How We Got Here: A Brief History of the Opioid Epidemic

America lost 58 thousand soldiers in the Vietnam War according to the National Archives, and 620,000 deaths in the Civil War.

In 2016, there were more than 60,000 deaths caused by drug overdoses in 2016 alone, and in 2017, 200 Americans died per day in the opioid epidemic.

The opioid epidemic that is rocking the nation is now exceeding the cost of lives to America by that of more than two of America’s greatest wars of all time combined. Let’s trace this crisis back to its roots to find out how this crisis began, and then we’ll discuss how you can avoid becoming a statistic in the history of the opioid epidemic.

It started with the overprescription of opioids.

Today, two million Americans abuse opioids.

Nobody is dying alone in the opioid epidemic, even when their addiction has led them to the point of complete isolation from the world they once knew.

First Step on the History of the Opioid Epidemic

Although history shows that opioid use for pain relief has been in place since the Civil War, the real opioid crisis dates back to the 1990’s. They say it is a three-wave problem over the opioid epidemic timeline. For the first time since 1999, the life expectancy for Americans has decreased because of this crisis.

The crisis is due to the overprescription of opioids, but the use of illegal opioids has also increased and contributed to the crisis.

Prescription opioids include substances that include either morphine or codeine. Synthetic forms of opioids are now on the market, however, and include methadone, tramadol, and fentanyl.

Opioid abuse has been in play since the beginning of the last century. Veterans were given morphine, a derivative of the poppy plant, during and after the Civil War.

By the late 1800’s, pharmaceutical companies started to create synthetic versions, and this is when heroin was born.

It was no secret at this time that heroin or other synthetic forms of opium were addictive. By 1912, the United States joined other nations in forming the International Opium Convention. This convention would work to control the opioid market.

In 1924 came the Heroin Act, bringing more regulations to the heroin market. By the time both World Wars were over, heroin abuse was becoming a problem.

The 1924 Heroin Act was a revision of the 1909 Smoking Opium Exclusion Act that authorized poppy plant imports for medical purposes. Even in 1909 American citizens were using a pipe or “vaping” to consume heroin.

By 1924, it was illegal to import or possess heroin.

In 1970, this drug was developed into synthetic drugs of hydrocodone and oxycodone for pain relief and to treat cancer pain. As years went on, an overprescription of these drugs for various diagnoses has led to the opioid epidemic that we face today.

The United States Leads the World

Today, drug abuse is costing America over $442 billion dollars a year in both health care and criminal justice costs. The opioid epidemic comprises $78 billion of that number.

The United States leads the world in opioid use, consuming over 80 percent of the world’s opioid production.

Opioid abuse is America’s leading cause of death for those under the age of 50. More are dying from an opioid overdose in America than the flu or kidney problems, pneumonia, car accidents, or firearm deaths.

The Surgeon General Vivek H. Murthy M.D. M.B.A. says that opioid use is more common in America than diabetes and all cancers combined.

10 percent of those who are addicted to opioids are dying because they just don’t get the help they need. They often don’t seek help because they fear the costs or stigma associated with going to rehab.

The stigma of drug addiction is a leading cause of overdose deaths as well. Many users today just don’t want to admit they have a problem that could be criminal. They also may not be able to afford care.

But today, more and more insurance companies are saving lives by covering addiction treatment services. Additionally, addiction treatment services today are working to get rid of the stigma associated with addiction by just focusing on saving lives.

The Science of the Opioid Crisis

The opioid epidemic is all rooted in the science of opioids. Many national agencies refer to the history of the opioid epidemic like a plague.

The science of opioids is all about how they impact the brain. When opioids cross the blood-brain barrier, they hit the pleasure centers in the brain in such a way that the user describes it as a euphoric high.

Chasing the high is the center of every addiction. Opioids bind to receptors in the brain that block pain. When this happens, a chemical addiction occurs.

The addiction is not just chemical. The patient feels good psychologically and wants to keep feeling this good, so they continue to abuse the substance.

But not only is the addiction chemical and psychological, but the body also becomes chemically addicted or dependent on this euphoric feeling.

New research shows that scientists are getting closer to untangling the neural pathways that lead from opioid use to dopamine triggers. Dopamine is the substance in the brain that is released from the pleasure centers that makes the person feel good.

These scientists say that addiction occurs when the effects of consuming a drug provide a beneficial outcome to the human body. A dopamine release is one of those pleasurable outcomes that keep people going back to opioids for more after their first use.

This dopamine release contributes to the dependency on opioids. This even serves as a gateway to abusing more dangerous drugs such as heroin, according to these scientists. Heroin is a drug that many doctors today will say can become addictive upon first use.

But opioids are also dangerous upon first use. While there are thousands of examples world-wide, one harrowing story is the story of a 15-year-old named Sam. He consumed heroin once and went into a coma for two months.

