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A Timeline of the Opioid Epidemic

The opioid epidemic continues to be a major crisis that the United States is struggling with. How did this epidemic arise? By exploring the history of the opioid epidemic, we can better understand opioid addiction and how to treat it.

Substance use disorders are complex and involve many moving parts. Drug problems are rooted in both personal and circumstantial issues like world affairs and drug accessibility and stigmatization. An article published in the Pharmacy Times stated that “several factors initiated the opioid pandemic and propelled its growth.”

The Start of the Opioid Epidemic

Opioids are often associated with pain management. In 1995, the American Pain Society introduced pain as the fifth vital sign, increasing physicians’ obligation to help regulate pain in patients during appointments. In the same year, Purdue Pharma launched oxycodone (OxyContin) on the market, “employing marketing campaigns that emphasized the benefits that extended pain relief provided while downplaying the implications.” The drug probably seemed miraculous at the time because of its ability to alleviate pain just by ingestion. Because of the excitement generated by the introduction of these new pain-relieving medications, most pharmaceutical companies producing them were able to minimize risk factors in their marketing. Several companies, including “Purdue, as well as Allergan, Endo International, and Teva Pharmaceutical Industries Ltd, also downplayed the serious risk and likelihood of addiction that occurs with their opioids.”

Over-Prescribing Practices

As a result of this lack of transparency, by 2012 physicians across the country had written over 259 million opioid prescriptions, which is “enough for every adult in the country to have a bottle of pills.” The large number of prescriptions issued without detailed information about side effects, and “advertising and false information concerning extended-release opioids’ addictive properties,” are only two of the reasons why the epidemic has continued to spiral. Eventually, the hidden truth about the potential harm of these drugs was addressed.

Unethical Practices By Distributors

Intending to protect public health, the FDA discovered that most major drug distributors were complicit in the distribution of unregulated narcotics. The US Food and Drug Administration (FDA) is responsible for protecting public health by “ensuring the safety, efficacy, and security of human and veterinary drugs.” A Wall Street Journal article entitled “Drugmakers Go on Trial Over Opioid Epidemic” revealed how drug distributors shipped loads of opioid drugs to retail pharmacies across the country “neither questioning nor reporting them to the Drug Enforcement Administration.” How did they get away with this? This distribution was made possible because “chain retailers operated within loopholes of the law to dispense opioids to an unwitting public.” Another article published in The New York Times entitled “Big Pharmacy Chains Also Fed the Opioid Epidemic, Court Filing Says” discussed the tactics that pharmacy chains relied on to distribute opioids. Some of these tactics included “providing seminars on pain management and safety, self-policing opioid orders without oversight, and using workarounds to evade hard limits on purchasing.”

A Rise in Public Awareness

Fortunately, over the past few years, public awareness about the dangers of opioid use has substantially increased. Public understanding of the risk of opioid overdose has resulted in education and access to naloxone, a drug used to treat a narcotic overdose in an emergency situation that is “designed to rapidly reverse opioid overdose.” Before 2012, only six states had laws that expanded access to naloxone or lowered criminal repercussions for drug use. Within five years, 46 states and the District of Columbia had issued laws that protect people who help individuals that overdosed or first responders who administer naloxone. Additionally, 46 states have laws that allow pharmacists to distribute naloxone to third parties or first responders from a prescription or standing order. In the years since, naloxone has become more widely available, thanks to an FDA-approved nasal spray formulation for untrained use in a setting without the need for medical assistance. This nasal formulation was popularized in April 2019 and is typically the preferred method of administration.

Hope For The Future

It is hopeful that the FDA approval encapsulates an “all-hands-on-deck approach with statistical models suggesting that 21% of opioid overdose deaths can be averted.” While there are efforts in place to reduce preventable deaths from overdose, they still occur daily. The takeaway from this data is that there are steps we can each take to prevent overdose deaths and help end the opioid epidemic. By studying the data we can learn and advocate for awareness of opioid issues and settle the stigma surrounding drug use and addiction.

At Boardwalk Recovery Center, we recognize addiction as a disease and have the resources to help you heal. Our empathetic approach assists us in making every possible effort to help prevent opioid overdoses and the continuation of the opioid epidemic.

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