The Opioid Epidemic

Ethan Park

Green Group

May 15, 2017

 Congress must push for further regulation of prescription opioids, as long-term use of

opioids can lead to addiction, criminal activity, and potential overdose, opioid painkillers are

often a gateway drug to more dangerous substances such as heroin, and the use of other methods

to relieve pain prove to be safer than prescription opiates. Since 1999, deaths involving

overdoses on prescription opioids have increased drastically (Prescription Opioids). The

increase in opioid-related deaths is often tied to the ways Americans have used and continue to

use drugs to alleviate chronic pain. Since before the 1900s, Americans have been using different

kinds of painkillers to stop their chronic pain, without knowing about the potentially addictive

natures of the drugs. Heroin, now illegal in the U.S., was once hailed as a wonder drug to

alleviate Americans of chronic cough before officials realized the addictive nature of the

substance; likewise, more than 11 million prescriptions for opioids were filled out in 1999 alone

- about 10 years before Americans started to realize the increasing amounts of opioid-related

deaths each year (Moghe). It is imperative that the U.S. government take further action to

regulate opioids, as opioid-related deaths continue to rise and safer ways to relieve pain are

beginning to surface.

Prescription opioids, advertised by pharmaceutical companies as effective painkillers,

have proven to be the most dangerously addictive medicines on the market. The misuse of

prescription opioids has led to an increase in unintentional deaths due to overdose and opioid-

abuse disorders. According to the Centers for Disease Control, approximately 40 Americans die

each day from prescription opioid overdoses. CDC director Thomas Frieden stated in March

2016 that, [the CDC] knows of no other medication routinely used for a nonfatal condition that

kills patients so frequently (Szabo). Pharmaceutical companies are often credited with the

widespread use of these opioids as painkillers. Through advertisements and denial of their
products potentially addictive side effects, pharmaceutical companies quadrupled their sales of

prescription pain relievers from 1999 to 2008; similarly, overdose death rates have quadrupled

over that same span of time (Opioid Addiction). The correlation between prescription opioid

sales and overdose deaths points to the danger of many of the painkillers, as well as the

increasing risk of overdose by opioids. Not only do opioids have the potential to kill those who

use it, but their highly addictive nature often leads to the user becoming dependent on the

painkiller. Once the user becomes hooked on the opioid, it is very difficult to stop using the drug

in order to relieve pain (Volkow and McLellan). Addiction becomes very problematic if the user

needs the painkillers for chronic pain, resulting in the need to take the prescription opioids for

long periods of time. Side effects of long-term use of opiates include brain damage, liver

damage, and a development of tolerance (The Effects).

Not only does long-term use affect the users body, but it also may lead to further

criminal activity in order to satisfy their cravings for the drug. As ones addiction escalates,

constant use of opioids will cause their prescriptions to run out faster. The craving for opioids

may cause addicts to engage in illegal practices including buying the drug without a

prescription, doctor shopping to get multiple prescriptions from multiple

professionals, or deceiving or stealing from pharmacies (Is Opiate).

Addicts may also commit theft in order to fund their addiction, as they

become motivated to do nearly anything to obtain their next dose. Criminal

activity relative to opioid use often worsens when the addict does not

attempt to find treatment for their addiction, and continues to develop

tolerance and cravings for the substance. Many addicts who realize that they have an
addiction to opioids are able to seek help for their opioid-misuse disorders; however, it is still

evident that opioids remain accessible enough that people can become easily addicted.

The rise in opioid addiction can be credited to the pharmaceutical companies that misled

the American public to thinking opioids were not addictive. In 2000, the Joint Commission

printed a book, sponsored by pharmaceutical company Purdue Pharma, that denied any risks of

addiction by opioid, stating that there is no evidence that addiction is a significant issue when

persons are given opioids for pain control" (Moghe). The Joint Commissions claim sparked a

significant rise in opioid use, as well as addiction. Opioids were later proven to be highly

addictive, but little action was taken to deal with the already widespread use of the drugs. Opioid

addiction has grown drastically since the 2000s, as an estimated 2.5 million American adults

were affected by opioid addiction in 2014 (Volkow and McLellan). Opioids, despite claims from

pharmaceutical companies, have proven to be highly addictive and, in some cases, lethal. The

addictive nature of prescription opioids, used for nonfatal purposes, has proven to be a dangerous

combination that has led to addiction, crime, overdose, and death.

