What the Hell is the ‘Opioid Epidemic’? A Brief History

While the rise of the term “opioid epidemic” certainly has something to do with the highly-publicized and competitive 2016 election rhetoric, it isn’t fake news. According to a study done by Michael’s House Treatment Center, drug overdoses now represent the leading cause of accidental death in the United States—higher than the number of people killed in car crashes. Over a quarter of those deaths were due to heroin or other opioids, and nearly a quarter of all people in the country who have a substance abuse problem are addicted to opiates—more than alcohol, cocaine, or benzodiazepines. This is a 300% increase from 2010.

References to the use and abuse of opioids stretch back, quite literally, millennia.  It is estimated the plant was harvested as far back as 3400 B.C, before the invention of written language. References to its medicinal effects and addictive properties can be found in pieces of art and literature in Mesopotamia, India, and Europe. It has been used as an anaesthetic, a means of execution, and as a cure for maladies such as depression, migraines, and many other common illnesses. Prominent figures  like Elvis, Lou Reed, Kurt Cobain, William S. Burroughs, Edgar Allan Poe, Samuel Coleridge and Philip Seymour Hoffman have admitted to or been suspected of abusing either the perennial favorite, heroin, or one of several other types of opiates such as Demerol (meperidine), Vicodin (acetaminophen/hydrocodone), morphine, laudanum, Dilaudid (hydromorphone), and codeine. OxyContin (oxycodone) is still prescribed in many cases for the removal of wisdom teeth.

The question is then, why has this drug, which has existed for centuries, suddenly become an ‘epidemic?’

Like “3rd Rock From the Sun,” the band Limp Bizkit, backwards baseball caps, gritty super-hero reboots, frosted tips, and many other plagues that have ravaged America, the opioid epidemic began in the 90’s. A series of studies conducted by multiple large hospitals in the country discovered that patients were being chronically under-prescribed pain killers. These studies were largely factual—a combination of factors, from racial profiling by doctors to a lack of adequate funding to purchase safe anaesthetics, to a fear of over-prescription and its effect on the body meant that many of those in pain from medical conditions were not receiving adequate relief.

A solution quickly presented itself: synthetic opioids. Any competent chemist can create them for a fairly low price, and certain chemical purification and alteration processes could drastically decrease the risk of overdose. Not only this, but these drugs were largely more effective than other widely available painkillers, making the decision to begin prescribing them seem logical.

However, while scientists were able to mitigate overdoses by synthesizing and altering opium-based narcotics, they could not make them less physically and psychologically addictive. And while the vast majority of the 245 million prescriptions written for opioid analgesics were for short-term chronic pain, and are unlikely to result in addiction, the New England Journal of Medicine reveals that over 10 million adults were given the drug for 7-9 months, which rapidly increases risk of addiction.

This would be a problem even if users continued to abuse the regulated drugs like OxyContin, Demerol and Codeine. But they are significantly less lethal than heroin. Burroughs, mentioned above, lived to 77 after reportedly abusing heavily modified synthetic opioids every day since his 20s, and while The College Voice does not endorse this decision, several of these newer addictive medicines are demonstrably safer than street-cut heroin. Methadone, for example, is frequently used to help wean opioid users off of these drugs due to its lower risk of impeding respiration and causing overdose. This certainly isn’t true of all of the above chemicals, however, and both OxyContin and codeine, both of which can be prescribed for ailments as mild as an intense toothache, are often deadly when used or abused for lengthy periods.

Burroughs, as well as most other recreational users of these newer, medical-grade opiates, was fairly wealthy. The time and effort required to make these safer synthetics means that they are much more expensive to produce and purchase. When well-meaning doctors cease prescribing painkillers to patients who have become physiologically addicted (a process which the DEA reports can occur after less than a month of regular use), many of these users begin to experience withdrawal symptoms. This is less of a problem for wealthy Americans with private healthcare, who can afford treatment at rehabilitation clinics, expensive and experimental withdrawal drugs, or simply to go “doctor-shopping.” But working-class Americans who lack these resources are driven to seek out cheaper, more dangerous alternatives, namely, heroin.

But big pharma, lack of adequate healthcare, and the now wealthy and politically influential opioid lobbies are not solely to blame. Since the United States’s 2001 military invasion of  Afghanistan, one of the top producers of poppy plants, the price of heroin has dropped and available supply has grown markedly. While much of it is smuggled into the country illegally by soldiers, government officials or opportunistic outside contractors (here many readers may remember the heavy involvement of the CIA in the ‘crack epidemic’ of the 80’s and 90’s, in which Reagan and his administration are widely accused of exacerbating in order to further their political aims), thus making an exact figure difficult to accurately identify, many reports estimate the amount of heroin in the country has nearly tripled.

Though widely reviled by both parties, the opioid epidemic is a symptom of several failed economic, social, and military decisions. Focusing on eliminating the drug and providing treatment for addicts may be a good first step to mitigating deaths, but to fully negate the problem, and if we wish to see a meaningful decrease in the alarming statistics related to opioid consumption, abuse, and related deaths, it is necessary to commute several neoliberal policies which benefit the American military and economic elite.