The Opioid Crisis: How Did We Get Here?

Earlier this month, when addressing the opioid crisis in the Unites States, Attorney General Jeff Sessions, speaking to the annual conference of the National Alliance For Drug Endangered Children, called deaths due drug overdoses “the top lethal issue” in the United States. Sessions then called on law enforcement and social workers to “create and foster a culture that’s hostile to drug use.” He said preliminary data show nearly 60,000 overdose deaths in the U.S. in 2016, the highest ever.

“Our current drug epidemic is indeed the deadliest in American history. We’ve seen nothing like it,” said Sessions.

How Did We Escalate To An Opioid Crisis?

It’s not clear when opioid addiction officially began, but one great event certainly caused a national impact: the Civil War. Morphine is an opioid, and was used in field hospitals to reduce pain in wounded soldiers. After the war, soldiers found themselves returning home with more than battle wounds and psychological trauma. Many had an addiction to morphine. Yet “drugs were already on the scene and being consumed at alarming rates long before the start of the war,” according to Mark A. Quinones, who studied drug abuse during the Civil War.

At the end of the 19th century, another opioid was produced on a commercial scale. The Bayer Company had discovered something that was considered by many to be a “wonder drug”, and the use – and abuse – of this drug, heroin, only grew, as addicts found out the effects of it could be magnified if it was injected.

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Jump ahead a hundred years or so. Throughout the early 1990’s, the use of prescription medicines for the purpose of reducing pain grew substantially. According to a National Institute on Drug Abuse study, painkiller prescriptions increased by 2 million to 3 million each year. Then, from 1995 to 1996, it jumped by 8 million.

“I Got My Life Back” was a video production from a drug company, Purdue Pharma, that came out in 1998. It was used in physician waiting rooms, and followed six people suffering from chronic pain. They were all treated with the drug OxyContin, a highly addictive opioid painkiller.

The video was a huge success for Purdue Pharma. A year after it came out, the overall number of opioid prescriptions jumped by a staggering 11 million. In 2000, Purdue took out ads for OxyContin in medical journals across the nation.

But it all came crashing down on Purdue when, 7 years later, the company and three executives were charged with misbranding its drug and downplaying the possibility of addiction. The executives pleaded guilty, and the company settled with the U. S. government for $635 million.

Efforts to change the formulation of OxyContin to make it harder to grind up and abuse were somewhat successful, but with an unintended consequence. “Most people that I know don’t use OxyContin to get high anymore,” one opioid user said in a study. “They have moved on to heroin [because] it is easier to use, much cheaper and easily available.” The study also showed that 66% of those surveyed switched to other opioids.

Despite how addictive and damaging opioid painkillers can be, drug companies still maintain that their products are safe. “We manufacture and develop high-quality products that are safe and effective when used as prescribed by physicians,” Endo Pharmaceuticals, the maker of Percocet, told CNN.

While that may be technically true, the problem lies in the second half of their statement. Opioids are highly addictive. And when someone becomes an addict, they won’t restrict themselves to following a doctor’s orders. This is something we’ve known for a long time, at least since the Civil War.