Prescription opioids often serve as gateway drugs to illegal and more dangerous

substances such as heroin, which contains similar, stronger chemicals. Due to the high prices of

opioids on the market, many people turn to buying cheaper and stronger drugs, which greatly

increase the already high chance of overdose and death. Heroin and prescription opioids contain

chemical structures that are very similar, and bind to the same group of receptors in the brain;

thus, those who become addicted to opioids have a higher chance of becoming addicted to heroin

in order to gain the same high. Over a 10 year span from 2002 to 2012, it was measured that

someone who had priorly used prescription painkillers was 19 more likely to initiate heroin than

someone who had not taken painkillers (Prescription Opioids). After one becomes hooked on
prescription painkillers, he/she likely will start taking heroin, which is cheaper and much more

accessible. According to Dr. Jason Jerry of the Cleveland Clinics Alcohol and Drug Recovery

Center, the price of one milligram of OxyContin is $1. One can get the same amount of heroin

for about a tenth of the price (Carey). In a recent study of people being treated for opioid

addiction, around 94 percent of those surveyed chose to use heroin because prescription opioids

were far more expensive and harder to obtain (Prescription Opioids). Not only is heroin

more addictive, but it is much stronger and can be laced with contaminated substances. Users of

heroin often experience collapsed veins, rheumatological diseases, and infections of the heart

lining and valve (Gupta). The increased strength of heroin, along with the chances of

contamination, greatly increases the chance of overdose and death. Since 2010, heroin overdose

deaths have more than quadrupled (Heroin Overdose). As opioid addiction spreads rampantly

across the country, more and more people are turning to the cheaper and more accessible

alternative of heroin. Prescription opioids serve as a gateway drug to heroin for many Americans,

causing many lives to be lost due to overdose and the harmful effects of the drug.

For years, many Americans have relied solely on prescription opioids to relieve all types

of pain; however, new alternatives for opiate painkillers are available, including therapies,

exercise, and alternative medication. Although these alternatives may not be effective for acute

pain and diseases such as cancer, they give doctors options so they do not immediately have to

resort to opioids if a patient complains about chronic and less severe pain. An example of a

method to relieve pain is Cognitive Behavioral Therapy, or CBT. According to Cleveland Clinic,

CBT is a short-term, goal-oriented form of talk therapy. Using CBT, one can gain control over

the pain, and choose to make healthier choices when weighing the options for pain relief. A

person who is discouraged by the pain is more likely to search for quick fixes, including
medication; however, a person who uses CBT to gain a better perspective on the pain will be

able to choose healthier alternatives to opioids (How Can You Relieve). Along with controlling

thoughts and feelings, exercise can be useful as well. Exercise and stretching can help to loosen

joints and improve circulation; in addition, exercise will help to build up tolerance to discomfort,

making the brain more tolerant to chronic pain. According to Matthew Jones, a researcher at the

University of South Wales, moderate exercise allows the brain to accept that [one] is tougher

than it had thought, and it allows [one] to continue longer although the pain itself has not

lessened (Reynolds). Changes to diet can also result in pain being alleviated, as a healthier

lifestyle can help get rid of chronic pain. Eating foods that reduce inflammation while avoiding

foods that cause it can help alleviate different types of pain; in addition, drinking lots of water

and avoiding alcohol and nicotine helps the body stay healthy (Pohl). Although these methods

for pain relief may take more effort than taking a pill, they diminish the risks of addiction and

overdose that opioids present. By using different types of therapies, exercising, and eating

healthier, one can build a good attitude and good habits that will help to cope with the pain and

live a healthy lifestyle.

