The opioid crisis has hit America hard. According to the Centers for Disease Control, nearly half a million lives have been claimed by this epidemic in the past 20 years. On average, 130 Americans die from opioid overdoses every day, with prescription pain killers as its driving force. It’s the leading cause of death for Americans under 50 years old and in 2017, it was declared an official public health crisis by the CDC. The opioid crisis has been described as a “uniquely American problem” because the healthcare system in the United States favors writing out prescriptions for those who don’t qualify for health care or have to buy their own rather than explore other therapies that are more expensive.
The opioid epidemic can be traced back to the pharmaceutical industries alleged deceptive marketing practices that not only downplayed and denied the highly addictive nature of these drugs, but also encouraged doctors and healthcare professionals to prescribe these painkillers liberally. Drug manufacturers such as Purdue Pharma LP and Janssen Pharmaceuticals Inc. Now face hundreds of civil litigation lawsuits that claim they unlawfully increased sales to increase profits, committed gross negligence, and have used misleading marketing tactics; all of which has generated a public health emergency. The problem is that there are many other factors involved in this crisis, including the fact that doctors and healthcare professionals were pressured into prescribing these drugs by insurers who wanted to pay less out-of-pocket medical expenses for patients.
In the medical world, opioids are commonly prescribed as pain relievers. They are used to treat severe and chronic pain caused by various circumstances such as recovery from surgery, illness, or an auto accident. Opioids work by attaching themselves to opioid receptors, which are proteins located in the brain, abdomen, and spinal cord. The three opioid receptors – mu, delta, and kappa – are part of the opioid system; a neuropeptide system responsible for controlling pain and is the reward center for addictive behaviors. The mu receptor triggers the brain reward system, initiating euphoria and addictive behaviors. In a non-medical setting, opioids are used to produce that feeling of euphoria or prevent withdrawal symptoms associated with previous use of the drug.
Opioids and opiates are derived from the opium poppy; a flowering plant whose seed pods produce a liquid “gum” or “latex” that is dried and cultivated. Opiates are alkaloids such as opium and morphine. Opioids are semi-synthetic, or synthetic drugs either derived from morphine or fully grown in a lab. Both have the same effect on the central nervous system and brain function by blocking the feeling of pain and triggering a rush of dopamine, which is the chemical responsible for reward, pleasure, euphoria, and motivation in the brain. This rush of endorphins that create this euphoria, or high, does not last and since it is only achievable through artificial means (taking actual opioid drugs), the only way a person can experience that feeling again is by taking the drug again. Over time, the brain builds up a tolerance to opioids and either a higher dosage is needed to achieve that same feeling of euphoria or the brain becomes completely dependent on the drug to produce dopamine and function normally. Even though opioids are often prescribed by a doctor.
The 1990s saw a threefold increase in the amount of prescription painkillers, which is when the current opioid epidemic began, starting with overprescribing and progressing to addiction, misuse, and eventually death.
Opioid manufacturers were able to raise their revenues while simultaneously increasing addiction and overdose mortality by downplaying the addictive and ultimately fatal nature of opioids. The opioid mortality toll in Michigan in 2016 was close to 2,686.