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Jakob Lara-Woodburn

Professor Stalbird

English 1201.277

April 5, 2018

Prescription Opioids are the Problem

Opiates make for a killer high, quite literally.​ Currently,​ the opioid epidemic is sweeping

across the nation. I think that when people consider the topic of addiction, many of them believe

that opioid abuse is a ​self-inflicted habit​. Although that may be the case sometimes, it usually

does not start out that way. Most often, the people who become​ hopelessly​ addicted to

prescription opioids are innocent. The most effective path to bring these addicts into a recovery

stage and stop the furthering of future addicts would be to dismantle the pharmaceutical agenda

of prescription opioids, increase public awareness on the chemistry and science behind the

addiction process, and increase government support for addiction prevention methods.

Firstly, pharmaceutical drug companies have been pushing dangerous pills at high

volumes and low costs for decades now. Prescription opioids represent a multi-billion dollar

industry within pharmaceutical sales (​Scott Higham​ and ​Lenny Bernstein​). Oxycontin,

methadone, and ​buprenorphine are just a few prescriptions opiates or opiate mimicking drugs

that are still widely available for prescription use. These drugs are usually used in connection

with a Medically Assisted Treatment Plan also abbreviated as (MAT) by the U.S. government.

MAT was the government's initial plan to address the issue of opioid abuse in the U.S. However,

the prescription of addiction relieving medication such as ​methadone and buprenorphine was

meant to slowly wean addicted drug users off harder opiates through a series of stages but often
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it can cause patients and opioid users to become further addicted. (​Littrell, Jill). Prescription

Oxycontin provides just another case of this. For example, Oxycontin is usually prescribed by

doctors to patients with severe back pain and physical ailments. Statistics from the U.S.

Department​ of Health and​ ​Human Services has shown a severe correlation between the rise in

prescription opioids and the increase of opioid addiction. The Department has stated in an article

about The Opioid Epidemic, “​In the late 1990s, pharmaceutical companies reassured the medical

community that patients would not become addicted to opioid pain relievers and healthcare

providers began to prescribe them at greater rates.” Corporate pharmaceutical companies have

generally supported this falsity over the past few decades in order to profit immensely off of the

people who become addicted.

Pharmaceutical drug companies have ​had​ such a large influence over opioid addicts

across the country. From 1999 to 2016 pharmaceutical opioids had claimed the lives of over

200,000 men women and children.​ Every day​ 46 people will overdose ​on​ prescription opioids

(“Opioid Overdose.”). It is imperative that legislation​ is ​passed to prevent pharmaceutical

companies from rapidly prescribing opioids. This would effectively halt the further creation of

many opioid addicts. Recently, There has been some progress made combating overdose rates.

Narcan is​ an overdose-reversing​ drug that just as of October of 2017 was available for over the

counter purchase for the first time. Walgreens announced it would be selling this product in all

its stores across the country the same week President Donald ​Trump​ proclaimed a nationwide

opioid epidemic. The availability of ​overdose-reversing​ drugs serves as a small gain for the

community ​of​ suffering opiate addicts but ultimately leaves the profit margin of big pharma

undisturbed. Prescription pain medications are some of the fuling factors that lead people to
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become addicted to opioids in the first place. Over the past few decades, the attempted

crackdowns on opioid abuse lead by the DEA have largely proven ineffective and in fact made

matter worse ​(​Estren and Potter). “​Prescriptions for powerful painkillers doubled between 1994

and 2008 and abuse skyrocketed as well.” is a direct quote from Mark Estrens book,​ ​Prescription

Drug Abuse​ which further helps to link prescription rates with drug abuse.

Assuming that the pharmaceutical and the U.S. Government industry has had some role

in prescribing and enforcing opiates use, the point remains that the public must be aware of the

science behind addiction and the opiates work on to the brain. Breakthroughs in medical research

have proved that far more effective methods of addiction recovery and prevention do exist in

contrast to the tradition plan of just simply prescribing more opiates to current opioid addicts. In

the book ​Treating Addiction : A Guide for Professionals​,​ the author, ​William R Miller​ explains

that addiction is a very common clinical issue and the availability of treatment can make a life or

death difference. He presents strategies with the support of the latest clinical science to prove

addiction is a treatable disease. As alternative and innovative methods of abuse treatment, he

suggests the effectiveness of of detox therapy, individualized treatment, and maintenance of

change as important steps in recovering from and preventing addiction. Addiction is always a

chemical imbalance ​in​ the brain, often opioids can have a more powerful grasp over those who

are addicted than they can realize. Miller explains, “Opiates flood the person with a euphoric

sense if well-being, combined with drowsiness and relief of pain.” ​Generally,​ the euphoria felt is

so significant opioid users can become severely hooked after the use of the drug.

