The U.S. Opioid Epidemic: Solved or a Work in Progress

Illustration by Allen Chen

Illustration by Allen Chen

To many, Matthew McKinney was an outgoing teenager who, according to his mom, was “full of adventure, mischief, and zest for life” (1). Yet, despite having this outgoing disposition, Matthew faced his own personal battle: one against drugs (2).  At the age of 13, he succumbed to peer pressure and tried pot, mostly in hopes of impressing his friends. This decision took a turn for him, as his grades began to drop, and his behavior deteriorated with an increased reliance on over-the-counter medication and alcohol (3). He was sent to multiple rehab programs and came back home in January 2004 clean and sober (4). Unfortunately, this sobriety was short-lived, as Matthew associated himself once again with his friends from “the bad days,” leading to his death of a heroin overdose in December 2004 (5).

Unfortunately, stories like Matthew’s are becoming increasingly common in the United States. Despite not being reported much in the news, drug overdoses are rapidly becoming an epidemic that we need to take a stronger stance against. In 2016, drug overdoses claimed over 64,000 lives, “more than the entire death toll during the Vietnam War” (6). In fact, by the end of today, more than 175 Americans will have died of drug overdoses (7). If this problem continues, it is estimated that over 1 million lives will be taken by 2020 (8). Currently, the United States government has no plan of action to combat this, and such inaction has only added to the problem. If the government does not take initiative to control this situation, the drug epidemic runs the risk of getting out of hand, digging the United States into a deeper hole than it is already in.

In the United States, government officials refer to the current drug problem as an “opioid epidemic,” and as a result, this term gets inaccurately tossed around by news channels when they do refer to this problem (9) Even though opium was the first drug that became abused by people, triggering the epidemic, people have used opium to “derive a whole host of drugs with similar properties,” such as prescription painkillers including Vicodin, Percocet, and OxyContin; such drugs are referred to as opiates (10). In fact, since 2011, deaths from opioid overdoses have decreased, and in turn, heroin and prescription painkiller deaths are proliferating (11). Even though the drug problem initially started with the abuse of opium, one can see that with better knowledge of opioid receptors in the brain and drugs that can attack them, various derivatives of opium are being produced, reducing the reliance on pure opium but increasing the risk of getting addicted to an opium derivative.

Today’s “overdose epidemic is a composite of multiple sub epidemics” (12). This supports the recent development in which many derivatives of opium are being created, increasing the possibility of one getting access to such drugs. Currently, the most commonly abused drugs include heroin, prescription opioids, methadone, and cocaine (13). In fact, mortality as a result of heroin overdose and synthetic opioids are sharply increasing, while mortality due to natural, prescribed opioids have begun to level off (14). This is attributed to the reformulation of OxyContin in 2010, which added abuse-deterrent formulations, or ADFs, to counter the risk of addiction (15). However, according to Joanna Lyford, the reformulation of OxyContin has only added to the problem at hand, as due to OxyContin’s inability to be crushed and snorted, more are moving towards abusing heroin and synthetic opioids (16). Another reason heroin and synthetic opioids have become more synonymous with the current epidemic is due to its diminishing prices (17). The price has allowed for drug networks to channel heroin and other synthetic opioids into suburban and rural parts of the United States, where customers are eager to purchase at discounted rates (18).

The development of synthetic drugs and the rise of heroin to counter the regulations made for prescription opioids haven’t been the only concerns that have surfaced due to the “opioid epidemic”. Synthetic opioid and heroin use have caused a “dramatic spike in hepatitis C infections, as well as dangerous bacterial infections that, if left untreated, can cause strokes and require multiple open-heart surgeries” (19). This is primarily because people are reusing their needles for these intravenous drugs, leading to the proliferation of these infections (20). Between 2004 and 2014, there was a 400% increase in hepatitis C infections among 18 to 29-year-old Americans, which has a positive association with the rise in intravenous drug use (21). It is estimated that $45 billion is the money necessary to fix the drug crisis; however, with the rise of these infections, experts argue that more money is needed to factor the cost of treatment for hepatitis C (around $20K to $90K) and open-heart surgeries ($100K to $200K) (22).

As the epidemic continues to get out of hand, the Trump administration’s actions to combat the problem have been little to none.  In 2017, President Trump promised to declare the “opioid epidemic” a national emergency and dedicate resources towards combating the problem (23). However, the administration has failed to back up this promise, primarily using speeches to assuage the country’s concerns without acting upon their content (24) In fact, President Trump’s outrageous solution to ending this drug epidemic is to execute drug dealers, “build a wall along the nation’s southern border,” and arrest “illegal immigrants and drug dealers, traffickers and gang members” in sanctuary cities around the United States (25). Unfortunately, Trump is using this epidemic as an excuse to advance his campaign promises of “building a wall” and tightening immigration policies, as he sees those as the root causes of the “opioid epidemic” (26). Additionally, the Trump administration and Congressional Republicans are proposing cuts to Medicaid, which “covers about 38% of people with an opioid addiction” (27). Instead of trying to solve the problem, the administration is stripping funding from areas that contribute in part to solving the epidemic; people recovering from addiction will be forced to pay exorbitant amounts from their pockets. What is needed are concrete solutions that not only rapidly attack the problem but also provide treatment to users.

The United States government has undermined the severity of the country’s opium epidemic, which has only gotten worse with better knowledge of opium’s enhancing properties. The evidence of its rise is astonishing, and it is baffling as to why the United States has taken no tangible action towards solving this problem; efforts have only been made by local communities to protect their people. For instance, in a study conducted by Michael Flaherty, Precia Stuby, and William Kose, researchers analyzed Ohio’s Hancock County, which had anticipated the rise of the opioid epidemic and created a community that fostered receiving judgement-free help for addiction free of judgement (28). For instance, Hancock County transformed a community center into a “recovery center where those in recovery can meet, advance, and mobilize to give back to the community” (29). As a result, people who successfully complete recovery become a support system for those fighting addictions, giving them hope of their own future successes. (30). The longer we ignore this pressing problem, the more likely new public health crises will derive from this epidemic. Only time will tell if and when the United States will finally open their eyes to the situation at hand and slowly solve the problem through impactful solutions.

Edited by: Eric Song

Illustrated by: Allen Chen

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