Leer en Español
Nearly 40 years ago, an essential label ceased to appear on certain types of pain-relieving drugs. While it didn’t seem to matter much at the time, it turned out to be the source of a crisis affecting millions of people in the U.S. For example, in 2020, 68,630 people lost their lives to opioid overdoses, accounting for 74% of all drug overdose deaths.
How did the opioid epidemic originate?
Prior to proceeding with the history, it is necessary to know what opioids are and how they work. According to the Mayo Clinic website, they are “a broad group of pain-relieving drugs that interact with opioid receptors on cells,” which “are distributed through the blood and bind to opioid receptors on brain neurons,” releasing “signals that dampen your perception of pain and increase feelings of pleasure.”
Prior to the 1980s, pain relief medications came with a very clear label that stated: “May cause addiction.”
However, perceptions began to change after two key events. The first was a letter to the editor that appeared in the New England Journal of Medicine, written by Dr. Herschel Jick, who analyzed hospital records with his assistant Jane Porter, and then concluded that “despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”
According to him, only 4 of 11,000 people treated with opioids developed an addiction. Over the following decades, companies, physicians, and academics have cited that letter as purported evidence of a low likelihood of opioid addiction.
The second event took place in 1986 and consisted of a study involving only 38 participants. It advocated the use of opioids for the treatment of chronic non-cancer pain.
Despite the weak evidence that both cases presented, they enjoyed unwarranted relevance and ended up encouraging the perception that opioids were not addictive if used to treat chronic pain.
During the same decade, the so-called “pain crisis” caused some states to pass laws allowing doctors to prescribe pain relief drugs without the possibility of being sued later.
The explosion in the 1990s and the birth of OxyContin
These perceptions created in the 1980s patiently built up a powerful explosive, which detonated like a huge shock wave years later. The pro-opioid narrative led to the popularization of Purdue Pharma’s OxyContin.
According to Nature, many doctors working in private clinics benefited by achieving an increase in the number of patients.
Pharmaceutical companies began bombarding viewers with promising advertisements for these drugs. The segmentation was such that they generally showed suburban and rural white people, starring the famous “before and after”. Indeed, Purdue Pharma’s most popular commercial was dubbed “I got my life back.”
The states most affected by the opioid crisis have been Kentucky, West Virginia, Pennsylvania, Arizona, Ohio, Ohio, Indiana, Tennessee, Massachusetts, and Maine, among others.
With medical prescriptions for opioids dramatically increasing, some resourceful patients began to resell the drugs, aiding in their distribution and, of course, expanding addictions.
The opioid crisis in numbers
According to numbers from the National Institute on Drug Abuse (NIDA), the number of total opioid overdose deaths has increased by more than 300% in 20 years. While in 1999 the number was less than 20,000, by 2020 the number of deaths was 68,630.
If we dive a little deeper into the data, it turns out that over the past 16 years more than 10,000 people a year died from medically prescribed opioids, peaking in 2017, when fatalities were 17,029.
Joaquín Núñez es licenciado en comunicación periodística por la Universidad Católica Argentina. Se especializa en el escenario internacional y en la política nacional norteamericana. Confeso hincha de Racing Club de Avellaneda. Contacto: [email protected] // Joaquín Núñez has a degree in journalistic communication from the Universidad Católica Argentina. He specializes in the international scene and national American politics. Confessed fan of Racing Club of Avellaneda. Contact: [email protected]