The Opioid Epidemic: From Evidence to Impact

You probably heard about it before you saw it. NPR and CNN were running stories about it once a week for a while. And then twice a week. For a period of time, it was all anyone could talk about: The Opioid Epidemic. People were getting addicted to powerful prescription painkillers.

Those news stories went away after a while. And for much of the country, it tasted acutely similar to the Ebola scare. That is to say, it seemed like a lot of media attention was given to a problem that did not end up affecting anybody that strongly. But in major cities the effect was obvious.

It still is obvious. Go down any street in any large city in the United States and you will see people lined up on the street begging for money. Rehab clinics are overflowing, and used methadone vials and used needles litter the back alleys. This is what caused the opioid crisis to become played out. After all, how often can people hear about a crisis before they’re numb to it?

Let’s take a walk through history. The opioid crisis did not emerge from anywhere. It has causes, and it is currently having effects. But it can be a lot to take in at once.

For that reason, we will be breaking it into three parts.

Part One: How it Started

For the longest time, the main painkiller used by the United States military was morphine.

Morphine is what is known as an “opioid drug”, meaning it interfered with the opioid receptors in your nervous system. These receptors are how you feel pain; if they don’t work, then you do not feel pain at all. But morphine had some pretty nasty side effects, including temporary paralysis.

The military began searching for their next-generation painkiller. And in the 1990s the pharmaceutical industry delivered with OxyContin. This drug was mass-produced and not only approved for military use but also approved for use by the general public.

What did OxyContin Do?

These new, extremely powerful painkillers saw release to the general public. But a problem swiftly developed: It was almost impossible to do anything but overmedicate with these drugs.

Individual doses were too strong, but pharmacies had little choice but to give them out as-is. There were just no alternatives. The power of the drugs meant that dependencies formed quickly. But once the patient’s injuries were treated, they could prescribe no more opioids.

Many patients turned to alternatives. The most common was heroin and its main ingredient, fentanyl. The opioid crisis quickly turned into a wide-scale drug crisis with people losing family members, stability, livelihoods, and even their homes to debilitating substance abuse issues.

Part Two: How it’s Going

Since the beginning of the crisis, not much has been done to restrict the prescription of opioids. It is common for powerful painkillers to be prescribed for broken bones and dental procedures. Doctors and dentists are both regularly lobbied by the companies that make the drugs to prescribe them to patients, ensuring a steady supply of addicted customers.

And of course, lawmakers are lobbied as well. There are few FDA-approved alternatives to opioid painkillers on the market these days, meaning that you either have to carefully deal with dangerous medicine or just endure the pain.

The result of this is that overdose and addiction to these drugs are worse than ever. Both are more frequently found in young people, and people below 30 years old these days are predicted to have a shorter life expectancy than their parents as consequence.

Things are looking a bit better on the recovery side of things. Prevention is heavily hamstrung by politics and corporate greed, but a good amount of money has been put towards making overdose medication more available, along with detox treatment drugs like methadone.

Getting just these things done has been a fight though. It is hard to convince anyone that does not live near drug addicts that drug addiction is a public health problem. That means most drug rehab centers are either expensive, privately funded centers or cheap city-funded facilities.

Part Three: How it Could Go

While things are not going great right now, they have the potential to get better. Even without constant news stories, even the most disconnected layman will be able to identify the homeless on the streets. It does not take that layman asking too many questions to learn about opioids.

The fact that cities are able to build rehab and detox centers is a big win. It means that public health is more of a concern for the cities, which will lead to greater interest in elections.

If you can say one somewhat positive thing about the opioid crisis that makes it different from the climate crisis or most economic crises, it is that its effects are highly visible. They are also highly destructive and damaging, so this visibility is obviously a silver lining to a dark cloud.

But visible problems are not just far easier to identify, they are far easier to solve. They are public problems, but not every public problem gets solved. If you call gun violence a public problem, there will always be someone saying it comes down to individual choice.

That rhetoric does not apply here. Addicts with open wounds used needles, and the empowerment of the gangs that deal in these drugs are all direct consequences of the opioid epidemic. A shooting can be relegated to a neighborhood. But everyone sees these symptoms.


Perhaps the most important thing about understanding the opioid epidemic is that there is help out there right now. Dealing with addiction is hard. This is true in the public health sense, but it is also true in the individual sense. It is not just about quitting the drug and detoxing.

Emotional recovery is just as important as chemical recovery. Do not be afraid to reach out to us if you or a loved one needs help, as it is one of the greatest struggles a person can face.

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