THE NATIONAL INSTITUTE ON DRUG ABUSE,
part of the National Institutes of Health (NIH), quotes that the Centers for Disease Control
and Prevention (CDC) found, “Every day, more than 130 people in the United States die
after overdosing on opioids” (NIH, 2019). This epidemic of abuse with significant human
cost is a serious national crisis with an impact on the physical, mental, and economic health
of the country. One study estimated the annual economic impact of prescription
opioid abuse alone in the U.S. to be $78.5 billion, when you consider healthcare costs,
loss of workplace productivity, treatment for those who are addicted, and the involvement
of the criminal justice system (NIH, 2019).
The Opioid Epidemic: How Did We Get Here?
An addiction to opioids often has an ordinary, unremarkable
beginning, starting with a routine surgery or an accident,
such as a fall or car crash. Then, a prescription opioid
may be prescribed for pain during recovery. Due to their
profound pain-killing properties and dependence-producing
potential, prescribed opioids can cause patients to become
dependent. Dependence may subsequently shift to heroin
with its relatively low cost in comparison to prescribed
medication. And now illicitly sourced and far more powerful
fentanyl may be included in the illegal drugs being used.
“Many factors have intersected to drive the rate and reach of
the opioid epidemic. Prescribing practices have played a
substantial role, but those practices have been shaped in
turn by circumstances ranging from medical issues—increases
in chronic diseases, new surgical interventions, and professional
calls for better pain management—to the influence of market
distortions, including misinterpretation of scientific data,
introduction of new products, commercial marketing, and
large quantities of unused opioids made easily accessible in
the home” (National Academy of Medicine, 2017).
These factors, along with the scientific literature perspective
that opioids produced low rates of addiction and were
relatively safe, have fueled the problem. According to a
HealthLeaders article, “Two decades ago, Purdue Pharma
produced thousands of brochures and videos that urged
patients with chronic pain to ask their physicians for opioids
such as OxyContin, arguing that concerns over addiction
and other dangers from the drugs were overblown, company
records reveal” (Schulte, 2018). The tendency to prescribe
opioids alongside aggressive marketing approaches worked
to accelerate our nation’s dependency on opioids.
What is the Magnitude of the Problem?
Opioids are very effective for treating pain. However,
when used improperly they can produce serious harm,
including overdose as well as potential dependence
(CMS, 2017). The following statistics demonstrate the
magnitude of the problem:
• From 1999 to 2017, more than 700,000 people died
from a drug overdose.
• Opioids were involved in 47,600 overdose deaths in
2017 – 67.8% of all drug overdose deaths (CDC, 2018).
• In 2017, the number of overdose deaths involving
opioids (including prescription opioids and illegal
opioids like heroin and illicitly manufactured fentanyl)
was 6 times higher than in 1999.
• The age-adjusted rate of overdose deaths increased
significantly, by 9.6%, from 2016 (19.8 per 100,000) to
2017 (21.7 per 100,000).
In only a few years of being available, fentanyl has become
a leading overdose-driver in the U.S. Fentanyl, a synthetic
opioid many times stronger than heroin and morphine and
other similar synthetic opioids, killed nearly 30,000 people
in 2017 (Sanger-Katz, 2018).
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