As The Daily Wire reported, President Trump is currently drafting paperwork to declare the opioid epidemic a “national emergency.”
Once upon a time, we considered drug abuse to be an underground issue impacting the dregs of society. “They” have a drug problem, we told ourselves. The “other,” that faceless statistic we all heard about but never talked about in polite company, was beyond our help. Today, the opioid crisis is staring us in the face. It’s inescapable. This is a full-scale epidemic affecting hardened criminals and unassuming housewives alike.
America’s opioid addiction is costing countless lives every day. But why? How did we get here? The fact is, we’re here because we’ve done very little to address the problem.
Some have linked the uptick in opioid-related addiction to the recession, arguing that unemployment has bred a culture of despair in which drugs are sought as a refuge to blunt the pain of loss. Others place the blame on the astonishing accessibility of painkillers and other prescription drugs.
But the truth is, of course, more complicated than these reductive reasons imply. To understand opioid addiction, we first need to understand what the drug does and the effect it has on the brain.
“Opioids are a class of drugs that include the illicit drug heroin as well as the licit prescription pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and others,” notes the American Society of Addiction Medicine. “Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain.”
Here are seven things you need to know about the opioid epidemic:
1. The majority of drug overdose deaths in the United States involve an opioid. Drug overdoses are the leading cause of accidental deaths in America. “Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) quadrupled,” explains the Centers for Disease Control and Prevention (CDC). “From 2000 to 2015 more than half a million people died from drug overdoses.”
Citing extensive research, the CDC concludes: “We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths.”
A staggering 91 Americans die everyday from opioid overdose.
2. Opioid sales have skyrocketed over the last few years. Here’s the CDC again:
Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids — drugs like oxycodone, hydrocodone, and methadone — have more than quadrupled since 1999.
3. Millions and millions of Americans are misusing prescription drugs. The opioid epidemic isn’t a reflection of some uptick in illicit heroin use. Rather, the majority of Americans dying from opioid overdose were misusing prescription drugs. In 2015, 12.5 million people regularly misused prescription opioids, according to the Department of Health and Human Services (HHS).
“Although most people take prescription medications responsibly, an estimated 52 million people have used prescription drugs for nonmedical reasons at least once in their lifetimes,” explains HHS.
4. Young adults, specifically those ages 18-25, are the biggest abusers of prescription opioid drugs. Young adults also misuse disproportionately ADHD and anti-anxiety medications. “They do it for all kinds of reasons, including to get high or because they think Rx stimulants will help them study better,” states the National Institute of Drug Abuse.
5. Prescription opioid overdose deaths have increased at a much faster rate for women than men. “Women are more likely to have chronic pain, be prescribed prescription pain relievers, be given higher doses, and use them for longer time periods than men,” reports the American Society for Addiction Medicine. “Prescription pain reliever overdose deaths among women increased more than 400% from 1999 to 2010, compared to 237% among men.”
6. In absolute terms, opioid deaths are highest among middle-aged white men from the Midwest and Northeast. Rural America is hurting the most, but the reason for that is complicated.
According to The Economist, “the terrifying rise in opioid deaths in the past few years seems to have less to do with white working-class despair and more to do with changing drug markets. Distinct criminal networks and local drug cultures largely explain why some parts of America are suffering more than others.”
Before 2010, OxyContin was easily accessible and prescribed by doctors with relative ease. But lately, doctors have been more wary about prescribing the drug, fearing abuse and overdose.
“Fentanyl is cheaper [than prescription OxyContin sold on the street], explains The Economist, adding:
It is often made in Chinese laboratories and smuggled into America; some traffickers obtain it through the dark web, an obscure corner of the internet. Fentanyl is usually added to heroin to make it more potent or is made into pills, which can resemble prescription painkillers. Because it is such a powerful drug — at least 50 times stronger than heroin — the smuggling is easy and the potential profits are huge.
7. There’s a psychedelic drug out there that may cure opiate withdrawal, but it’s illegal in the United States. The drug in question is called Ibogaine. It’s currently listed as a Schedule 1 controlled substance in the U.S., ironically in the same category as heroin. Given the federal government’s view of the drug, the available research on the drug has been limited and somewhat controversial. Nonetheless, extensive anecdotal evidence backed by scientific understanding of neural pathways attest to the drug’s efficacy in treating opiate withdrawal.
It’s important to note that the drug has been used illicitly in the United States and legally in Mexico and Canada (as an unregulated substance) to treat opiate withdrawal, not opioid addiction. The difference between opiate and opioid is subtle but important. Opiates have recently been grouped under the opioid family, but traditionally speaking, opiates are derived from natural plant matter. Opium, morphine, codeine, and heroin are considered to be opiates. In contrast, opioids are mostly synthetic. Most opioid prescription drugs fall into this category.
As it stands, current treatment options for both opiates and opioids are highly ineffective. Most people enrolled in substance abuse programs for opiate addiction drop out and go back to abusing drugs.
“Treatment for addiction varies widely, and is not very effective. Addicts may have to go through a supervised detox from the drug, often lasting over a week. Sometimes they are then prescribed a drug, like methadone, to treat withdrawal — but sometimes they are simply put on an abstinence program in a rehab facility,” reports The Verge. “Some facilities in the United States report treatment dropout rates as high as 75 percent; relapse rates for people who go through treatment can be as high as 90 percent.”
While ibogaine is by no means a panacea, some opiate abusers have reported an expedited withdrawal process or being cured of their addiction altogether after undergoing either supervised ibogaine treatment or a “spiritual” retreat in which shamans administer the West African-based iboga plant to those seeking clarity.
To be clear, ibogaine treatment isn’t for the faint of heart.
Ibogaine is an psychotropic drug that induces intense hallucinations. Users have reported re-experiencing some of the most traumatic incidents of their lives play out like a movie reel in front of them. According to these users, the drug forces you to confront perplexing aspects of your past and eventually, after a horrifying trip down memory lane, brings you to the other side, a place of calmness and peace where your past no longer weighs you down. In other words, the drug purportedly allows you to reach into the darkest depths of your subconscious to forgive yourself. It’s unclear if this hallucinogenic process is necessary for helping you push through withdrawal, but scientists are researching whether the drug can help with opiate addiction without inducing the intense psychotropic effects.
To date, there’s been a handful of official ibogaine studies carried out by accredited researchers. The studies have yielded varying results but overall seem to indicate that ibogaine can help in some cases of opiate addiction and not others.
For more information about the drug read here.