When someone first ingests opioids, the chemicals inside the drug (opiates) make their

way into the brain and take complete chemical control of a person's pleasure response system.
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Prescription opioids have the same effect on a person's brain as non-pharmaceutical opiates such

as morphine or heroin. After entering the brain through the bloodstream, the opiates within the

drug naturally latch on to the body's opioid receptors located in the brain, spinal tissue, and other

parts of the body. This blocks all pain and releases dopamine into the brain. The brain's reward

system has now been activated causing opioid users have such a euphoric feeling after the drug

has been ingested (“Why Are Prescription Opiates So Addictive?”). ​Accompanying ​the euphoria,

other feelings that induce promote activities that are paired with survival such as sexual

intercourse, binge eating, and the urge to use opiates again and again. Opioid use results in

immediate chemical imbalance and repeat use of the drug can have drastic ​long-lasting ​effects.

Long-term ​use can result ​in diminishing the​ production of the body's natural opioids it produces

such as endorphins and dopamine which naturally trigger ​as a response​ to healthy and productive

activities (“Why Are Prescription Opiates So Addictive?”). With with increased use of opioids

the brain's opioid system becomes desensitized to opiates making a person crave more and more

to reach the same effect as the first time used. This cycle helps to fuel addiction causing person

to go back to the drug in search of more and more pleasure, the often never know it is virtually

impossible to reach the same effect that they had the first time they used. This is​ a concept​ in the

heroin community called chasing the dragon. A person will always feel in reach of their peak

sensation but they will never be able to fully get what they want. This concept works the same

with all opiates across the board. With addiction comes tolerance. Tolerance also contributes to

many overdoses because the dangerous effects increase with higher doses of opiates.

“​Combining opiates with other drugs and alcohol​ may further increase the risks of addiction,

medical complications, and overdose.” (“Why Are Prescription Opiates So Addictive?”). This
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quote is very important because all types of drugs can interact differently with each other after

they've entered the body.

In addition, new developments within neurological surgery have proven very effective in

curing opioid addiction. A long term ​Buprenorphine Implant has been developed to last long

enough for a patient in recovery to be weaned off an opiate dependency ​as the effects of the

implants​ diminish over time. This strategy of drug administration is superior to previous methods

of opioid recovery such as prescription medication and IV injectables which have proven less

effective over the years. “To date, the newest implant approved by the US Food and Drug

Administration (May 2016) is Probuphine®, which delivers steady-state levels of buprenorphine

over the course of 6 months.” (Itzoe). This method of opioid addiction therapy represents an

innovative effective cure for patients in dire need of treatment.

Neurological implants represent just one solution in a large pool of issues concerning

opioid abuse. The increased growth in the use of ​opioids,​ in children and adults in the United

States explains why prescription opioids play a large role in the growth of widespread addiction

to the drug, It is very important to differentiate the types of opioids from each other and the

different effects they cause. For​ instance,​ the severity of addiction and withdrawal to fentanyl or

heroin is far worse than that of prescription opioids. Opioid addiction is a growing problem

among children and adults and the hazards between the wide array of opioids available to use can

can range from deadly to addicting​. The quote, “The demographics of heroin use have also

changed significantly in the past 50 years. While heroin was formerly thought to be largely a

phenomenon of urban males, use has increased among women and those in non-urban areas.”
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(​Chhabra and Aks) ​help conceptualize the scope of the opioid problem and how it has changed

over the years.

