In 2017, the U.S. Department of Health and Human Services (HHS) declared the opioid epidemic in the United States a “public health emergency.” It’s only been a few years since that has happened, but it seems a lot of progress has been made with the opioid crisis. We are now in a position to reflect on the situation and learn from it. It’s important to look at the impact the opioid epidemic had, how the problem started, what actions we took and where we stand today.
An Overview of the Opioid Epidemic
The United States has been dealing with an opioid epidemic since 1999. In total, there have been three “waves.” The first wave of opioid prescription overdose deaths started in 1999. The second wave in heroin deaths began in 2010. And a third wave of synthetic opioid (fentanyl) deaths started in 2013.
Some vital statistics on the epidemic are:
- From 1999-2019, almost 500,000 people died from opioid-related overdose deaths (both illicit and prescription opioids).
- The number of drug overdose deaths has almost quadrupled since 1999.
- A 2019 survey on national drug and health use found that 1.6 million people reported having an opioid use disorder within the previous year.
- The same 2019 survey reported that 745,000 people used heroin in the past year.
- 10.1 million people misused prescription opioids in 2019.
- 2016 was the record year for opioid-related deaths, sitting at 42,000.
- It’s estimated that 40% of opioid deaths involve prescription opioids.
- In 2016, across the nation, the rate of opioid-related hospitalizations was 297 per 100,000.
Understanding the Opioid Epidemic: How It Happened & Why
Many people removed from the opioid epidemic don’t understand how it happened. For many, it seems that all of a sudden, there were constant news reports of opioid use and drug overdose deaths. So, how did it all come about?
To understand the opioid epidemic, you have to look at each of the waves. The first wave started in 1999, when there was a sudden increase in prescription opioid deaths. This primarily stems from pharmaceutical companies reassuring doctors and medical staff that the risk of addiction to opioid medications was low. These companies started promoting prescription opioids as a way to treat chronic pain. Previous to this, these types of drugs had mostly been reserved for pain management in cancer patients.
By 1999, “86% of patients using opioids were using them for non-cancer pain.” These prescriptions became easily accessible, and addiction rose. Unfortunately, all of this led to the first devastating wave of the opioid epidemic.
The second wave occurred in 2010 and shifted to heroin. As efforts to curb easy access to opioid prescription drugs became more prevalent, people got desperate. Heroin is easy to obtain on the street and a more affordable option. People who were addicted to prescription opioids quickly transitioned to heroin to feed their addiction. From 2002-2013, heroin-related overdose deaths rose by 286%.
Along with the risk of taking a strong street drug, heroin has some additional risks that prescription opioids don’t have. As most people inject heroin, there’s a risk of HIV/AIDS, hepatitis B and C, blood infections and other diseases.
The third wave started in 2013 with the increase of fentanyl in the market. Fentanyl is a synthetic opioid that’s much more concentrated and deadly. This third wave peaked in 2016, after which there was a gradual decline.
Are We Still in the Opioid Crisis?
The sheer number of people struggling with opioid addiction in this country is still incredibly high. Still, before the COVID-19 pandemic, there were signs of improvement. For example, drug overdose deaths from 2017 to 2018 declined by 4.1%. And numbers seemed to have peaked for the opioid crisis in 2016, with a slow decline in rates every year.
Unfortunately, COVID-19 has undoubtedly challenged this progress. It’s still unclear of the full extent, but experts assume the COVID-19 pandemic set the drug crisis back. Previous research studies have found that unemployment and economic downturns can increase the rates of illegal drug abuse.
Regardless of the COVID-19 pandemic, the opioid crisis was never over; it was simply slowing. There’s still a lot of work to do to get the number of people abusing and dying from opioids down.
The Devastating Impacts
Hundreds of thousands of people have died from the opioid crisis. Unfortunately, some people are prescribed opioid pills without understanding the potential dangers of the drug. Prescription opioids are highly addictive and can lead to a spiraling addiction. One study found that 80% of heroin users started by misusing prescription drugs.
Government Reaction to the Opioid Crisis
So, since there’s been a looming opioid crisis for over two decades now, many people ask themselves, “What have we done about the opioid epidemic?”
In 2017, after declaring a public health emergency, the HHS announced a “5-Point Strategy” to address the opioid epidemic. The idea was to empower local communities to address the crisis head-on. The five points of the strategy are presented below.
1. Better Addiction Prevention, Treatment and Recovery Services
The HHS issued over $800 million in grants to support addiction facilities in 2017.
2. Better Data
The HHS worked with the CDC to issue more accurate and frequent reporting on drug overdose data. One example of this was ramping up monthly reporting by the CDC for provisional data on overdose deaths.
3. Better Pain Management
The HHS launched the NIH HEAL (Helping to End Addiction Long-term) Initiative for new approaches to effective pain management that aren’t addictive.
4. Better Targeting of Overdose-Reversing Drugs
HHS focused on providing drugs to help reduce the impacts of overdoses. The Surgeon General emphasized the importance of naloxone in 2018. Since then, naloxone is frequently used to “reverse” overdoses.
5. Better Research
The NIH Heal initiative is one of the many research initiatives being undertaken to challenge the opioid crisis.
Legislative Action Against the Opioid Crisis
In November 2020, Purdue Pharma, the maker of OxyContin, pleaded guilty to three federal charges. The charges laid out Purdue’s role in the nation’s opioid epidemic. The three charges were:
- One count dual-object conspiracy to defraud the United States and violate the Food, Drug and Cosmetic Act
- Two counts of conspiracy to violate the Federal Anti-Kickback Statute
This opioid epidemic lawsuit resulted in a plea of $3.544 billion in fines and another $2 billion in criminal forfeiture.
Looking to the Future
A lot of progress has been made to deal with the opioid crisis. Most communities have made naloxone readily available. Pharmaceutical companies are being held accountable for their role in this national crisis. Additionally, education around the importance of professional rehabilitation services continues to be a priority. Hopefully, all these actions will continue to decrease numbers of opioid addiction and overdose rates.
If you or someone you know is struggling with opioid addiction, FHE Health can help. Our skilled and friendly staff help patients take back control of their lives. Opioid addiction doesn’t have to be a lifelong addiction — help is available. Contact us today by calling us at (833) 596-3502.