As the death toll for opioid-related deaths continues to rise, it is evident that prescription

opioids are hurting more than they are helping. Opioids are not only addictive and potentially

lethal, but they are gateways to illegal drugs such as heroin. Congress has yet to take any serious

action on regulating opioids, and stopping the epidemic that is sweeping the nation. As

Americans continue to search for faster ways to cure pain, it is critical that people begin to

realize the serious effects of opioids on American society. The government must take action to

further regulate the amount of prescription opioids available to the American public today, as
more and more people are overdosing on painkillers, getting hooked on heroin, and relieving

pain in unhealthy ways for both themselves and the people around them.

Works Cited

Carey, Benedict. "Prescription Painkillers Seen as a Gateway to Heroin." New York Times, 10

Feb. 2014, www.nytimes.com. Accessed 15 May 2017.

"The Effects of Opiate Use." DrugAbuse.com, www.drugabuse.com. Accessed 3 Apr. 2017.

Gupta, Sanjay. "Unintended Consequences: Why Painkiller Addicts Turn to Heroin." CNN, 2

June 2016, www.cnn.com. Accessed 15 May 2017.

"Heroin Overdose Data." Center for Disease Control and Prevention, www.cdc.gov. Accessed 15

May 2017.

"How Can You Relieve Pain - without Drugs?" Cleveland Clinic, 15 Feb. 2017,

www.health.clevelandclinic.org. Accessed 15 May 2017.

"Is Opiate Addiction a Crime?" Opiate Rehab Treatment, www.opiaterehabtreatment.com.

Accessed 15 May 2017.

Moghe, Sophia. "Opioid History: From 'Wonder Drug' to Abuse Epidemic." CNN, 14 Oct. 2016,

www.cnn.com. Accessed 15 May 2017.

"Opioid Addiction: 2016 Facts and Figures." American Society of Addiction Medicine,

www.asam.org. Accessed 15 May 2017.

Pohl, Mel. "Healing Chronic Pain without Drugs." Fox News, 3 June 2016,

www.foxnews.com/health/. Accessed 15 May 2017.

"Prescription Opioids and Heroin." National Institute on Drug Abuse, www.drugabuse.gov.

Accessed 15 May 2017.

Reynolds, Gretchen. "How Exercise Helps Us Tolerate Pain." New York Times, 13 Aug. 2014,

www.nytimes.com. Accessed 15 May 2017.

Szabo, Liz. "Doctors Told to Avoid Prescribing Opiates for Chronic Pain." USA Today, 15 Mar.

2016, www.usatoday.com. Accessed 15 May 2017.

Volkow, Nora D., and A. Thomas McLellan. "Opioid Abuse in Chronic Pain Misconceptions

and Mitigation Strategies." New England Journal of Medicine,

doi:10.1056/NEJMra1507771. Accessed 15 May 2017.

 Annotated Bibliography

Carey, Benedict. "Prescription Painkillers Seen as a Gateway to Heroin." New York Times, 10

Feb. 2014, www.nytimes.com. Accessed 15 May 2017.

Annotation: This article connects opioid addiction to heroin use, providing different

professionals perspectives on the epidemic as well as some statistics to help support

evidence. Being that the New York Times is a well-known newspaper, this source is

credible and very useful when trying to research the effects that opioid addiction and

heroin addiction can have on someone.

"The Effects of Opiate Use." DrugAbuse.com, www.drugabuse.com. Accessed 15 May 2017.

Annotation: This website explains the symptoms from prolonged use of prescription opioids, and

can be used in order to explain the different physical effects that opiates have on a person

taking them for chronic pain. DrugeAbuse.com has lots of information about the

symptoms of drug addiction, so it is a credible source for researching the actual effects of

opioid abuse.

Gupta, Sanjay. "Unintended Consequences: Why Painkiller Addicts Turn to Heroin." CNN, 2

June 2016, www.cnn.com. Accessed 15 May 2017.

Annotation: This source not only discusses the effects of taking heroin, but also how people get

hooked on it from opioids. Dr. Gupta explains how heroins accessibility makes it a drug

that opioid addicts turn to once they cant get any more opioids. CNN is a credible news

organization and the author is the Chief Medical Correspondent, so the source is reliable.
"Heroin Overdose Data." Center for Disease Control and Prevention, www.cdc.gov. Accessed 15

May 2017.

