastating. It is even moreso when you look at the overall impact. From 1999 through 2017, 700,000 people died from a drug overdose. Equally striking is that amongst adolescents, opioid and heroin use is down, but overdose death rates in this age group continue to increase because of contamination from fentanyl and other dangerous drugs.

The Hidden Victims: Impact of the Opioid Epidemic on Youth

With the large number of opioid deaths, there has also been a second, and equally alarming epidemic – the rate of children entering foster care is drastically increasing. From 2013 to 2015, the number of children in foster care skyrocketed to over 429,000, and parental substance abuse was a factor in about 32% of these placements.

Parental substance abuse has also resulted in an increase in the number of children experiencing neglect, abuse, and psychiatric conditions linked to trauma. Even more tragic is that children that witness drug abuse in their family are far more likely to begin abusing drugs, continuing the epidemic in a new generation.

Dangers of Opioid Abuse

While opioids are often prescribed for pain management, abusing opioids can have significant consequences on the body. Repeated opioid use can slow the body’s production of endorphins, resulting in a need for increased doses of medication to produce those “feel good” hormones. Of course, increasing doses, in turn, results in increased tolerance, dependence, and then ultimately abuse.

Opioid abuse can impact the entire body. Some of the body’s systems that are impacted include:

  • Heart: The lining of the heart can become infected (endocarditis) from heroin use.
  • Blood: Veins can collapse when heroin is injected. In addition, blood vessels can experience blockages from injection contaminates, resulting in organ damage.
  • Brain: Opioid use can cause sedation, even leading to coma or death. There is also a risk of major depression, anxiety, and other mental health issues.
  • Lungs: Respiratory depression and slowed breathing can cause sudden death.
  • Liver: Heavy opioid use can cause liver dysfunction and disease, in addition to shared needles possibly leading to hepatitis. Additionally, using opioids with alcohol can greatly reduce your liver’s functionality, leading to liver failure and eventually death.
  • Immune system: Substance abuse an lead to a lowered immune system, making you more vulnerable to infections, including HIV.
  • Nervous system: Because opioids impact the pain response, chronic abuse can lead to increased pain sensitivity and decreased response to pain medications. You might also experience psychomotor impairment and other difficulties with movement.

Mass Opioid Overdoses

Several towns across the United States have experienced mass opioid deaths because of “bad batches” and contaminated heroin or other opioids. Montgomery County in Ohio experienced a string of mass opioid deaths in July and August 2018, when 22 people died from heroin laced with high levels of fentanyl. Nearby counties in Ohio experienced an increase of deaths at that same time, with 39 accidental overdoses and 63 drug-related emergency room visits due to contaminated heroin.

In March of 2019, Central New York experienced a rash of opioid overdoses, with 21 overdoses and five deaths within a 10 day span of time. Just as with Montgomery County, heroin laced with fentanyl was implicated in the overdoses.

Fentanyl: A Deadly Addition

The trend towards cutting heroin and other opioids with fentanyl, a powerful synthetic opioid, has resulted in increasing numbers of overdose deaths. Often, users are not aware that fentanyl has been added to their heroin and unknowingly use the tainted drug.

The U.S. Drug Enforcement Administration has been cracking down on the amount of fentanyl available on the streets. In January 2019, the largest ever fentanyl bust was made, with U.S. Customs and Border Patrol seizing 114 kilograms of fentanyl, along with 179 kilograms of methamphetamines.

In March 2019, another large fentanyl bust took place, with federal agents confiscating five kilograms of fentanyl and six kilograms of heroin in a home in Westchester County, New York. For perspective, five kilograms of fentanyl is potent enough to kill two million people.

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Getting Help

There is no doubt that opioid addiction is a serious problem. An fatal overdose can happen even with the first time using heroin or other opioids. It is essential to get appropriate and skilled treatment if you or someone you know is abusing opioids. The only guaranteed way to prevent an overdose death once you begin abusing opioids is to detox from the drug and begin a treatment regimen to help you overcome withdrawal symptoms, avoid relapse, and get on the path to clean living.

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