The History Of Beginning Of Opioid Crisis

The Usage of Opioids in the United States has a Long History

The opioid crisis has been a huge issue in the United States for the past 25 years, inflicting widespread pain and death. From 1999 to 2019, the number of drug overdose deaths doubled, with opioids accounting for the majority of those deaths. During this 20-year span, about half a million people died of opioid overdoses, with the numbers continuing to rise.

The Opioid Crisis has Three Waves

Opioid abuse originally became an issue in the United States during the Civil War, when troops were given morphine to treat injuries, and many of them acquired opioid addiction. Opioid use was restricted in the 1910s and 1920s, and while opioid use disorder has been a concern since then, it truly took off in the later half of the twentieth century.

One Wave

The first wave began in the 1990s with increased opioid prescribing in response to a push from medical leaders for more pain management and a greater focus on patient happiness. The pharmaceutical industry took advantage of this tendency, and drug companies aggressively pushed opioid drugs to physicians while downplaying the dangers of addiction. Prescription opioid overdose deaths (natural and semi-synthetic opioids, as well as methadone) have been on the rise since at least 1993.

The Second Wave has Arrived

The second wave began in 2010, with substantial rises in heroin overdose deaths – death rates from heroin more than doubled between 2010 and 2012. Simultaneously, mortality from prescribed opioids decreased marginally but remained more than twice as high as heroin deaths.

Many patients are said to have proceeded from prescribed opioids to illicit use of prescribed opioids, and subsequently to heroin, which is less expensive, easier to obtain, and provides a more intense high: Three-quarters of habitual heroin users said their first opioid of choice was a prescription medication. When their doctor stopped prescribing or moved away, many patients report turning to illicit opioids.

The Third Wave

The third wave began in 2013, when overdose deaths utilizing synthetic opioids, such as illicitly made fentanyl, skyrocketed. DEA seizures of these substances also increased during this time period (426 percent from 2013 to 2014). Criminal groups largely distributed synthetic opioids, which sold them as counterfeit prescription tablets or mixed them with heroin or other illicit substances like cocaine, with or without the knowledge of the consumer.

Fentanyl and its analogs (carfentanil) are up to 10,000 times more strong than morphine, which means that even when given by mouth, the risk of overdosing is extremely significant. Overdose deaths caused by synthetic opioids now account for more than half of all overdose deaths. According to recent estimates, benzodiazepines, cocaine, or methamphetamine are discovered in more than half of persons who die from opioid overdoses.

What Distinguishes the Opioid crisis from other drug-related issues?

Opioids are distinct from other illegal substances for various reasons. One is that opioids are prescription pain relievers that are used to treat both acute and chronic pain. People with opioid use disorder frequently begin with a doctor's prescription, whereas illicit drug use disorders may begin as a result of teenage rebellion or deviant behavior.

Second, opioids can be fatal if overused: there is a high danger of overdose due to respiratory suppression, but the risk of overdose from cocaine, methamphetamine, and cannabis is lower, but still there. However, now that drug cartels are adding synthetic opioids to other illicit narcotics, there is a greater risk of overdose from drugs like cocaine, which can be laced with these high-potency opioids. Furthermore, mixing opioids with benzodiazepines and alcohol raises the risk of an opioid overdose even more.

Who is Affected by the Opioid Crisis?

Teenagers, retirees, veterans, chronically sick patients, and members of the LGBTQ community are all affected by the opioid epidemic. Death rates have risen across all age categories and across socioeconomic sectors in recent decades. Because the path to addiction typically begins with a common medical complaint (pain), the opioid problem has become so widespread.

In contrast, 80 percent of people who acquired opioid use disorder in the 1960s said they started with heroin. A single medication can send you down the wrong path. About 10% of persons who take opioids for chronic pain develop an opioid use disorder, and about 5% of those who misuse prescription opioids progress to heroin. Regardless of one's upbringing or demography, the temptation to use can become so strong that obtaining the drug takes precedence over all other priorities in one's life.

However, in the current outbreak, there are certain notable risk groups. For example, Caucasians account for 80% of those who overdose (although the rate of increase appears to be high in African American populations with semisynthetic opioids).

Overdose risks are particularly high in rural locations and places with a high concentration of construction and manufacturing jobs, as well as among people without a college diploma. Additionally, groups of people with anxiety and depression, who are at a higher risk of developing a use disorder, had higher rates of opioid prescribing than those without (20 percent versus 5 percent ).

The demographics of heroin use reflect these shifts: before, heroin use was concentrated in inner-city, minority communities, but now it is more widely distributed.

Defending Against the Opioid Crisis

The CDC's strategy to combat the problem is to conduct research in a rapidly changing environment, facilitate cooperative agreements between states for data collection and public health efforts, provide safe opioid prescribing guidance to providers and health systems, collaborate with community leaders and law enforcement, and raise public awareness through education.

More public and provider education about safe opioid prescribing, effective treatments for opioid use disorder (often referred to as medication for addiction treatment or medication-assisted treatment (MAT) and how to access them, the importance of naloxone for overdose prevention, and the alarming rise in high-potency fentanyl use will save lives.

Patients and physicians can also do their share to stop the opioid pandemic from spreading further. Non-opioid pain management is more effective for both acute and chronic pain. People should tell their doctors that opioids should only be used as a last option.

A New Ray of Hope For the Aministration of OUDs

Taking medicine to help with opioid use disorder (MAT) recovery reduces cravings, minimizes relapse, boosts productivity, and prevents overdose mortality. Numerous studies show that taking one of the three main classes of medication long-term (naltrexone, methadone, or buprenorphine-containing) is far more effective than taking medication only to get through acute withdrawal, even if 12 step meetings or counseling visits are attended after detoxification.