The Roots of the Opioid Epidemic

Jul 24 2017

The Roots of the Opioid Epidemic

According to the CDC, since 1999, deaths attributed to the overdose of prescription painkillers has quadrupled. As the death toll has continued to skyrocket in the Opioid Drug epidemic (over 183,000 deaths from 1999-2015), one wonders how this all began?

Johns Hopkins Bloomberg School of Public Health published a paper detailing some of the root causes of the widespread abuse of controlled substances. Around the end of the 20th century, the paper states “patient advocacy groups and pain specialists successfully lobbied state medical boards and state legislatures to change statutes and regulations to lift any prohibition of opioid use for non-cancer pain. In at least 20 states, these new guidelines, statutes, regulations and laws dramatically liberalized the long-term use of opioids for chronic non-cancer pain, reflecting the prevailing thought at the time that there is no clinically appropriate ceiling on maximum opioid dosing.” Basically, it means that a doctor cannot be sued based on the quantity or frequency of prescribed opioids.

Beginning with this legislation, along with pharmaceutical companies marketing their wares directly to doctors, there has been a marked increase in opioid prescriptions. As a result, there is a direct correlation between these numbers and the mortality rates associated with these drugs.

As an editor of several treatment center magazines, I have also read story after story of individuals who were prescribed a prescription pain medication and then when their insurance ran dry, switched to heroin as a cheaper alternative. Adding heroin overdose deaths to the total number of drug overdose deaths, on average, there are 125 deaths per day. “The trend is now similar to that of the human immunodeficiency virus, or H.I.V., epidemic in the late 1980s and early 1990s,” said Robert Anderson to the New York Times in January, 2016. He should know, as he is the CDC’s chief of mortality statistics.

Prescription Drug Monitoring Programs (PDMPs) are state-run databases useful in tracking the prescribing and dispensing of opioid prescription drugs. The PDMPs are meant to evaluate this information for suspected abuse or dealing the drugs illegally, and can give a doctor or pharmacist critical information regarding a patient’s opioid prescription history. This information can help both doctors and pharmacists identify high-risk patients who might benefit from early interventions. PDMPs continue to be one of the most promising state-level interventions to improve and decrease opioid prescribing and protect at-risk patients.

To further help combat the crisis, in October, 2010, President Obama signed into law the Secure and Responsible Drug Disposal Act, an amendment to the previous law, promoting state involvement for drug take back days on a national scale. The U.S. Dept. of Justice and the Drug Enforcement Administration (DEA) says the next “National Prescription Drug Take Back Day” is scheduled for October 28, 2017.

The DEA does go after doctors who overprescribe, however, pharmaceutical companies are another matter. In researching the book, “American Pain”, John Temple, for the Daily Beast, says, “Each pharmaceutical company has to apply to the DEA to make a certain amount of a given controlled substance each year, but the DEA won’t reveal those numbers to the public. The companies and the DEA have negotiation meetings, the content of which is also not made public. The DEA then sets quotas based on “expected need.” The only information the DEA reveals each year is the total amounts requested by the entire industry and the total amounts the DEA is allowing them to produce. The DEA says it would be unfair to the pharmaceutical companies to reveal how many pills the individual companies wanted to manufacture.” Evidently, some people in the DEA think it is just fine to have massive amounts of opioid pills produced.

My father always taught me that a dandelion problem is only solved when you take out the whole root of the plant, otherwise it will grow right back. It seems that instead of the government putting amendments on previous laws, they should go back to the start of the problem, which was okaying states to prescribe opioids for non-cancer pain. I know that is going to make a lot of chronic pain sufferers upset, but isn’t the overdose epidemic worth that kind of backlash?



  • julioinglasses

    More nanny-state poppycock! Fake news from the DEA?

  • Laura4444

    I don’t understand what makes cancer pain so special that those patients are deserving of pain relief while others suffering from debilitating pain aren’t. I was hit by a truck while riding my bike and suffered horrendous injuries. I was an endurance athlete before this happened so I was used to pushing my body to its limits. The pain from my accident was beyond anything I could even comprehend before I experienced it. Opioids made the agony bearable, barely. Because of these meds, I’ve been able to work and live a relatively normal life.

    Taking away pain patients’ access to their pain meds is cruel beyond belief. I’ve heard countless stories of people losing their jobs and homes because they can’t work anymore since their pain meds were taken away. People are committing suicide because of their pain. Chronic pain patients have become pariahs and can’t find doctors who are willing to accept them as patients. if removing access to pain meds will solve the opioid problem then we should return to alcohol prohibition since tens of thousands die from alcohol poisoning and liver cirrhosis. You should give up your beer to prevent those addicts from dying and to keep you from becoming an alcoholic. Cigarettes should also be outlawed since they kill hundreds of thousands every year.

  • Jonelle

    At the end you state, “I know this is going to make a lot of chronic pain sufferers upset, but isn’t the overdose epidemic worth that kind of backlash?” If you ever spent a day in the life of a chronic pain suffer you would realize that they are all being treated unfairly in this war. Chronic pain patients should not be held accountable for what they go through daily. They didn’t ask for this. 98% of them will never abuse their medications. Addicts and chronic pain patients should not be bunched together but that is exactly what the media, government and medical institutions are doing. Please understand that chronic pain patients deserve to try and have a quality of life. They should not be treated like addicts.

  • julioinglasses

    NO, eliminating opioids for non-cancer pain is not the answer. People die from cigarettes at ten times the rate from opioids (1200/day), where is the outrage?

    As counterintuitive as it sounds, legalization is the way out of this morass, look at the huge decrease in smoking rates over the last 40 years…