Three Factors that Led to the Opioid Epidemic in America

Three Factors that Led to the Opioid Epidemic in America

America finds itself in the midst of an opioid epidemic. In 2016, about 64,000 Americans died due to drug overdoses, surpassing the entire death toll for the entire  Vietnam War in a single year.

About two-thirds of those deaths were directly tied to opioid use.

The statistics surrounding opioid use and abuse in America are staggering. Worse, experts forecast deepening crisis. The health and science journal STAT predicts opioid overdoses will likely claim as many as 650,000 lives over the next decade. In late October 2017, the White House officially declared the opioid crisis a public health emergency.

How did opioid abuse take on such epidemic proportions? In this blog series, we’ll explore why opioid use – and abuse – have surged in recent years. We’ll also focus on the specific challenges this public health crisis presents to physicians, patients, and pharmacists before highlighting concrete measures to help curb the epidemic.


Three key factors contributed to the the rise in opioid abuse we face today


Short-Term Effectiveness

Opioids foster addiction for one simple reason: they work. They help patients handle pain better than any alternative therapy. With prescription opioids, even the most immense pain becomes tolerable.

When it comes to short-term pain management, opioids remain one of the most potent tools for relief., For that reason, doctors feel confident prescribing them for patients recovering from surgery or an automobile accident.

And while prescription rates have gradually been decreasing in the last two decades, the numbers are still staggering. In 2015, there were three times as many opioids prescribed per capita than were in 1999.

Yet their very effectiveness at alleviating suffering can easily create dependence. Unfortunately, it is only over time that the negative effects of continued opioid use can become evident- at which point the patient may already be addicted.


Lack of Education

Failure to appreciate the risks of opioid use creates an environment for abuse to flourish. Doctors don’t hesitate to prescribe painkillers to help patients live in relative comfort, but don’t always take the time to help educate them on proper use. Handing those recovering from treatment several pages of dense medical prose along with their prescription rarely impresses upon patients the dangers of dependence.

While the general public is now better informed about the risks opioids carry than previously, few know all of the best practices for safe consumption, storage, and removal. This makes a surplus available for abuse; one estimate holds that enough prescription opioids are in circulation for every man, woman,and child to have a month’s supply.

To appreciate the gravity of this problem, consider the afterlife of a painkiller prescribed for a outgoing surgical patient. He might find himself no longer feeling pain but left with two weeks’ worth of pills still in the bottle. What does he do with them? What should he do?

In most cases, patients like this one simply don’t know – so they stow prescriptions away in the medicine cabinet because they might need them later. It can feel like a waste to throw half a bottle of expensive painkillers away. Unfortunately, holding onto pills you’re not using runs the risk of someone else using them to feed an addiction.

What if our hypothetical surgical patient chooses to throw the leftover pills away? Depending on how they’re disposed, they could still wind up in the wrong hands. And with opioid addiction running rampant, there’s a good chance they will.  


Unavailability of Prescription Medications

Despite the surplus of prescription opioids in circulation, they can be surprisingly hard to acquire.

Certain medications can be difficult to find, the patient to make stops at multiple pharmacies to get their prescriptions filled. Combined with the hefty price tag that many painkillers carry, it can be tempting to simply give up – or turn to more dangerous alternatives.

If they have trouble finding, affording, or getting a script to manage pain, many patients resort to a cheaper and more readily-available option: heroin.

A survey of people in treatment for opioid addiction featured in the American Society of Addiction Medicine’s “Opioid Addiction 2016 Facts and Figures” found 94% of respondents chose to use heroin simply because prescription painkillers were far more expensive and harder to obtain.

The step from killing pain to killing people, from prescription opioids to heroin and fentanyl, is a surprisingly common one – and the subject of our next blog.

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Dan Berman