In the past 20 years, more than 300,000 deaths have occurred as a result of fatal opioid poisoning. (Minhee & Calandrillo, 2019). In the year 2017 the United States sustained more than 70,000 deaths from drug overdose; 48,000 resulted from opioids and 28,000 from the use of synthetic opioids like fentanyl and carfentanil. Research data from investigating the root cause of the opioid crisis shows the increased number of opioid related deaths directly correlates with the increase use of prescription opioids by physicians to treat patient’s symptoms. The staggering numbers of fatalities from the opioid crisis has caused enough concern in the United States government to persuade the president to take action. The president has declared the crisis a national public health emergency and laid out an initiative to solve the current opioid crisis. (Brown & Morgan, 2019). While the initiative has good intent, it relies heavily on outdated methods of incrimination and prohibition and lacks treatment and education funding. Recent studies show that addiction treatment and education is the only way to solve an epidemic of this nature and this proportion. (Issitt, 2018) Ending the current Opioid crisis, which stems from corporate greed paired with poor government oversite and regulation on the medical community, will only be accomplished by funding a massive plan to implement addiction treatment and education programs across the nation.
Prescriptions for pain management planted the seed for addiction which cultivated a generation of addicts. A growing number of Americans suffering from healthcare issues such as obesity, cancer, and age related illness like arthritis and muscular skeletal surgeries, have the symptom of chronic pain. Treating the underlying issues of chronic pain usually requires extensive and expensive healthcare. (Issitt, 2018) When a patient complains of pain, a doctor’s first reaction is to ease the pain by treating the symptom with the best application for relief. A Study conducted in 1986 suggested the long term use of opioids may be a safe and effective way to treat chronic pain. The study was conducted over a 6 year period with 19 patients, and much of the evidence pointing toward addiction, abuse, and even hospitalization was discounted or discarded completely from the results. The data from this research and support which it received is now the topic of discussion in several law suits against the largest pharmaceutical companies in the country. The Pharmaceutical companies, referred to as Big Pharma, capitalized on studies such as these, the Portnoy & Foley study in particular, and launched a marketing campaign to push the sales of their narcotics into astronomical proportions. Post 1995, OxyContin was the leading market prescription opioid for more than a decade and between 1995 and 2001 it’s sales totaled more than $2.8 billion.(Brown & Morgan, 2019) By 2012 the opioid painkiller market accounted for almost $9 billion of the total U.S. market annually. The CDC reported more than 200,000 deaths as a result from prescription opioids between 1999 and 2016. (Jacobs 2018) According to Jacobs (2018), “In 2016 alone, more than 46 people a day died from prescription opioid overdose.”(p. 7) Big Pharma’s conduct and the charges filed against them rivals that of the most nefarious cartels and mobs throughout history; so does the body count. The CEOs and executives of these companies face charges that range from negligence, misrepresentation and fraud, to racketeering, bribery and coercion. With these investigations shedding light onto the pharmaceutical companies’ role in creating the opioid crisis, light is also shed on others to blame as well. The medical community and government regulatory institutions of health, share equal blame in their abuse of power and position; willingness to except human casualties in lieu of money or personal gain and complete disregard for alarms and warning signs of the impending crisis. (Jacobs, 2018) The seeds for addiction were sewn in the first 2 decades of the opioid crisis. Common-practice in the healthcare community to treat symptoms by irresponsibly handing out opioid prescriptions to their clients, in exorbitant amounts, gave harvest to the deadly opioid epidemic we face today. Research shows that the rise of prescription opioids directly correlates with the rise in opioid addictions and abuse, reflecting the sudden onslaught of the opioid crisis.(Brown & Morgan, 2019)
From prescription abuse and addiction to the use of dangerous street drugs; by 2010 the opioid crisis took an even more dangerous turn as the body count from heroin, followed by synthetic drugs like fentanyl and carfentanil, rose exponentially. It was around this time, the government began tightening restrictions on opioid prescription practices as concerns for addiction and overdose showed a connection with the long term use of opioids. (Brown & Morgan, 2019) Studies show that those who suffer from chronic pain often show signs of psychosocial illnesses like depression and hopelessness, making them more susceptible to behaviors of addiction and drug abuse. With several uninsured and under-insured Americans seeking relief from chronic pain and psycho-social stress issues, coupled with the expensive cost of prescription drugs, many Americans turn to the cheapest option of self-medicating by soliciting illegal drugs for treatment of their chronic pain and stress. (Issitt, 2018) Legal purchase of prescription opioids like OxyContin averages around $1.25 for a 10mg tablet and $6.00 for an 80mg tablet, whereas, the street price range from $5 to $10 dollars per 10mg tablet to as much as $80.50 per 80mg tablet. Street prices for heroin are approximately $152 dollars per gram. (Minhee & Calandrillo, 2019) An observation of simple economics can explain the increase of supply and demand for illegal street drugs as opposed to the harder to obtain, more expensive, legal prescription drugs. As supply and demand increase the need to cut down bulk on the illegal supply side also increases, influencing the desire for more potency per pound. Fentanyl has a lethal potency in the size of a grain of salt, making it the prime candidate for mixing with popular drugs like heroin to increase potency. (Brown & Morgan, 2019) As these drugs hit the market in 2013, the death rate from their lethal potency skyrocketed, making this the deadliest drug epidemic in American history.
