NATIONAL EMERGENCY
The United States is facing a crisis. Deaths from drug overdoses have increased over the years, to the point that they now outnumber deaths from gun homicides and car crashes. In its search for a solution to this rapid increase, a White House commission proposed a radical solution: Declare the epidemic a national emergency. Addiction has always posed an issue in one way another for this country, but it has not reached these epic proportions in decades. How exactly did we get here?
Some experts trace the current epidemic back to the 1980s and 1990s, when powerful opioids like OxyContin hit the market. The subsequent advertising was relentless, and it underplayed the addictive properties of these drugs. Soon, drugs that had previously been reserved for end-of-life care were prescribed for relatively minor aches and pains. They became commonplace in medicine cabinets across the country.
BEGINNING OF A CRISIS
Some experts trace the current epidemic back to the 1980s and 1990s, when powerful opioids like OxyContin hit the market. The subsequent advertising was relentless, and it underplayed the addictive properties of these drugs. Soon, drugs that had previously been reserved for end-of-life care were prescribed for relatively minor aches and pains. They became commonplace in medicine cabinets across the country.
These medications frequently act as gateway drugs. According to the National Institute on Drug Abuse, recreational use of pain medication makes people 19 times more likely to develop a heroin addiction. Heroin offers another host of problems. For example, intravenous injection creates a pathway for HIV to spread through communities via shared needles. These additional problems require their own solutions like needle exchanges that are being implemented in some neighborhoods.
SYNTHETIC OPIOIDS
Even more disturbing though, is the "next step" for many heroin addicts. Those who have a high tolerance for heroin may move on to substances like fentanyl. Whereas heroin is produced from opium poppies, fentanyl is entirely synthetic. It produces the same effect, but to a much more potent effect. Recently, an Ohio police officer overdosed on particles of the drug at a traffic stop. The CDC requires that emergency personnel now wear protective gear if fentanyl is suspected at the scene.
The image below compares the amount of drug needed to lethally overdose on heroin, fentanyl, and another synthetic drug called carfentanil. Carfentanil is also synthetic, but it is even stronger. In fact, it is most frequently used as an elephant tranquilizer. That should give you some idea of how strong it is. And the fact that a few grains of the drug can kill means that there is very, very little room for error before a user overdoses.
NEXT STEPS
Do we need to cut off the supply of painkillers by limiting doctors' ability to prescribe haphazardly, or do we need to make addiction treatment more accessible? Those are the two sides of the standard debate, but Stanford's Keith Humphreys argues that we need both. He sees two problems at once: "stock" and "flow." Increasing treatment options would help the "stock" of those who are already addicted while decreasing the number of painkiller prescriptions would slow the "flow" of people becoming addicted in the future.
However, drug users hooked on the most potent substances require many more public health initiatives. Along with the needle exchanges we discussed earlier, some advocates want to introduce "injection centers," locations for addicts to use while under close medical supervision. New York City subway ads tout its program that distributes free naloxone, a drug that can quickly reverse the effects of overdose. Other developed countries have even seen results with prescription heroin. Still, these changes would require a large shift in politics, so they would likely take many years to become mainstream.
For the time being, we will have to see how the current administration takes the commission's advice. Some experts are concerned that declaring an emergency will repeat what happened decades ago with the disastrous "War on Drugs." What is clear to everyone involved though, is the fact that the current policy is not working and a radical change is required to turn things around.
Banner image courtesy of Flickr