What are Opioids?

These days, you can’t turn on the TV, read a newspaper or even go online without seeing something about the opioid epidemic. Celebrities are always in the headlines for checking into rehab for opioid addiction, relapsing, overdosing and even dying. Yet the opioid epidemic is not only affecting the rich and famous, it is destroying small communities in addition to large cities. In fact, almost 70 percent of the more than 70,200 drug overdose deaths in 2017 involved an opioid (Centers for Disease Control and Prevention, 2019).

Oxycodone is a commonly abused opioid.

Opioids are a broad range of drugs including prescription pain medications such as oxycodone and illegal drugs such as heroin. Although initially intended to treat pain, opioid misuse and abuse has run rampant due to the addictive nature of these drugs. By attaching to opioid receptors in the brain and spinal cord, opioids block the transmission of pain messages to the brain. In addition to pain relief, opioids are known to cause feelings of pleasure since they trigger the release of endorphins, which are your brain’s feel-good neurotransmitters (Mayo Clinic Staff, 2019). As soon as those pleasurable feelings wear off, you may have the craving to regain those feelings as quick as possible. This is often the prelude to an opioid addiction. To put this epidemic into perspective, the Centers for Disease Control and Prevention (CDC) report 130 Americans die every day from an opioid overdose. That’s almost six people every hour.

History of the Opioid Epidemic:

Ironically, many people think the opioid epidemic began in 1990s, yet it appears that history is currently repeating itself. The Civil War brought about the first opiate epidemic. During this time, countless soldiers’ battle injuries were treated with either opium pills, opium powders and tinctures. Upon returning home, an unknown number of soldiers returned home addicted to these powerful pain relievers. Doctors at the time considered opium a miracle drug that could treat any form of pain quickly and effectively. As a result, many doctors were overprescribing these medicines without fully understanding the high risk of patients developing a dependency. By the late 1800s, upper to middle-class white women were among the largest population addicted to opiates. Scores of women were prescribed these powerful pain relievers for minor ailments such as menstrual cramps, morning sickness and “diseases of a nervous character” (Trickey, 2018).

Medical journals throughout the 1870s and 1880s are filled with warnings about the danger of morphine addiction. Sadly, many doctors did not heed these warnings. By the 1890s, medical instructors and textbooks made the risks of overprescribing opium-based medicine abundantly clear. Aspirin was introduced to the market in 1899, further contributing to the decline of prescriptions being written for opiates.

Modern opioid Epidemic:

In 1999, we started to see a rise in prescription opioid overdose deaths, which have been rising continuously ever since. From 1999 to 2017, the CDC reported almost 400,000 opioid overdose deaths. To put that number into perspective, it would take almost six football stadiums to accommodate 400,000 fans. Looking further into the current opioid epidemic, it appears there have been three distinctive waves, with the first beginning in 1999. These overdose deaths involved prescription opioids including natural opioids, semi-synthetic opioids and methadone. In 2010, the second wave began, involving a surge of overdose deaths involving heroin. The third wave began in 2013, with a substantial increase in overdose deaths involving synthetic opioids. Illicitly manufactured fentanyl (IMF) appears to be the common denominator involved in these deaths (Centers for Disease Control and Prevention, 2019).

Centers for Disease Control and Prevention (2019) Understanding the Epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
Mayo Clinic Staff (2019, January 1) How opioid addiction occurs. Retrieved from https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
Trickey, E. (2018, January 4) Inside the Story of America’s 19th-Century Opiate Addiction. Retrieved from https://www.smithsonianmag.com/history/inside-story-americas-19th-century-opiate-addiction-180967673/