The addiction epidemic spreading throughout our nation has been growing at an unprecedented rate. It has been a problem for a number of years, but the past couple decades have been the worst of it. One of the largest contributing factors to the current state has been the widespread opioid epidemic and opiate medication abuse. Of course, opioids hold a valuable purpose within the medical realm, which would be pain relief. When prescribed and used correctly, these medications can be very effective in helping people to recover from various ailments and to operate without pain in their daily lives. Although, many of these medications can be massive issues when it comes to addiction as well. Aside from legal opioid and opiate medication, there are also illicit opioids that are problems, with the most prominent of these being heroin.
Previously, heroin used to be a drug that was more commonly used by people within low-income neighborhoods, but this has changed greatly over the years. Nowadays, heroin is even being used by young adults in affluent neighborhoods. The opioid painkiller and opiate medication epidemic mentioned above is what has largely led to this situation. In today’s age, painkillers are being prescribed to more people and for more conditions than ever and many of those prescribed these medications have been converting to using heroin down the road. Realistically, the chemical structures of heroin and many of these painkillers are highly similar, which makes them only a hop skip and a jump away from each other. Most of these substances are sourced from the opium poppy plant, while others may be partly or completely created synthetically, but all of them bind to the same receptors in the brain. When used, opioids bring about reduced pain, a sense of euphoria, relaxation, and drowsiness.
With any of these opioids or other opiate medication, there comes a matter of tolerance. When an individual has been continuously using one of these substances, their body grows accustomed to it and develops a tolerance, meaning that it then requires them to take higher amounts to achieve the same effects. This is where the road of addiction and heroin use begins. As a person continues to use oxycodone, they could also develop a physical dependence, which is when the body is so used to the drug being in the system that it has trouble properly functioning without it. If the person stops using or doesn’t use enough, they can experience hellacious cravings and withdrawal symptoms. Of course, this often prompts them to use more to relieve these ailments, and so begins the downward spiral.
Then comes the matter of how this leads to these individuals using heroin. There are generally three main factors that contribute to this transition. Firstly, comes the matter of tolerance. If an individual continues to build a larger tolerance, they may move to heroin as a way to get a more potent dose and achieve the desired effects. Secondly, heroin is much cheaper than pain medications. The typical cost of a pain pill for an uninsured individual is about $1 per milligram, meaning that an 80-milligram pill will cost them about $80, whereas an equal amount of heroin can be obtained for around a tenth of that price. As an individual’s habit grows, it can be harder to afford the larger amount of pain pills they need to achieve their desired effects, which prompts a move to heroin so they can afford their fix. Lastly, heroin is often more easily found on the streets than pain pills.
Unfortunately, this progression is not limited by demographic whatsoever anymore. With how prominently painkillers are being prescribed these days, more and more people are falling into this chain progression. There have even been police officers, doctors, nurses, ministers, and various other professionals moving to heroin after having developed an addiction to painkillers. As mentioned above, this is not a new issue either. Painkiller abuse and addiction have been growing problems for many years. They have heavily contributed to increased rates of accidental overdose, with someone dying in this way every 19 minutes in America, which is more deaths than car accidents cause.
One important factor that needs to be viewed in this issue is the rate with which our country prescribes these medications. A very mind-blowing statistic shows why our country is having the largest problem with this situation, which would be that 80% of painkillers in the world are consumed within the United States. What makes this statistic even worse is that our country only holds about 5% of the world’s population.
Obviously, there have been some efforts to curb this massive issue, such as making opiate medication abuse deterrent. One of the most prominent of these efforts was in 2010 when OxyContin was released in an abuse-deterrent version. It underwent a reformulation that made it much more difficult to crush or dissolve the pill, which limited people from snorting or injecting it. This did help somewhat by reducing OxyContin from 35.6% to 12.8% as a drug of choice over the course of two years. Unfortunately, this also greatly increased the rates of heroin use by nearly double. The problem ran into here is something referred to as the balloon effect. This is an analogy for the way that if one squeezes a balloon, the air is simply displaced into a different part of the balloon rather than going away. Applying this to OxyContin and heroin, these pain pills were made harder to use for individuals, but instead of this stopping their use, they simply moved to a similar substance. OxyContin and heroin are quite closely related chemically, so it made the jump easy for users.
Many of our efforts over the years focused largely in the area of legality. Individuals caught abusing pain meds or using heroin were prosecuted and given ridiculous sentences. Sure, this may stop these individuals from using while serving their time, but many of them simply return to use soon after being released. This can be pretty easily understood, considering that there is much more to handling addiction than simply ceasing to use substances, and these imprisonments do nothing to handle the underlying condition. These punitive efforts essentially focus more upon curbing the resultant symptoms of these individual’s struggling with underlying difficulties.
As far as moving forward, further efforts need to be directed toward treatment of those struggling. There has begun to be a paradigm shift in this direction, with more states refocusing their law enforcement on getting these individuals help. Several other countries and even some states have chosen to go with harm reduction efforts. For instance, some countries actually provide heroin to addicts, which in some ways, can reduce risks and use of other drugs. There are numerous consequences that heroin users can face, such as injection site infection, infections of the heart lining and valves, and bloodborne illnesses from sharing needles. Providing individuals with heroin and clean needles can help to curb many of those medical risks. Although, this harm reduction methodology is not necessarily the right direction either, as it is more of a defeatist enabling of the problem. Of course, heavy legal prosecution has already displayed that it is not very successful in addressing the issue. We need to focus on treating the underlying conditions that these individuals are struggling with and that is how we will truly begin to address and move forward from this opioid and opiate medication epidemic.
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