America’s Opioid Epidemic

ANJALI HOPLEY

STAFF WRITER

Opioid addiction is plaguing the United States. According to the Centers for Disease Control and Prevention, 91 Americans die every day of opioid addiction, which includes heroin and prescription drugs such as Oxycontin and Vicodin. Public health officials have called the current epidemic the worst drug crisis in American history. From 2010 to 2016, the number of people diagnosed with opioid addiction rose 493% according to Blue Cross Blue Shield.

PHOTO CREDIT: CENTERS FOR DISEASE CONTROL AND PREVENTION

Opioids are a class of drugs that include heroin, synthetic drugs such as fentanyl
and prescription painkillers such as morphine, codeine, oxycodone (Oxycontin) and hydrocodone (Vicodin). These drugs interact with opioid receptors on nerve cells and produce a feeling of euphoria. Although prescription pain-killers are said to be safe if taken as instructed, they are often misused because of the sensations they arouse. According to the National Institute on Drug Abuse, even regular use of pain-killers, as prescribed by a doctor, can lead to a strong dependence. Each day more than 1,000 people are treated in emergency departments for misusing opioids. Additionally, according to the National Survey on Drug Use and Health, around 2.1 million Americans misused prescription drugs in the last year.

In 1995, Purdue Pharma developed the well-known prescription painkiller, Oxycontin. Upon its release, Purdue hailed the drug as a medical breakthrough for people suffering from moderate to severe pain and commenced a marketing campaign to count- er the attitude that opioids are addictive. The extensive campaign reached out to doctors nationwide to change their prescribing habits and instill the notion that concerns about opioid addiction were overblown. However, before the release of Oxycontin, Purdue had conducted no clinical studies on how addictive the drug might be. One year later, in 1996, opioid prescriptions increased precipitously.

Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Braindeis University told the New Yorker, “If you look at the pre- scribing trends for all the different opioids, its in 1996 that prescribing really takes off. It’s not a coincidence. That was the year Purdue launched a multi-faceted campaign that misinformed the medical community about the risks.” Furthermore, Purdue Pharma funded hundreds of highly regarded doctors and pain specialists to advertise opioids as a helpful drug with little to no side effects. Russell Portenoy, then a pain specialist at Kettering Cancer Center in New York discussed the problem of untreated chronic pain and the myriad of benefits associated with using opioids.

Portoney, paid by Purdue, said to The Wall Street that doctors that were hesitant about pre- scribing opioids were being “opiophobic.” Careful doctors that received criticism for being cautious about prescribing opioids were pressured into increasing their prescriptions. Once ahold of opioids, most patients developed an addiction, sold them on the street at high prices, or distributed them to friends and family members. This very process paved the way for mass, nationwide opioid abuse.

According to The Huffington Post, for the past 10 years, Purdue Pharma has blamed opioid addiction on the patient. Many critics believe that Purdue was well aware of the addictive effects of Oxycontin prior to its release. However, for years Purdue attributed rampant opioid abuse to the patients not taking the drugs as instructed. Now that the epidemic is destroying lives throughout the entire nation, Purdue has come forth with a different announcement. In a recent statement, Purdue recognized that even taking opioid pills as instructed by the Food and Drug Administration (FDA) can cause a strong, physical dependence to opioids. However, Purdue continues to enforce the notion that physical dependence and addiction are vastly different. Jane Ballantyne,

President of Physicians for Responsible Opioid Prescrib- ing told the New Yorker that once addicted, the difference between physical dependence and addiction means abso- lutely nothing. “…If they nd themselves unable to stop tak- ing a drug for fear of crippling withdrawal, at a certain point, that may as well be addic- tion,” said Ballantyne.

Many people who used prescription painkillers, like Oxycontin, in a medical or nonmedical manner have developed a strong, unstoppable dependence to their pleasurable effects. Because opioid prescriptions are extremely expensive, many addicts switch to heroin and fentanyl to satisfy their addiction. According to USA Today, an 80 mg Oxycontin can cost anywhere from $60 to $100a pill. Heroin, on the other hand, only costs around $45 for a multiple-dose supply.

The effects of both drugs produce a feeling of extreme elation that becomes hard to live without once experiencing it. In a study published in the American Society of Addiction Medicine, four out of five people who try heroin today started with prescription painkillers. Fentanyl, a synthetic opioid 50 to 100 times stronger than morphine and 40 times more potent than heroin has played a large role in opioid overdoses and deaths in America. Pharmaceutical fentanyl is used to treat severe pain, typically for those suffering from cancer. However, according to The Huffington Post most fentanyl is illegally shipped over from China, surreptitiously mixed with other opioids, and sold on the streets. Many addicts purchasing heroin or Oxycontin pills off the street or black market die from the hidden amount of fentanyl incorporated into the drugs.

According to The Guardian, it only takes about two milligrams of fentanyl, equivalent to four grains of salt, to kill the average adult. Renowned artist Prince was just one of thousands of people who fell victim to the deadly effects of fentanyl. When investigators raided his home in Chanhassen, Minn., they found pills labeled as prescription hydrocodone, but were actually made of fentanyl. The police concluded that he died from an extremely lethal mix of opioids, purchased off the black market. However, Prince was completely unaware that fentanyl was integrated into the pills. Barbara Carreno of the Drug Enforcement Agency (DEA) said, “These pills sold on the street, nobody knows what’s in them and nobody knows how strong they are.”