On March 19th of 2018 the Trump administration laid out a plan to combat the opioid crisis. While the plan has good intent and addresses the problems associated with the opioid crisis; the details to the plan show most of the efforts point toward cutting supply and demand and battling the illegal trafficking of banned substances. 2/3 of this 3 part plan is based on traditional punishment and prohibition style tactics with only 1/3 devoted to treatment and education. A New York Times report from the questioning of over 30 experts in the field completely refutes this. The experts in the study recommended a majority of the funding be dedicated to treatment and education and only 3 to 4 percent going to prohibition and punishment reform. (Issitt, 2018) When examining the root cause of the epidemic, one would think that applying strict regulation on the prescription of opioids for pain management would solve the main issue and have a successful ripple effect over time. Where this is somewhat true, studies show, those already dependent on opioid prescriptions to manage their illnesses, would be more inclined to turn to fatal, illegal street drugs in an attempt to self-medicate; thus increasing the number of drug related deaths from heroin, fentanyl and more potent mixtures of both.(Mihee & Calandrillo, 2019) The Trump administration boasts plans to crack down on illegal traffickers and distribution of opioids and synthetic opioids by increasing punitive measures for those caught in possession of, and using illegal drugs. This method has proven to be ineffective and greatly increases the number of incarcerations from petty drug crimes creating dire psychosocial conditions conducive of manifesting stronger addictions to drugs and habitual criminal activity. The “Iron Law of Prohibition” proves that, such a crackdown would only push users to more potent and lethal drugs. (Beletsky & Davis, 2017) Prison and punitive measures, while seen by some as a natural deterrent for committing illegal acts, is seen by prior convicts as less intimidating and ineffective deterrent. Being an addict also hinders one’s ability to think rationally, or even consider the importance of self-preservation over their perceived addiction needs. (Issitt, 2018)
The past wars on drugs have been based on the theory of reducing supply and increasing penalties which, in turn, increases the amount of incarcerations in relation to petty drug crimes. The research and data shows that decriminalization and treatment of addiction, in combination with education and MAT (Medication-assisted Treatment) programs is the most effective way in battling the opioid crisis. This has been proven in countries like Portugal and Canada along with other European countries as well. (Issitt, 2018) To refute this data and information would be irresponsible and would only exacerbate this epidemic which plagues America.
It is clear that the Opioid crisis stems from the over-prescription of opioid based drugs in treatment of many ailments related to the health issues that Americans face today. The uncontrolled and licit use of opioids to treat a range of ailments created a generation of addicts. The government responded to the first recognition of opioid misuse by attempting to regulate a medical community with liberal prescription habits; thus choking the supply of legal drugs to an already addicted population. With a population of addicts in desperate search of relief, some legitimate and some manifested from psychosocial disorders, the black market quickly becomes the go-to for self-medicating their issues without the red tape imposed upon prescription drugs. These conditions paired with the influx of much more potent synthetic drugs on the black market created an environment conducive for overdose deaths. In the face of an epidemic sweeping our nation the U.S. government is slow to take action. The opioid crisis has already claimed hundreds of thousands of American lives. The time for corrective action is now. Research and evidence clearly shows that old methods based on punishment and prohibition will only exacerbate the problem and result in more casualties. Further choking the supply and increasing the punishment for illegal drug use will only fuel the fire which is the opioid crisis today. The successes from plans already implemented in countries which faced similar challenges shows how far behind America is in resolving this issue. Experts claim and studies show that addiction treatment and education is the only option for reducing the death toll of this epidemic and ultimately solving the issue for good.
- Beletsky, L., & Davis, C. S. (2017). Today’s fentanyl crisis: Prohibition’s Iron Law, revisited. International Journal of Drug Policy, 46, 156–159. https://doi.org/10.1016/j.drugpo.2017.05.050 Retrieved from: https://eds-b-ebscohost-com.vlib.excelsior.edu/eds/detail/detail?vid=1&sid=afd3bcb2-63cd-4362-b89a-9576bf9e2f75%40pdc-v-sessmgr03&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=S0955395917301548&db=edselp
- Brown, R., & Morgan, A. (2019). The Opioid Epidemic in America: Implications for Australia. Trends and Issues in Crime and Criminal Justice. 578, 1-7. Retrieved from: https://eds-b-ebscohost-com.vlib.excelsior.edu/eds/pdfviewer/pdfviewer?vid=3&sid=eda151f6-85a9-4ce1-a38b-dc3a0488c683%40pdc-v-sessmgr04
- Issitt, M.L. (2018). The New Opioid Problem: Prescription Drugs Gone Wrong. In Grey House Publishing (Ed.) Opinions throughout History: Drug use and Abuse (pp. 519-538). Grey House Publishing. Retrieved from: http://vlib.excelsior.edu/login?url=https://search.credoreference.com/content/entry/greyothdua/the_new_opioid_problem_prescription_drugs_gone_wrong_2018/0?institutionId=1649
- Jacobs, B. L. (2018). A Rot in Heaven: A Powerful Investigative Partnership, the Opioid Crisis, Pill Profits, and a Pulitzer Prize. Tennessee Journal of Law & Policy, 13, 267–283. Retrieved from: https://eds-b-ebscohost-com.vlib.excelsior.edu/eds/pdfviewer/pdfviewer?vid=2&sid=aef4a511-2a91-4df2-9608-24ff4b9d7e61%40sessionmgr101
- MINHEE, C., & CALANDRILLO, S. (2019). The Cure for America’s Opioid Crisis? End the War on Drugs. Harvard Journal of Law & Public Policy, 42(2), 547–623. Retrieved from: https://eds-b-ebscohost-com.vlib.excelsior.edu/eds/pdfviewer/pdfviewer?vid=11&sid=eda151f6-85a9-4ce1-a38b-dc3a0488c683%40pdc-v-sessmgr04