The abuse of and addiction to opiates such as heroin, morphine, and other prescription pain relievers has become known as the national opioid epidemic, one of the worst drug crisis in the United States. According to the American Society of Addiction Medicine (ASAM), drug addiction is the leading cause of accidental death in the United States, with 20,101 overdose deaths related to prescription pain relievers and 12,990 overdose deaths related to heroin in 2015. Since 1999, the overdose death rates from opiates have more than quadrupled, in parallel with the sales of prescription pain relievers.
Opiates have been used for thousands of years, for both recreational and medicinal purposes. Each opiate has the ability to depress, or slow down, the body’s central nervous system, relieve pain, and produce pleasurable effects. Prescription opiates are used to control chronic pain, although they also positively alter moods and can produce happy and euphoric feelings. The National Institute on Drug Abuse (NIDA) reports that opioid painkiller prescriptions reached 207 million in the United States in 2013. Some opiates are legal, such as fentanyl, codeine, and morphine, and others, such as heroin, are illegal due to their high potential for abuse. According to NIDA, there is growing evidence that suggests a relationship between increased non-medical use of opioid pain relievers and heroin abuse in the United States. In other words, the surge in heroin and opiate use is at least partly due to a spike in the use of prescription painkillers. NIDA reports that in 1991, doctors wrote 76 million prescriptions, and by 2011 that number had tripled to 219 million.
Furthermore, drug cartels have been bringing cheaper, more potent heroin into the U.S., thus making heroin easier to acquire than prescription pain medications. NIDA noted that Mexican heroin production experienced a six-fold increased from 2005 to 2009. Mexican and Colombian heroin have become the dominant sources of heroin in the U.S. market, and have steadily increased the availability of easily-injectable white powder heroin. Accessibility is one of the main factors cited by patients that affected their decision to start using heroin.
In Akron, Ohio, drug overdose deaths in 2016 exceeded 59,000, according to data compiled by the New York Times. It's estimated that this number increased by about 20 percent from 2015, and is expected to continue increasing despite Ohio filing a lawsuit accusing five drug companies of encouraging the opioid epidemic. In some Ohio counties, overdose deaths from heroin have almost disappeared and have instead been replaced by fentanyl, another opiate. The most dangerous form of fentanyl, carfentanil, is 5,000 times stronger than heroin, meaning that an extremely small amount can be a lethal dose. The New York Times cites that on the day carfentanil became available in Akron in July 2016, one person died in a span of 9 hours and 17 people overdosed. The data also points to large increases in overdose death on the East Coast, specifically in Maryland, Florida, Pennsylvania, and Maine. Furthermore, Alabama, Tennessee, and West Virginia had more opioid prescriptions than people in 2012. For example, in Alabama, doctors wrote 143 prescriptions per 100 people, more than anywhere else in the country.
Every racial demographic has experienced more deaths from overdose since 2010. The Centers for Disease Control and Prevention (CDC) notes that in 2014, whites and Native Americans were dying at up to triple the rates of African Americans and Latinos. The New York Times wrote that racial stereotyping is a possible explanation for the gap, in which doctors are less likely to prescribe painkillers to minority patients due to worry that they might sell or abuse them. However, the rate of deaths from heroin overdoses has still increased across all races. Additionally, CDC data shows that nearly every age group has been hit by the opioid epidemic. Heroin deaths are more frequent at younger ages, while fatal opioid overdoses are likely to happen in middle age.
In current news, a federal opioid commission urged President Trump to declare a national emergency in response to the heroin and opioid epidemic plaguing the United States. The commission noted that the current death toll in America due to this epidemic is the equivalent of the September 11th terrorist attacks occurring every three weeks. Other recommendations to cure the national opioid epidemic include expanding treatment facilities across the country, educating doctors on the proper way to prescribe pain medication, and equipping police officers with naloxone in the case they need to treat overdoses on the spot. To combat the national opioid epidemic, scientists will also conduct more research on prescription opioids and doctors will develop new approaches to treat pain, as well as more effective means for preventing overdose deaths. The epidemic can be put to an end by educating the population on prevention and treatment and promoting addiction awareness.