Once shipped out of China, fentanyl heads to the Mexican cartels where it is combined into opioids such as heroin, Oxycontin, and morphine, and illegally transported onto American streets. Cartels began using fentanyl once prices for prescription painkillers started increasing and people’s desire for a cheaper alternative, such as  heroin, grew. Because fentanyl is extremely potent, cartels find that they can decrease the amount of heroin and combine it with a less expensive alternative, such as fentanyl, to produce the same or stronger effect. However, most individuals buying opioids or other drugs like cocaine, are completely unaware that it is laced with fentanyl. Those who do not die from the lethal effects end up extremely addicted. According to the Wall Street Journal, fentanyl, like all other opioids, binds to opioid receptors on the brain and increases dopamine levels in the reward area producing extreme happiness and relaxation. However, opioid receptors are also located on the areas of the brain that control breathing. Even consuming a small amount of fentanyl can cause an individual to stop breathing altogether, thus leading to a lethal overdose.

PHOTO CREDIT: CENTERS FOR DISEASE CONTROL AND PREVENTION

The state of New York has seen its fair share of opioid related deaths and overdoses. According to LoHud, in Westchester County alone, 2,160 people were admitted to an emergency department for opioid misuse during the year of 2016. Furthermore, recent data investigating current opioid use in Westchester County shows that from January to March around 728 people have been admitted to a hospital for opioid misuse, which includes heroin. Although the number of people admitted to hospitals for opioid misuse may not seem that signicant, opioid use in Westchester County is greater than meets the eye. Naloxone, also known as Narcan, a drug used to reverse opioid overdose, is commonly used by emergency medical technicians (EMT) across the nation. In Westchester County alone, 3,201 EMT’s reported using Narcan on patients to revive them from their overdose. Effectively using Naloxone on the scene prevents EMT’s from  transporting patients to the hospital for further care. Thus, opioid use surrounding Manhattanville College is actually a summation of all of the people admitted to the hospital as well as those treated with Narcan.

Opioid addiction affects adolescents significantly. In a 2015 report by the American Society of Addiction Medicine, it was found that more  than 122,000 individuals between the ages of 12 and 18 have a strong addiction to prescription painkillers. More importantly, the prescribing rates for prescription opioids among young adults nearly doubled from 1994 to 2006. Because the minds of teens are still developing, they are especially vulnerable to opioid addiction. According to the National Institute on Drug Abuse, seven out of ten adolescents mix opioids with other substances, which puts teens at an extremely high chance of overdose.

Because opioids are extremely addictive and potent, withdrawal symptoms can be deadly. An addict who stops using opioids cold turkey can die from the dreadful sensations of withdrawal. Some of the results of withdrawal include nausea, vomiting, cold sweats, anxiety, insomnia, muscle pains, loss of appetite and more. The extensive list of effects can be extremely uncomfortable and actually render an addict to crave opioids more. Someone suffering from opioid addiction is best taken care of in a controlled, in-patient treatment program where safe, long-term abstinence from the drug is promoted. Treatment programs usually start with detoxication and medically managed withdrawal, where the patient gradually learns to live without opioids. In order to safely and effectively wean the patient off of drugs, the treatment program must include giving the patient opioids. As their time in the program continues,  the amount of opioids will decrease until the withdrawal symptoms are bearable.

The Trump administration declared the opioid epidemic a public health crisis due to the fact that it has permeated many towns in America. Although in the past, heroin and opioid
addicts were seen as “junkies” it has increasingly become the situation where people from all different walks of life suffer from opioid misuse and addiction. Cindy McCain, John McCain’s wife, developed an addiction to prescription painkillers after she injured her back. Craving Vicodin and Percocet, she tried to hide her addiction from the public world but could not overcome her longing for opioids without awareness and help. American radio talk show host and conservative political commentator, Rush Limbaugh, also suffered from an opioid addiction. Mr. Limbaugh was concealing information to obtain Oxycontin prescriptions as well as buying opioids off the black market to satisfy his addiction.

There is much discourse over how to effectively defeat the opioid epidemic. However, all sides of the discussion acknowledge that overcoming the crisis involves money. Communities and states that have been overwhelmed by opioid addiction need money to hire more people to battle the epidemic. Additionally, greater funding is needed to increase the number of treatment and education programs available nationwide. Without constant infomercials on opioid addiction and prescription painkillers, people will not fully understand the degree to which the opioid epidemic must be addressed. Mike Moore, Mississippi’s attorney general told the New Yorker, “To resolve the opioid problem you’re going to need billions. Treatment alone could be fifty billion dollars or more. And you need prevention and education programs on top of that.” Furthermore, in order to address the issue at its roots, many people and states have sued Purdue Pharma for the national opioid crisis. The state of Washington led a lawsuit against Purdue for deceptive marketing of Oxycontin and for convincing both doctors and patients that prescription painkiller addiction is rare.

PHOTO CREDIT: CENTERS FOR DISEASE CONTROL AND PREVENTION

Opioid abuse can happen to anyone. Suffering from an addiction is nothing to feel ashamed or embarrassed about. If you or someone you know needs help, effective treatment is available and can save lives. Manhattanville College students are encouraged to contact the Counseling and Wellness Center or the Health Center for assistance, information and help

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