Our Opioid Epidemic
The United States is in the midst of an opioid epidemic. In 2016, there were
64,000
deaths related to fentanyl, heroin and other opioids and according to
STAT, there are projected to be 650,000
opioid deaths over the next decade. The total number of deaths attributed
to the opioid crisis is more than the total number of US fatalities in the Iraq
and Vietnam war combined. There are believed to be 2.1
million American's suffering from some form of opioid addiction and in
2016, 92,000
children were put into foster care because of the crisis.
The opioid epidemic is a product of our healthcare system. In the 1990's, there was a movement within the medical community to consider pain as the "fifth vital sign." Pharmaceutical companies like Purdue Pharma, the creator of OxyContin, exploited this trend as an opportunity to push their opioids on doctors. They engaged in false marketing about the safety and addictive qualities of their drugs to convince doctors to prescribe them.
The severity of the opioid epidemic is a result of the convergence of a variety of factors: companies marketing their drugs to treat pain they were not suited for, doctors utilizing the drug as a easy way to treat complicated medical issues and the overprescription of such drugs for operations as simple as removing wisdom teeth. Much of the overprescription came from prescribing opioids for chronic pain, an issue that we still do not have a good solution too. In the early days of the opiate boom, doctors handed out prescriptions believing that they were easing suffering and while there were many cases of malpractice, it is wrong to attribute the blame to doctors as a whole.
Because of the reliance on opioids for treating pain, patients became hooked on opioids and when their prescriptions ran out, or they wanted a stronger high, they sought out opioid analogs such as heroin and fentanyl. The supply of heroin and fentanyl grew rapidly to match the demand from opioid users who'd lost their prescriptions and the excess of heroin and fentanyl created openings for new users into the market. In 2016, there were enough opiates prescribed to fill a bottle for every adult in the US. The scale of the overprescription is truly astonishing. Furthermore, while the issue has been propagated by the failures and malicious strategies of doctors and pharmaceutical companies, the consequences of it inter-lap with the abuse of other drugs (In 2011, 31% of painkiller deaths were linked to abuse anti-anxiety medications and in 2003 half of heroin related deaths involved alcohol) and the socioeconomic and racial inequalities within society.
In an article for Vox from 2016, German Lopez described some of the reasons for why the opioid epidemic has hit white Americans much harder than minority populations. He cites a quote from Dr. Andrew Kolodny stating that "Studies have found that doctors are much more reluctant to prescribe painkillers to minority patients, worrying that they might sell them or become addicted." The implication of this is that the disproportionate effect of opiates on white people is a result of black stereotypes. Also, the resounding support for victims of the opioid epidemic exposes the racism that was behind the War on Drug policies geared towards ending the crack-cocaine epidemics during the 70's and 80's which predominantly effected low income, minority populations.
In December 2017, Lopez released another article titled "The opioid epidemic has now reached black America" explaining that the idea proposed in his previous article is only true for overdoses caused by painkillers. And that the most recent data from the CDC shows that there is less of a disparity when accounting for overdoses caused by alternative opiates such as heroin and fentanyl. There are many reasons for the rise in heroin and fentanyl related deaths of black Americans: Lopez writes that the distribution of heroin and fentanyl into the United States is not as discriminatory as doctors and that black Americans, who have used heroin for longer, are overdosing at a faster pace because the infiltration of fentanyl (which is stronger than heroin) into the supply has made heroin more dangerous. What can be concluded from the narrative of the opioid epidemic is that the change in the connotation of drug addiction, from a character flaw to an actual medical condition, is a result of the epidemics impact on white America.
The opioid crisis is complicated and thinking about solutions for it is even more complicated. However, it is clear that at the heart of solving this epidemic is ensuring that there is equitable access to treatment for everyone affected. And now, that the epidemic is infiltrating minority communities, it is essential that those solutions do not discriminate.
In my next few blog posts I plan to explore policies that have been adopted to calm the crisis and what the Trump Administration, after declaring it a Public Health Emergency, has done to fight the epidemic in the United States.
Link to CDC data on opioid deaths.
The opioid epidemic is a product of our healthcare system. In the 1990's, there was a movement within the medical community to consider pain as the "fifth vital sign." Pharmaceutical companies like Purdue Pharma, the creator of OxyContin, exploited this trend as an opportunity to push their opioids on doctors. They engaged in false marketing about the safety and addictive qualities of their drugs to convince doctors to prescribe them.
