The Opioid Epidemic

Fig 1. CNN. America’s Opioid Epidemic.

Drug overdose is the leading cause of accidental death in the United States. In 2015 alone, there were 52,303 lethal drug overdoses. As the American Society of Addiction Medicine (ASAM) points out, opioid addiction is the leading cause of this epidemic. The ASAM is quick to highlight the over-20,000 overdoses related to prescription pain relievers in 2015, as well as the nearly 13,000 heroin related deaths in the same year. America’s opioid epidemic is a huge problem that we should all be well aware of. Opioid prescriptions are fairly easy to come by. I can say that I have heard first hand of people selling extra pain killers following common procedures in the youth demographic, such as wisdom teeth removal or ACL reconstruction. It is stated that most opioid addicts are introduced to the drugs through the gifting of family members and friends. The fact that teens, and Americans as a whole, aren’t aware of the severity of this epidemic and the ease of developing an addiction to opioids, is highly concerning.

Fig 2. New York Times. The Opioid Epidemic: A Crisis Years in the Making.

The opioid epidemic has been a problem of mounting degree over the past decade. Above is an image created by the New York Times to illustrate the growth in the number of overdoses across the US. As you may see, the scope and density of overdoses have increased dramatically since 1999 to 2014. In 2016, the government produced the first national data to break down this rise by drug and state. The account of drug deaths showed that deaths by the use of synthetic opioids, primarily fentanyls, had gone up 540 percent in only 3 years. Though President Trump claimed to bring this problem to the level of national emergency, he has only deemed it a public health emergency thus far. No additional federal funding has been put towards deterring this epidemic.

Fig 3. Board Vitals. Are Doctors Addicted to Prescribing Opioids?.

In terms of enabling the spread of this problem, the healthcare industry needs to shoulder a large part of the blame. While the New York Times points out that pharmaceutical companies and physicians have been catching most of the flak, it also calls out insurers for their hand in the matter. The problem lies with insurers restricting more expensive, but less addictive painkillers. These alternatives to addictive painkillers such as morphine and oxycodone are safer, but come at a greater cost to insurance companies. Insurers, in conjunction with pharmacy benefit managers who coordinate drug plans, are coming into the spotlight more though now. The New York State attorney general’s office, as of 2017, reached out to CVS Caremark, Express Scripts, and OptumRx (3 of the largest pharmacy benefit managers) to inquire about how they were looking to curb the issue. Hopefully, this pressure will force action and results toward solving the problem. Currently though, the state of the situation is dire. While it is easy to obtain highly addictive opioids, it is still incredibly hard to get the drugs prescribed for treatment against addictive substances. Behind what seems to be an easy conspiracy is solely the desire for cost-savings and a reduced hit to Big Pharma and the insurance companies’ expenses per patient. What this accomplishes in the medical community is the incentivization of cheap and fast treatments. Despite the immediate gratification, these have no shortage of consequences, as seen in the overdose death toll.

Another, lesser known, problem is the proliferation of hepatitis C in young America because of the epidemic. Those injecting themselves with opioids and sharing needles are causing a rapid spread of the disease. According to a post on Reuters, the number of hepatitis C infections has almost tripled from 2010 to 2015. This has caused the under 30 population to now be the most at-risk for contracting and transmitting hepatitis C. This virus kills nearly 20,000 Americans every year—that figure is more than HIV and all other infectious diseases combined. Hepatitis C results in cirrhosis of the liver and, eventually, liver cancer or liver failure. With such a large associated death rate tied to the opioid epidemic, the price tag only gets bigger for what it’s costing our country’s welfare.

Fig 4. Spine Health. Narcotic Pain Medication.

Not enough people are aware of how severe the opioid epidemic is. While the legalization and popularization of marijuana in many states has affirmed for many that one form of drug consumption is safe, a large crackdown on drug culture is still necessary in America. Having heard personal accounts of young Americans contributing to the normalization and spread of prescription painkillers, I fear the outcomes in my generation if we don’t work to stop this crisis. I think there is a direct tie to a more laissez-faire attitude on drugs as of late, regardless of one’s view on marijuana and its legalization. Prescription painkillers are true gateway drugs to the other names of the opioid epidemic, such as heroin, and their overprescribing and high addiction rates should be better known.