What You Need to Know About the Opioid Crisis

Written by Buprenorphine Doctors

Imagine that a national disease took the lives of over one hundred Americans a day. Imagine that the epidemic lasted more than a decade and had no surefire cure. 

That scenario is the American opioid crisis, and this article is what you should know about it.

Where Are We Now?

The opioid crisis began in the late 1990s, when pharmaceutical companies assured everyone that pain-killing medicines called opioids were not too addictive to be widely prescribed. Doctors soon began to prescribe them more and more.

Nearly twenty years later, the problem of opioid addiction has swelled into a national emergency. In 2016 nearly 11.4 million Americans admitted they had abused opioids, and 2.1 million admitted to having an opioid abuse disorder. But the death rates connected to opioid abuse are the most grave consequence: 47,000 people died from opioid overdoses in 2016, and 70,000 more died the following year [include earlier totals?]. That’s almost a 10% increase in just a year, and roughly 130 people now die each day. The human cost of opioid abuse is harrowing.

What Are Opioids?

Opioids are chemical compounds that relieve pain. They bind to the centers which control the body’s pain and emotions. Once there, they increase levels of dopamine, the feel-good chemical which creates physical euphoria in the body. Because they generate dopamine, opioids can be effective pain-relievers for those suffering from chronic pain or extreme injury.

But opioids are so effective that they become addictive. With enough opioid use, the body will rely on the drug to generate dopamine. In other words, using opioids keeps the body from feeling good without them. Without opioids, the body undergoes painful withdrawal symptoms and fierce cravings for its new fix.

Many different drugs are considered opioids. Some come from natural compounds which are then made into medicines. Others are synthetic, meaning they are made in labs for medical use. All opioids, whether natural or synthetic, affect the body in the same way, though some are stronger than others.

How Are Opioids Abused?

To abuse an opioid means to take it too often, or to take dangerous amounts of it, due to an addiction. Abusing a prescription opioid means that someone takes it differently than their doctor has instructed, likely because the patient has become addicted to its pain relief. Abusing an illegal opioid means that the user takes dangerous amounts of the drug to satisfy their addiction to it. Addiction is the common element in opioid abuse. If someone risks their life to abuse an opioid, it’s because their body needs the drug to feel good.

The risk someone takes is the chance that they will fatally overdose. When someone takes too much of an opioid, their pupils will narrow, their breathing will slow, and their body will shut down. Many opioid users don’t know their own tolerance levels, and so they can smoke or inject fatal doses without even knowing it. An overdose will cause them to slowly suffocate.

Common Culprits

Though lots of opioids circulate in the U.S., a few have become the most common, most recognized, and most harmful to their users. Here are three examples:

Oxycodone

Oxycodone is a semi-synthetic opioid which doctors prescribe for pain relief, and is the primary ingredient in the medication Oxycontin. At the start of the opioid crisis, many pharmaceutical companies marketed Oxycontin as harmless for the public. The boom of its prescriptions, combined with its risk of addiction, caused many patients to abuse oxycodone.

It’s one of the most common prescription opioids responsible for overdose deaths in the U.S. Prescription opioids caused 35% of fatal opioid overdoses in 2017 (24,500 deaths that year), meaning that oxycodone is a regular threat to anyone addicted to it.

Aside from oxycodone’s physical threat, the drug is often tied to crime. Oxycodone users may steal to support their own addiction. This trend of increased crime alongside oxycodone abuse is prevalent in the eastern U.S.

Heroin

Unlike oxycodone, heroin is not a prescription opioid. But it’s highly addictive, and it exacts a deadly toll on those who use it.

Heroin is a naturally-occurring compound found in poppy plants which is then made into a powder or liquid. Heroin users then smoke, snort, or inject it to get “high” (that opioid euphoria). Chasing the high causes many heroin users to overdose, often fatally. Both heroin use has increased and fatal heroin overdoses have increased across most groups of people in the last few years. Heroin caused over 21% (15,000) of all fatal overdoses in 2017, a similar figure to its deaths in 2016.

But heroin users risk more than fatal overdose. Injecting heroin can contract Hepatitis C and HIV, diseases transferred by sharing unclean needles. Also, heroin users often take the drug alongside others, such as cocaine, meth, or fentanyl. This way, heroin users might run into more drug use and deepen their harmful addictions.

Fentanyl

Fentanyl is a synthetic opioid available for prescription pain relief. But its potency is astonishing and frightening: it is 50x more potent than heroin. As a point of reference, the prescribed oral amount for an adult would kill a child.

This opioid is the greatest threat in the nation’s crisis, because it’s easy to find and often mixes into heroin. Fentanyl is cheaper than most competing opioids; add in how easily it can be smuggled, and the drug proves hard to control. Preventing its illegal use works less and less.

Fatal overdoses from fentanyl are frequent. Many dealers mix fentanyl into heroin without telling their buyers, and those buyers unknowingly ingest the potent drug. Remember that fentanyl can cause an overdose with just a tiny amount. It caused the most fatal overdoses of any opioid in 2017, responsible for nearly 43% (30,000 deaths) of all opioid overdoses.

So What Can We Do?

The figures and facts of the opioid crisis are bleak. They don’t inspire hope. But they’re not the only part of the story which we should look to.

Opioid addiction doesn’t have to be a dead-end. There are chances for treatment, recovery, and sobriety available for anyone who needs it. Medically-assisted treatments (MATs) are becoming more common as viable treatments for opioid addiction. There are many campaigns to make naloxone, an antidote to opioid overdose, widely available. Opioid recovery clinics offer steady recovery across the country. Online tools assist opioid recovery nearly every moment. Visit any of these links to see how people fight this crisis every day.

No one is alone in addiction, or in mourning those lost to addiction. Those high death rates are chilling to even write down. But they also hint at a larger American community that could mourn with you, come support you, and fight alongside you against opioid addiction. Recovery requires community. If we have to keep suffering, let’s suffer together for now. That’s the best first step in overcoming.


Buprenorphine Doctors