The U.S. Opioid Epidemic – A Brief History

Due to decades of misuse and abuse of opiate substances, America has been grappling with a persistent drug crisis. Although a significant amount of legislation has been passed, medical practices reformed, and treatment methods developed over the years to address this epidemic, there is still much work to be done.

Opioids claimed the lives of over 64,000 Americans last year.

Understanding the history of the opioid epidemic and its spread through America is crucial for our future progress. Recognizing our past mistakes is essential to preventing their recurrence.

How Opioids Made Their Way onto American Streets

Initially, opioids were not perceived as hazardous when prescribed for medical purposes. In the 1800s, pain was not typically treated as a symptom but rather seen as an inevitable consequence of aging. Consequently, medications were often prescribed based on their pain-relieving properties.

Opioids effectively alleviate pain due to their interaction with neural receptors in the brain. However, they can be highly addictive and harmful when used without a full appreciation of their potential consequences.

In 1914, the Harrison Narcotic Control Act was enacted. This legislation mandated that manufacturers, distributors, or sellers of opiates register with the U.S. Bureau of Internal Revenue. This unprecedented drug regulation act, while curbing the over-prescription of opioids, inadvertently led to a rise in “street drugs,” which have since caused numerous opioid overdose deaths.

Pharmaceutical Companies are Held Accountable

While regulatory measures and increased education have at times mitigated the opioid epidemic, we have still observed a regrettable upward trend. Between 1999 and 2008, opioid overdose deaths increased at an alarming rate, nearly quadrupling nationwide.

However, 2007 saw a pivotal response. Instead of solely relying on legislative efforts, the U.S. government began filing lawsuits against major pharmaceutical companies. Purdue Pharma, for instance, pleaded guilty to federal charges accusing them of overstating and misrepresenting the benefits of OxyContin. This drug had been prescribed for long-term chronic pain for years, with much of the healthcare community unaware of its potent addictive properties.

At the trial’s conclusion, Purdue was mandated to pay over $630 million for the Justice Department’s investigations, along with an additional $19 million in settlements to more than 26 states.

Opioids: A Public Health Emergency

In 2017, the U.S. Department of Health and Human Services declared the ongoing opioid crisis a public health emergency. Despite numerous medical reforms over the decades, the epidemic had not shown signs of abating, a trend that sadly continues.

The estimated 42,000 opioid overdoses in 2017 soared to over 100,000 opioid-related overdose deaths in the United States in 2022. This equates to more than 270 individuals succumbing to an opioid overdose daily.

As we progress, the history of this epidemic provides insights for better assisting those affected by opioid addiction. Long-term behavioral therapy, medication-assisted treatment, and numerous other strategies are now subjects of extensive research, all aimed at addressing this longstanding crisis. By understanding our past, we are better equipped to address the profound impact of the opioid epidemic.

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