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by Pamela Israel
Peaceful Spirit Therapeutic Massage & Wellness Centers

With the US opioid epidemic causing over 130 deaths every day, many healthcare providers and patients are looking for ways to ease chronic pain without taking pills. In the next two blogs, we’ll be taking an in-depth look at the opioid epidemic, including its history, what these drugs are, and what people are doing to help. In this first segment, we’ll be answering questions about the history of opioids, their use today, and the current state of the opioid epidemic.

First off, what is an opioid anyway?

Opioids are a class of drugs that interact with certain sensors in the brain and body called opioid receptors. Examples of opioids include OxyContin, Vicodin, codeine, morphine, and fentanyl. Prescription opioids are usually considered safe when used as directed and for short periods of time. However, in addition to relieving pain, these pills also cause euphoria. In other words, they get the user “high”, which can lead to misuse. Misuse, in turn, can lead to addiction.

When were opioids first used?

Humans have been using opioids for thousands of years. Around 3400 BCE, people in Mesopotamia were cultivating poppies for medicinal use, and the Sumerians called opium poppies “Hul Gil”, meaning the “Joy Plant”. Around 460 BCE, Hippocrates encouraged drinking white poppy juice mixed with nettle seeds, noting opium’s narcotic effects.

In 1806, morphine was first extracted from poppies by Friedrich Wilhelm Adam Sertürner. It was used widely, and so many Civil War soldiers became addicted that morphine addiction was labelled “Soldier’s Disease”.

In 1898, heroin was synthesized from morphine. Bayer marketed it as a cough suppressant and a non-addictive alternative to morphine.

How were opioids first regulated?

In 1909, the Opium Exclusion Act made it illegal to smoke opium. In 1914, the Harrison Narcotics Act put a small tax on opium and required that it be regulated by a pharmacist or physician. Finally, in 1924, the Anti-heroin Act was passed, which criminalized importation and possession of opium for the purpose of making heroin.

How did the US opioid epidemic start?

In the early 1990s, pharmaceutical companies began marketing opioid pain killers more aggressively, assuring doctors and the public that these drugs were safe and that the risk of addiction was low. Before this change in marketing, opioid pain killers were largely reserved for cancer patients, who often endure debilitating pain. But by 1999, more than 86% of opioid prescriptions were written for non-cancer pain. In other words, doctors were prescribing opioid pain killers freely and without concern about addiction.


How did we go from overprescribing opioid pain killers to so many people abusing heroin?

Around 2010, the medical community began to realize that opioids were in fact very addictive, and doctors started to resist prescribing them. But the damage had already been done. People who had been able to get prescriptions for opioids found themselves addicted and with no way to get their fix. Many turned to heroin, which is a cheap and readily available opioid, but highly illegal. Heroin use increased across nearly all demographics, regardless of age, race, or income. Between 2002 and 2013, deaths from heroin overdoses rose 286%.


What are the current problems associated with the opioid epidemic?

There was another spike in deaths around 2013, caused by the increasing use of synthetic opioids like fentanyl. In 2016, more than 20,000 people died from fentanyl and related drug use. And while fentanyl is produced by pharmaceutical companies, the increase in deaths is linked to fentanyl that is produced illegally, not fentanyl that has been diverted from pharmaceutical companies. Since the introduction of these synthetic opioids, deaths from overdoses have risen dramatically.


2017 Opioid Misuse and Overdose Statistics

  • About 11 million people misused prescription opioids.
  • About 2.1 million people had an opioid misuse disorder.
  • About 47,600 people died from opioid overdoses.
    • That’s about 130 people every day.
    • Around 15,400 of those deaths were from overdosing on heroin.
    • Around 28,500 of those deaths were from overdosing on synthetic opioids (such as fentanyl).

Who is at risk?

  • Between 21 and 29 percent of people who are prescribed opioid pain killers for chronic pain will misuse them.
  • Between 8 and 12 percent of people prescribed opioid drugs will develop an opioid use disorder.
  • About 4 to 6 percent of people who misuse prescription opioids transition to using heroin.
  • About 80 percent of heroin users say that they began their addiction by misusing prescription opioids.


Check out our next blog to see what our government, scientists, and health care workers are doing to combat this epidemic.

Resources


“Opioid Overdose Crisis.” https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis. Revised January, 2019.

“What is the US Opioid Epidemic?” https://www.hhs.gov/opioids/about-the-epidemic/index.html. Updated January 22, 2019.