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Understanding the Opioid Epidemic

Written by Alice Darling, LMT

poppy, poppy field, opioid, opium, opioid epidemic

One of the facets that makes the Opioid Epidemic especially concerning, is that the term is not in reference to an increase in illicit substance drug addiction; but rather, a description of a growing death rate caused by the pharmaceutical drug industry and subsequent healthcare providers. In fact, according to the CDC in 2019 “over 70% of the 70,630 [overdose] deaths involved an opioid”. They also report that the rise in the number of prescription opioid overdoses has been trackable since 1993, and by 1999 the trend became undeniable. A notable contributing factor a false and irresponsible claim made by pharmaceutical company Purdue Pharma that Oxycontin was neither non-addictive nor presented significant effects on long term heath. After further investigation it was uncovered, they also trained their sales team to gain physicians as buyers through slander of other drug compounds, bribery, cohesion, intimidation, and threats of lawsuits. In 2013, after new synthetic opioids like fentanyl hit the market, the increasing overdose death rate became even more extreme, and continues to climb today. For example, the Colorado Health Institute (CHI) said in a press release that in 2020 ”overdoses involving fentanyl made up about 68% of all opioid analgesic deaths.” Overall, that boosted a 34% increase from just one year prior in 2019. Additionally, even the DEA admits that because the drug is so concentrated, even just two milligrams of fentanyl “can be lethal depending on a person’s body weight”. A call to action has now risen, to address what is now called a dire public health and safety crisis..

How Did We Get Here?

In 3400 BC Sumerian records show that the culture grew poppy plants, the original source for opium, morphine, codeine, and heroin before the advent of synthetic compounds. Later, in 1300 BC the Egyptian culture farmed poppies in an agriculture setting and profited from introducing the plant to trade routes. In the mid 1500’s the German-Swiss Alchemist Paracelsus famously invented a quite unconventional tincture formulation called laudanum. Of course, the most prominent ingredient was opium. Ultimately, this marked the first modern wave of opioid addiction and overdose. Up through the 1700’s there was a large increase in the instances of physicians prescribing opium tinctures like laudanum. Even historical inventor and diplomat, Benjamin Franklin, developed a dependency to the drug after he was prescribed to him for pain caused by a bladder stone. What many people don’t know is that complications of opioid drug addiction are what lead to his death. Chronic overuse leads to inflammation of the lungs and chest cavity, the receptors that initiate the body to exchange oxygen and Co2 become clogged and unresponsive, at which time the lungs cease to ever take another breath. Nearly 100 years later, due to the high instance of violent injuries in war time, the Civil War spurred another huge wave of opioid addiction, abuse, and fatality. According to Smithsonian Museum records “The Union Army alone issued nearly 10 million opium pills to its soldiers, plus 2.8 million ounces of opium tinctures”. It has even been suggested by historians that not one single soldier made it out of the war without suffering from dependency. By 1895, 1 in 200 Americans suffered from addiction after the introduction of opium powders like Oxycontin. Shortly following this, in 1914 the Harrison Narcotic Act AJPH.5.6.518 was passed which targeted physicians who prescribed opium. The act nearly caused a prohibition of opioids all together for a short time. The shape of the world took turn again post WWII through present day when Americans became deeply affected by commercial/medical heroin addiction, an opioid manufactured by the Bayer company. Bayer went as far as to negligently send free samples of heroin and aspirin to the homes of morphine addicts. Today the remarketing of existing opioids, the manufacturing of new dangerously potent opioids, deficient regulations, and the lack of any improvements in pain management for thousands of years, are all driving factors behind why our society continues to suffer today.

The Never-ending Search for Increased Potency

A discussion on opioids cannot be had without also mentioning The Alza Corporation. The Corp. was founded in 1968, the same year the US Food and Drug Administration approved fentanyl. Eight years prior, a Belgian chemist named Paul Janssen first synthesized the opioid in the year 1960. After he initially marketed the drug heavily in Europe for intravenous application, he caught the eye of Johnson & Johnson who acquired his company Janssen Pharmaceutica. They then took the drug to America and released it to market under newly founded Alza Corp. Unsurprisingly what followed was an increase in deaths in the 1970’s through the 1990’s when another massive event occurred in the pain management timeline.

fentanyl, fentanyl patch, fentanyl overdose, overdose deaths

The FDA approval of the transdermal fentanyl patch called Duragesic initiated an even more complex downward spiral. Despite the obvious and grave concerns, other delivery methods were approved including lozenges, lollipops, tablets and sprays. In 2009 the FDA even allowed an edible fentanyl film that dissolves in the patient’s mouth called Onsolis to be released on market. Beyond a high risk for dependency, other known consequences of Onsolis brand fentanyl are liver disease, kidney disease, mental illness, hallucinations, heart rhythm disturbances, and respiratory failure. Even more disturbingly, there have been instances of children falling victim to accidental poisoning and death after ingesting the dissolvable strips. In order to avoid growing social liability for the questionable and immoral harmful effects, the drug’s owners relinquished rights to Biodelivery Sciences, who was then later acquired by Collegium Pharmaceutical in 2022. The aforementioned conglomerate Johnson & Johnson was in fact legally granted to be dismissal of public safety liability. Originally, a multi-million-dollar civil judgment was entered against the company in Oklahoma. The state citizens and the nation were shocked when the OK Supreme Court favored J&J’s appeal and ruled to dismiss $465 million lawsuit.

Are Women Being Targeted?

A statistically significant fact about the initial rise in prescription opioid dependency in the 1990’s, is that addiction was highest among one demographic specifically: women. Any company, that sells any product, follows a marketing protocol in which they build a consumer profile. In order to best tailor the marketing and maximize profits, companies create a highly researched image of the precise demographic and psychographic elements of their target customer. According to the organization Women's Recovery a known phenomenon that women unambiguously experience is called the Telescoping Effect which they define as, “how quickly someone will go from initiating use of a substance to dependence upon that substance and the impact it has on your body”. In laymen’s terms, women experience addiction more quickly than men. Other verified aspects include touch points such as the instance of women reporting pain to their doctor is higher, the likelihood of experiencing chronic pain in their lifetime is more pronounced among women, and women are on average prescribed higher doses of pain medications than men. Furthermore, in the population of women with private health insurance, one-third of them are currently prescribed pain medications. In the population of women with state insurance like Medicaid, 39% are currently prescribed opioids.

United States Congress Shameful Response

In 2021 US Congress presented the Stop Fentanyl Act H.R.2366. What is most notable, is that the bill does not highlight prescription drug dependency, rather only what is termed as illicit fentanyl. As of now, there is no conversation to report on the subject of the prescription rate. Additionally, Regina LaBelle, Director of National Drug Control Policy made asinine recommendations to Congress including using fentanyl, the most potent opioid known to man, as a treatment for opioid addiction.

NanoRx was founded with the notion that our communities deserve access to a new breed of health care. The founder Jason Lopez has stated, “That notion, transformed into a mission”. In many ways in order to save ourselves from the Opioid Epidemic, maybe we all need to consider joining that mission as well.

After-all, we’ve only been waiting for this moment for over 5,000 years.

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