Annotation: This source helps when researching statistics and numbers regarding heroin

overdoses and usage rates. Although this source does not directly connect the opioid

epidemic to heroin usage, it gives statistics regarding heroin overdoses and deaths.

"How Can You Relieve Pain - without Drugs?" Cleveland Clinic, 15 Feb. 2017,

www.health.clevelandclinic.org. Accessed 15 May 2017.

Annotation: Written by doctors at the Cleveland Clinic, this source explains different kinds of

therapies to cope with pain, including CBT. It goes in depth on how one can use a better

mindset to help alleviate pain, and explains the psychological effects that pain can have

on someone. This source is useful to explain the psychological changes that one can

make in order to lessen pain, especially chronic.

Moghe, Sophia. "Opioid History: From 'Wonder Drug' to Abuse Epidemic." CNN, 14 Oct. 2016,

www.cnn.com. Accessed 15 May 2017.

Annotation: This article is a good source when discussing the history of opioids, and how their

image has transformed since the epidemic started. The article talks about the

pharmaceutical companies and the explosion of opioid usage in the early 2000s, as well

as the start of the epidemic and what people are trying to do to stop it.

"Is Opiate Addiction a Crime?" Opiate Rehab Treatment, www.opiaterehabtreatment.com.

Accessed 15 May 2017.

Annotation: This website provides insight into the links between opioid

addiction and crime, especially the ways in which addicts try to

illegally obtain prescriptions in order to satisfy their cravings. The

 website talks about other crimes as well, including theft in order to buy

other drugs such as heroin.

"Opioid Addiction: 2016 Facts and Figures." American Society of Addiction Medicine,

www.asam.org. Accessed 15 May 2017.

Annotation: This compilation of data is a reliable source to use when researching data related to

opioid addiction and overdoses. It gives numbers regarding how many people use

opioids, how many people become addicted, and how many turn to harder drugs such as

heroin.

Pohl, Mel. "Healing Chronic Pain without Drugs." Fox News, 3 June 2016,

www.foxnews.com/health/. Accessed 15 May 2017.

Annotation: Written by Dr. Mel Pohl, this article discusses alternative ways to heal chronic pain

without using opioids. It talks about different dietary restrictions, the importance of

exercise, and the usefulness of psychological positivity when trying to relieve chronic

pain.

"Prescription Opioids and Heroin." National Institute on Drug Abuse, www.drugabuse.gov.

Accessed 15 May 2017.

Annotation: This website article helps to connect prescription opioids and heroin, and goes in

depth into the people who use it. Everything from accessibility, overdoses, and

demographics of the people who use it are mentioned. The National Institute on Drug

Abuse is very reliable, and this article serves as a useful and credible source.

Reynolds, Gretchen. "How Exercise Helps Us Tolerate Pain." New York Times, 13 Aug. 2014,

www.nytimes.com. Accessed 15 May 2017.

Annotation: This article explains the importance of exercise when relieving pain, and discusses

the ways that exercising can help to build tolerance to discomfort. This source is good to

use when researching alternative ways to relieve pain, and adds an interesting perspective

that connects exercise to tolerance of pain.

Szabo, Liz. "Doctors Told to Avoid Prescribing Opiates for Chronic Pain." USA Today, 15 Mar.

2016, www.usatoday.com. Accessed 15 May 2017.

Annotation: Written by Liz Szabo, this source gives primary information about the opioid

epidemic, along with critical and shocking statistics. It also shows the first steps that the

government has taken to address this crisis, and also explains the epidemic as a whole.

Volkow, Nora D., and A. Thomas McLellan. "Opioid Abuse in Chronic Pain Misconceptions

and Mitigation Strategies." New England Journal of Medicine,

doi:10.1056/NEJMra1507771. Accessed 15 May 2017.

Annotation: This source, written in the highly credible New England Journal of Medicine,

provides statistics and a scholarly explanation of the opioid epidemic and how it came

about. Not only does it address the misconceptions about opioid abuse, but it also talks

about the different ways to address the situation.