Likewise, It is important for people to understand how far the U.S. has come in fighting

addiction although now almost half of opioid deaths come from prescriptions, the U.S. had

employed other less effective methods in the past to crack down on opioids and other addictive

substances. The War on Drugs was established in the 1980’s its original goal was to diminish the

size of illegal and addictive drugs entering the country. However, the rates of illegal substances

such as heroin and other opiates entering the country have actually increased rapidly since the

1970’s (Klassen). Although the federal government hasn't had a whole lot of success in

combating the opioid crisis, State and Local law enforcement agencies have had some success

with reform policies that have made addiction treatment more effective and accessible. While the

current federal regulations on drug policies and regulations serve to be counterproductive the

implications surrounding national drug abuse policies continue to exist. It is important to

understand some of the history behind addiction growth in the U.S. ​ In general​, Drug addiction

has never been given the adequate attention in order to properly be treated. Comparatively, the

quote, “​The non-enforcement of soft-drug possession laws that is practiced in parts of Europe

appears to be the most manageable alternative to a prohibitionist policy.” (​Klassen)​ provides a

perfect ​contrast to​ understanding the effectiveness of some of the European Drug control

methods as compared to those in use by the U.S. Government.

As a matter of fact, ​the​ opioid crisis was formally addressed for the first time last year.

On October​ 26th,​ 2017, President Donald Trump officially declared the opioid epidemic a

nationwide crisis. Trump's statement formally addressed the people affected by opioid addiction
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across the country but he did not prompt any additional funds to be allocated towards combating

the crisis. He even took it upon himself to suggest that certain ​Medicaid​ policies should be cut

preventing users from accessing rehab facilities (Hirschfeld). The president's stance on the opioid

epidemic since he declared it a crisis has been overly hands off. Even with public address

combating the opioid epidemic requires funding in order to be effective. The president should be

a lead voice in any ​national​ crisis and it is imperative for Trump to provide monetary support to

provide an avenue for success when combating the crisis. ​An article written by Julie Hirschfeld

also relates some of Trump's addiction prevention strategies to those employed by Reagan in the

80’s which have since proved to be ineffective.​ Contrast to the mindset of President Donald

Trump, addressing the opioid epidemic requires a community of funded medical ​researchers​ who

plan to combat it in order to make progress. The quote, “​No part of our society — not young or

old, rich or poor, urban or rural — has been spared this plague of drug addiction and this

horrible, horrible situation that’s taken place with opioids,” Mr. Trump said during an elaborate

and emotional ceremony in the East Room of the White House, attended by families affected by

opioid abuse, members of Congress and administration officials. “This epidemic is a national

health emergency.” (​Davis)​ to relate progress made by the federal government since the address

to combat the opioid epidemic.

In contrast, ​when most people consider the topic of opioid abuse they think of a homeless

junkie shooting heroin in an alleyway. Although that may be the case sometimes, It usually does

not start out this way. A common belief is a that all drug abusers come from​ low-income​ areas

and deliberately made the choice to become addicted. Also, many if not most people trust their

doctors would never prescribe them something that could be potentially dangerous or harmful.
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When people are told pain medication is a relatively safe way to treat pain as long as the person

takes it as prescribed they should never have to consider the fact that they could be hopelessly

addicted to opioids and then have them ripped away from them as quickly as they were provided.

Some people also believe that methadone is considered a safe and effective method to recover

from opioid addiction. Marc Lewis, an author of an article explaining why ​prescriptions​ are not

the cause of the opioid crisis stated, “Addiction is not caused by drug availability … but by

psychological (and economic) suffering, especially in childhood.” (“The Truth about the US

'Opioid Crisis' – Prescriptions Aren't the Problem | Marc Lewis.”). He goes on to claim that

doctors should not stop prescribing opioids.

Truly​, opioid addicts and drug users alike represent some of the most neglected groups

within human society.​ They are often left without the means to get the proper care they need.

Programs that have proven to be the most effective in treating opioid abuse are not widely used.

In terms of the methadone prescriptions that attempt to cure recovering addicts, an analogy

perfectly fits the situation: you can't put out fire with more fire. Effective and alternative options

for treating abuse do ​exist.​ ​In general,​ they are just less funded or promoted by the federal

government. In its entirety, the pharmaceutical companies actually generate more revenue of the

people who are hooked because as long as opioid addicts continue to exist, they will always have

repeat customers. In fact, there are cases that link big pharmaceutical companies interests and

connection to the U.S. government. Before bills passed through ​Congress​ during President