Sam is now in a wheelchair unable to read, write, or live with the quality of life of a typical 15-year-old boy.

The opioid epidemic timeline started over 30 years ago and continues today.

Prescription medication withdrawal and detox led to symptoms so uncomfortable that people began turning to heroin to recover from opioid withdrawal.

How Did We Get Here?

Pharmaceutical companies and the doctors prescribing meds are the roots of this epidemic.

In the 1990’s, drug companies were reassuring the medical community that opioid meds were not addictive. But they were and still are today.

This notion led to a widespread use of the medication and ultimately an abuse and misuse of prescribed meds. By 2015, tens of thousands of Americans were dying from this crisis.

It is estimated that 21 to 29 people prescribed opioid medications will abuse them, and that 8 to 12 percent will develop an addiction. It is also believed that 4 to 6 opioid addicts will transition to heroin addiction once medications like oxycodone and hydrocodone become less readily available.

Due to regulations and more awareness of the opioid crisis, fewer doctors are prescribing them today. This is leading to more dangerous drugs entering the crisis, such as methamphetamines and fentanyl.

Awareness is not to be underestimated, however. Information is power. Many don’t know or understand the gentle and kind support available in many different levels of detox today. This support saves lives.

Wave One – 1991 Opioid Deaths

The opioid crisis is widely considered a three-wave problem. The three waves are defined as the wave where the first rash of deaths first started, followed by an increase in heroin deaths. The final wave is the one the nation is facing now.

Experts consider today’s crisis as first starting in 1991 when opioid-related deaths began after an increase in prescription medication use.

At this time, Big Pharma was reportedly teaching the medical community that it was okay to prescribe opioids as they weren’t addictive. Initially, these medications were only prescribed for chronic or severe pain, such as for cancer or trauma victims.

But those guidelines began to decline once Big Pharma assured doctors that the drugs weren’t addictive. Even today, morphine may be the first drug administered by an EMT or emergency doctor when a patient presents with severe pain.

In this first wave, by 1999, 86 percent of people using opioid medication were using them for non-cancer related pain management.

Wave Two – 2010: Heroin Deaths Increase

The second wave of the opioid epidemic began in 2010 when heroin abuse deaths began rising dramatically. Prescription medications became harder to obtain, and addicts began turning to the streets for their high.

With that, heroin became a popular choice because it was easily available and more affordable than most other medications. By 2013, heroin-related deaths increased by 286 percent.

Because heroin is often injected, use also contributes to illnesses and deaths caused by improper use of intravenous equipment. Along with the rise of heroin-related deaths is the rise of HIV/AIDS, blood problems, infections, and hepatitis B and C.

The increase of these problems is also leading to an increase of the multi-billion-dollar health care burden. There are many costs to the country as a result of this crisis.

Wave Three – 2013: the Arrival of Fentanyl

By 2013, the arrival of fentanyl led to the spike in opioid-related deaths in epidemic proportions. Fentanyl is a synthetic opioid that is used in hospitals in minute doses for extreme pain. Today, it is becoming manufactured illegally and not safely.

The smallest dose of fentanyl can still kill someone when not administered properly. But this drug is becoming easier to obtain that oxycodone or even heroin.

In England alone, fentanyl-related deaths have increased by 27 percent in this third wave of the opioid epidemic.

The overprescription of medications is a leading cause of this crisis. But so too is the affordability of heroin on the streets.

National agencies for health are urging the medical community to follow guidelines for prescribing these medications for pain management.

The Opioid Crisis – What’s Happening Now

Many agencies refer to overprescription in the history of the opioid epidemic as a leading cause. This is a problem that is caused at the level of the doctor’s office but also at the level of the pharmaceutical companies.

Regulations and laws have been passed and continue to be passed to monitor and regulate these industries.

The United States Senate is regulating the ties between lobbyists and drug developers.

But the United States Department of Health and Human Services is still looking to work in the medical community to stop the epidemic. But to many, it feels like they are still just barely holding back a flood of problems.

The National Institute of Health is looking to find safer ways to manage severe and chronic pain.

They are also working to develop new medications that will be non-addictive.

At the same time, the medical community is becoming more supportive in the treatment of addictions. There are many different treatments and support options for drug addiction.

Avoid Becoming a Statistic

The American Journal of Public Health noted author William Cole who wrote a book about cancer pain in 1960. Here he wrote that severe pain such as cancer pain was demoralizing and debilitating, and opioid medications were critical to the quality of life.

But he also said, we must be “loathe” to overprescribe those because the addiction itself “may become a hideous spectacle.”
The history of the opioid epidemic confirms this statement.

And here we are today, in the middle of a crisis that is killing more Americans than the Vietnam War and the Civil War combined. Nobody is alone in this crisis no matter how isolated or alone you may feel.

Find out what resources are available in your state and let us help you or a member of your family start recovery today.