The severity of the opioid epidemic is a result of the convergence of a variety of factors: companies marketing their drugs to treat pain they were not suited for, doctors utilizing the drug as a easy way to treat complicated medical issues and the overprescription of such drugs for operations as simple as removing wisdom teeth. Much of the overprescription came from prescribing opioids for chronic pain, an issue that we still do not have a good solution too. In the early days of the opiate boom, doctors handed out prescriptions believing that they were easing suffering and while there were many cases of malpractice, it is wrong to attribute the blame to doctors as a whole.
Because of the reliance on opioids for treating pain, patients became hooked on opioids and when their prescriptions ran out, or they wanted a stronger high, they sought out opioid analogs such as heroin and fentanyl. The supply of heroin and fentanyl grew rapidly to match the demand from opioid users who'd lost their prescriptions and the excess of heroin and fentanyl created openings for new users into the market. In 2016, there were enough opiates prescribed to fill a bottle for every adult in the US. The scale of the overprescription is truly astonishing. Furthermore, while the issue has been propagated by the failures and malicious strategies of doctors and pharmaceutical companies, the consequences of it inter-lap with the abuse of other drugs (In 2011, 31% of painkiller deaths were linked to abuse anti-anxiety medications and in 2003 half of heroin related deaths involved alcohol) and the socioeconomic and racial inequalities within society.
In an article for Vox from 2016, German Lopez described some of the reasons for why the opioid epidemic has hit white Americans much harder than minority populations. He cites a quote from Dr. Andrew Kolodny stating that "Studies have found that doctors are much more reluctant to prescribe painkillers to minority patients, worrying that they might sell them or become addicted." The implication of this is that the disproportionate effect of opiates on white people is a result of black stereotypes. Also, the resounding support for victims of the opioid epidemic exposes the racism that was behind the War on Drug policies geared towards ending the crack-cocaine epidemics during the 70's and 80's which predominantly effected low income, minority populations.
In December 2017, Lopez released another article titled "The opioid epidemic has now reached black America" explaining that the idea proposed in his previous article is only true for overdoses caused by painkillers. And that the most recent data from the CDC shows that there is less of a disparity when accounting for overdoses caused by alternative opiates such as heroin and fentanyl. There are many reasons for the rise in heroin and fentanyl related deaths of black Americans: Lopez writes that the distribution of heroin and fentanyl into the United States is not as discriminatory as doctors and that black Americans, who have used heroin for longer, are overdosing at a faster pace because the infiltration of fentanyl (which is stronger than heroin) into the supply has made heroin more dangerous. What can be concluded from the narrative of the opioid epidemic is that the change in the connotation of drug addiction, from a character flaw to an actual medical condition, is a result of the epidemics impact on white America.
The opioid crisis is complicated and thinking about solutions for it is even more complicated. However, it is clear that at the heart of solving this epidemic is ensuring that there is equitable access to treatment for everyone affected. And now, that the epidemic is infiltrating minority communities, it is essential that those solutions do not discriminate.
In my next few blog posts I plan to explore policies that have been adopted to calm the crisis and what the Trump Administration, after declaring it a Public Health Emergency, has done to fight the epidemic in the United States.
Link to CDC data on opioid deaths.
I have heard so much about the opioid epidemic within the past year especially with it being a large issue in neighboring towns my me. It makes a lot of sense that it steamed from when doctors were pushing pain medications onto cancer patients and other conditions. (my grandpa was prescribed during chemo) I agree that the doctors aren't all the blame they were just following orders.
ReplyDeleteCharles, not only is this topic interesting, but I think it's something very important to talk about. The opioid epidemic has had a long history in the state of Pennsylvania and has affected a large number of families, my own included. This epidemic is so unpredictable with victims ranging from young adults to the elderly. I think our best approach until more can be done is to stay informed and keep others accountable.
ReplyDeleteDefinitely a very pressing and important topic to discuss and I applaud you for taking on the task of doing so in this blog. Providing the background on why opioids have become so prevalent and dangerous for addiction I think was very interesting and crucial to mention. Obviously something has to be done to limit this opioid epidemic, with the number of people that are becoming addicted and dying from it, and I look forward to reading your future blog posts on this topic.
ReplyDeleteThis is a good take on a topic that unfortunately has much to be said about. While my own family has thankfully been thus far unaffected, a family friend has been effectivley forced to take on an infant as a result of the parents (her niece and her niece's boyfriend) being unable to care for the child, largely as a result of opioids. Because this issue is clearly so dangerous to our society I hope to see more discussing this issue (and that some of that discussion will include some ways in which we can combat it, so as to put my mind at ease).
ReplyDelete