Obama's second term, billion dollar donations were recordabley made from big pharmaceutical

companies and were given to ​Congressman​, Tom Marino and Orrin G. Hatch who had supported

allocating more freedom to the pharmaceutical industry (​Scott Higham​ and ​Lenny Bernstein​).
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“Besides the sponsors and co-sponsors of the bill, few lawmakers knew the true impact the law

would have.” said ​Scott Higham​ had stated in his Washington Post article. This gave the

pharmaceutical industry the ability to continue to prescribe opioids at high rates

Finally, Prescription opioids account for 40 percent of all opioid overdoses. When

considering the topic of pharmaceutical opioid addiction it is important to understand it is not

always a person's choice to be addicted. Most often it is actually the powerful acting chemicals

within opioids (prescription or not) that cause a person be forced into a path of addiction.

Understandably, the most effective path to bring prescription opioid users back from addiction

and stop the creation of future prescription opioid addicts would be to dismantle the

pharmaceutical ​agenda of prescription opioids, provide the public with knowledge and education

about the reality of drug use and the dangers behind prescription opioid addiction, and harness

government support for addiction prevention methods nationwide.

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Works Cited

“About the U.S. Opioid Epidemic.” ​HHS.gov​, US Department of Health and Human Services, 12

Feb. 2018, ​www.hhs.gov/opioids/about-the-epidemic/​. Date Accessed 28 February 2018.

Chhabra, Neeraj and Steven E. Aks. "Current Opiate and Opioid Hazards in Children and

Adolescents." ​Clinical Pediatric Emergency Medicine​, vol. 18, no. 3, Sept. 2017, p. 173.

EBSCO​host​, Date Accessed 28 February 2018.

Davis, Julie Hirschfeld. “Trump Declares Opioid Crisis a 'Health Emergency' but Requests No

Funds.” ​The New York Times​, The New York Times, 26 Oct. 2017,

www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html​. Date Accessed 28

February 2018.

Estren, Mark J. and Beverly A. Potter. ​Prescription Drug Abuse​. Oakland, California : Ronin,

2013. EBSCO​host​, Date Accessed 28 February 2018.

“FAQ Prescription Drugs.” ​Narconon International​,

www.narconon.org/drug-information/FAQ-prescription-drugs.html.

Higham, ​Scott ​and ​Lenny Bernstein​. “How Congress Allied with Drug Company Lobbyists to

Derail the DEA's War on Opioids.” ​The Washington Post​, WP Company, 15 Oct. 2017,

www.washingtonpost.com/graphics/2017/investigations/dea-drug-industry-congress/?utm

_term=.a04ac4be20fc​. Date Accessed 4 March 2018

Itzoe, M and M Guarnieri. "New Developments in Managing Opioid Addiction: Impact of a

Subdermal Buprenorphine Implant." ​Drug Design, Development and Therapy, Vol

Volume 11, Pp 1429-1437 (2017)​, 2017, p. 1429. EBSCO​host​, Date Accessed 28

February 2018.
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Klassen, Jeff. "Drug Policy (Sociology)." ​Research Starters: Sociology (Online Edition)​, 2013.

EBSCO​host​, , Date Accessed 28 February 2018.

Lewis, Marc. “The Truth about the US 'Opioid Crisis' – Prescriptions Aren't the Problem | Marc

Lewis.” ​The Guardian​, Guardian News and Media, 7 Nov. 2017,

www.theguardian.com/commentisfree/2017/nov/07/truth-us-opioid-crisis-too-easy-blame

-doctors-not-prescriptions.

Littrell, Jill. "Expanding Access to Medication Assisted Treatment: The U.S. Government’s

Response to the Current Heroin Epidemic." ​Social Work in Mental Health​, vol. 15, no. 2,

Mar/Apr2017, pp. 209-229. EBSCO​host​, doi:10.1080/15332985.2016.1210555. Date

Accessed 28 February 2018.

Miller, William R., et al. ​Treating Addiction : A Guide for Professionals​. New York : Guilford

Press, [2011], 2011. EBSCO​host​, Accessed 28 February 2018.

“Opioid Overdose.” ​Centers for Disease Control and Prevention​, Centers for Disease Control

and Prevention, 1 Aug. 2017, ​www.cdc.gov/drugoverdose/data/overdose.html

“Why Are Prescription Opiates So Addictive?” ​DrugAbuse.com​, 17 Feb. 2016,

drugabuse.com/library/opiate-addiction/.