America, it is time for an intervention; we have a drug problem. However, this is no surprise to anyone. It’s time to stop the opioid epidemic and if action is not taken now, thousands more will die, blue-faced and unconscious in the parking lots and sidewalks of where we call “home.” Opioid overdoses have recently taken the number one spot for the leading cause of death in Americans under 50. Opioids are now officially deadlier than many forms of cancer, guns, HIV/AIDS, and car crashes. Yet around 50 percent of opioid-related deaths are caused by legal prescriptions. Worst of all, over 80 percent of the world’s opioids are supplied by America, a very high amount for a country that only makes up around 4.3 percent of the population. We are not only the drug abusers, but we are also the drug dealers. What does this say about America as a country? What does this say about our healthcare system? And most importantly, what does this say about our morals?
Opioids are considered the most addictive substance in the world and it is a shame that we have plagued ourselves with it. They are analgesics which are responsible for pain relief, and some common examples include OxyContin, Fentanyl, Percocet, Morphine, and Heroin. Most commonly, opioids are referred to as “painkillers”, although a more fitting name would just be “killers.” By binding to opioid receptors in the central, peripheral, and enteric nervous system, opioids cause the inhibition of the transmission of sensory information–like pain–to the spinal cord. In addition, they activate inhibitory neurons in the midbrain, down-regulating many of the central nervous system’s functions. Together, opioids two-way action synergizes to create feelings of euphoria, dizziness, constipation, fatigue, respiratory depression, addiction, and of course death.
Research will tell you that the opioid epidemic started around the 1990’s but in reality it started ever since their discovery. Ever since The Spanish Inquisition in the 1400’s, opioids have been considered to have the “quintessence of gold” as coined by early toxicologist and alchemist, Paracelsus. As if opioids were not already praised enough, the first use of opioids as a painkiller in the U.S. during the 1680s started from a solution called “Laudanum” which in Latin translates to “to praise.” Quickly becoming a huge hit in America, morphine was introduced and became the American “panacea” for treating maladies from “women-related issues” to gunshot wounds. At that time, if the baby was crying and keeping you up all night, you would put codeine in their baby bottles to get them quiet. It was used for everything especially during the Civil War when soldiers would be unable to participate in battle due to crippling “Soldiers Disease” aka opioid addiction. As awareness of morphine addiction started to rise, The Bayer company (responsible for Advil and many drugs you take everyday) decided to help combat opioid addiction with it’s new “non-addictive” morphine substitute called “Heroin” and even had free samples of Heroin mailed to people with morphine addiction around the early 1900s. The best solution that the government could come up with was the Harrison Narcotics Tax Act of 1914 which placed a tax and required a physician’s registration for the distribution of opioids which acted as the first step towards the prohibition of opioids. Heroin sales were finally banned in 1924. However, in 1969 the World Health Organization made the mistake of debunking the belief that morphine abuse can constituent as “drug dependence.” However, the 1990s is when the opioid epidemic got very out of hand. After lobbying and marketing to healthcare providers and, pharmaceutical companies were able to continuously able to fuel the fire of opioid prescriptions and consumption. By the year 2002, 6.2 million Americans were abusing prescription opioids. It is unofficially estimated that around 65,000 (or 91 Americans per day) Americans died from opioid overdoses just in 2016.
The worst part of the opioid epidemic is the heart-wrenching truth behind it’s origin. Although related to many possible factors, the opioid epidemic in America mainly stemmed from corruption that plagued large pharmaceutical companies, conflict-of-interest between clinicians and drug consultants, pressure from politicians and their constituents, and lastly, the physiological nature of opioids and its defining property of addiction. For example, one of the infamous pharmaceutical companies that is responsible for maintaining the opioid epidemic in the United States is Purdue Pharmaceuticals. After carrying out grants and obtaining subsidies based on fraudulent information, Purdue touted that their new “non-addictive” drug called OxyContin would be the new replacement to all opioids, claiming that as long as a patient is in chronic pain, they will not become addicted. In addition, the non-profit organization in charge of regulating hospitals, the Joint Commission started revaluted doctors and healthcare providers in their techniques for treatment of pain encouraging that pain be viewed just as important as heart rate, breathing rate, and other vital measurements referring to pain as the “fifth vital sign” and should be decreased when possible. However, short-term pain relief with opioids only led to having the same patients come back to the hospital, but this time in a body bag.
In addition, researchers and doctors working on ways to treat opioid addiction also worked as consultants for the big pharmaceutical companies in charge of making them in the first place. This created a conflict-of-interest for researchers and drug consultants as they were more inclined and “encouraged” to “accidentally” leave out certain details of the opioid drugs in exchange for an increased salary. But it was not only the healthcare system that failed America, it was unsurprisingly our own politicians as well. Political action committees that represented large pharmaceutical companies donated over 1.5 million dollars to 23 legislators in order to encourage them to pass laws that decrease the Drug Enforcement Agency’s (DEA) oversight over illegal big pharma-based opioid trafficking around the U.S. and hospitals. The bill ironically called “The Ensuring Patient Access and Effective Drug Enforcement Act” passed by Republican House legislator Tom Marino (R-PA) in 2016 prevented the DEA from confiscating suspiciously large opioid shipments from pharmaceutical companies unless the shipments presented “a substantial likelihood of an imminent threat.” The thing about opioids is that their inherent addictive properties are not instantaneous, therefore addiction will almost never pose an “imminent” threat.
Here’s the deal: this opioid epidemic cannot be solved through medicine, cures, or vaccines; it can only be solved through a major attitude shift in the values that modern American healthcare hold dear. Einstein once said, “Many people think it is the intellect that makes a good scientist; they are wrong, it is character.” However, when scientists have intellect but lack character, it creates a dark, looming cloud that unremittingly snuffs out and consumes our lives as we know it…. literally. The only way to solve this internal problem of corruption and negligence requires advocacy…advocacy to the highest extent. Out of self-preservation, we, as a society, must come together and email our local congressmen and women demanding that the malevolent pharmacticual companies and doctors that willingly murdered mass numbers of innocent patients are held accountable for their actions. “If not now….when?”