Our current addiction challenge with prescription opiates like Oxycontin can be better understood by looking at our previous experience with addiction to the very same drug well over a century ago. As Confucius said, ‘a true teacher is one who, keeping the past alive, is also able to understand the present.’
In their search for a less addictive opiate, in the mid-1990s drug companies first designed extended release opiates like Vicodin (containing hydrocodone and Tylenol) and Percocet, which contains oxycodone and Tylenol. Subsequently, they created a purer opiate, containing only oxycodone, most commonly known under the brand Oxycontin.
From 1990 to 2004, the number of first time opiate addicts increased nearly four-fold to 2.4 million. Today, for those experimenting with any drug for the first time, 17% are using prescription painkillers, like Oxycontin, second only to marijuana. What changed in the U.S. was a ‘cultural shift in the medical community’s attitude toward pain and medication’, says Dr. Jason Jerry, psychiatrist and addiction expert at the Cleveland Clinic. Previously, doctors would prescribe such drugs only for late-stage cancer patients or after major surgery, but ‘the marketing practices in the pharmaceutical industry shifted the culture of medicine to the point that there was a fifth vital sign: pain’.
It soon became common for doctors to prescribe drugs like Vicodin or Oxycontin for everything from arthritis to lower back pain, and pharmaceutical companies flooded the U.S. market with these medications. As users of these opiate painkillers became increasingly addicted, they began crushing the pills and snorting the powder, or worse, dissolving the tablets (filtering out the insoluble material), and injecting it just like heroin.
Between 2004 and 2011, medical emergencies involving opiates rose 153%. And despite U.S. government efforts to reduce excessive opiate prescription, which led to 2 million fewer prescriptions in 2012 over 2011, prescriptions rose 67% over a 10-year period. Opiate addicts often lead lives of crime and deception, 95% committing crimes, most commonly theft and prostitution, to support their addiction, either to get drugs, or money to buy drugs.
The most disheartening consequence of the opiate crisis has been the surge in fatal overdoses. From 2001–2014, there was a staggering 3.4 times increase in prescription opiates deaths. Prescription opiates alone killed more than 15,000 Americans in 2015. All drug overdoses exceeded auto accidents by 15% in 2015. While the media has been covering the crisis, there seemed to have been little if any concerted response by the U.S. government at the federal level until 2016, when the Obama administration began to raise awareness on the issue and the U.S. Congress passed comprehensive legislation to deal with opiate addiction. The Comprehensive Addiction and Recovery Act (CARA) of 2016, seeks to address addiction and demand for prescription opiates and heroin. Specifically, the bill promotes best prescribing practices as well as a national education campaign and grants to address local drug crises. It is worth pointing out that while there is ample room to improve the control over prescription opiates, their already legal status should give serious caution to anyone who thinks that legalizing hard drugs (especially for recreational purposes) would not occur without serious consequences.
