The opioid crisis has claimed many lives in the United States and leaves many dependent on opioids. But who really is responsible? Who should be held accountable? Are pharmaceutical companies responsible for the opioid crisis? Or is it the federal government?
A poll by NPR and Ipsos finds that 57% of Americans believe pharmaceutical companies should be held responsible for making the opioid crisis worse. Data reveals drug companies supplied and pushed out highly addictive painkillers at the height of the opioid crisis. They were available like any other over-the-counter medicine. According to Drug Enforcement Agency (DEA), 76 billion pills were distributed between 2006 and 2012. The Centers for Disease Control and Prevention (CDC) noted that in in 2019 alone, over 70,000 drug overdose deaths has been recorded.
Who Should Stand Accountable – What The Experts Say
Addictionology expert Dr. Rob Kelly shares his take on who should be held accountable. He says:
The bottom line is, it’s not the person going for the payments. It’s the company that is making this very strong painkiller. They are pushing them out with hundreds of sales representatives to push these extortionate pain medicines to their patents. Doctors and physiatrists are 100% responsible for prescribing to their patients. They got incentives to write prescription opioids to their patients and then enjoy a nice vacation with their family.
As an emergency room physician, Dr. Chris Johnson has worked on the front lines of the opioid epidemic. He mentions that the opioid epidemic is not a sudden accident but a panned disaster. The broken medical industry has made up this crisis at the expense of effective, compassionate medicine driven by science.
He brings an urgent message on the need to reform a medical industry that has prioritized business interests over patient safety. He remarked:
Those of us who were in charge of our health and safety failed us.
What are Opioids?
To better understand the issue that is the opioid crisis, we need to define what opioids are.
Opioids are prescription drugs used to treat acute and chronic pains. Opioids are the class of the drug that interact with opioid receptors on nerve cells in the body and the brain. They have the potential to decrease pain and activate the reward areas in the brain by realizing the hormone dopamine and creating a feeling of euphoria. These are some examples of opioids:
- Oxycodone
- Morphine
- Codeine
However, among society, these compounds are widely feared because of their association with addiction, abuse, and other adverse effects. Despite these fears, the use of opioids continues to increase across North America. Canada and the US are the two major consumers where rise in demand of opioids are noticeable. In 2016 alone, around 46 Americans died every day due to drug overdoses involving prescription opioids. In comparison, daily drug overdose rate in 1999 is only 5 per day. In Canada, a total of 2,458 deaths were attributed to opioid overdose. This was the deadliest opioid crises in Canadian history.
History of the Opioid Crisis
Throughout history, opioids were only prescribed to treat severe acute pains for cancer patients and the terminally ill. In the mid 90s, new opioid pain killers like OxyContin were marketed aggressively. The pharmaceutical industry was relentless and claimed that OxyContim was less addictive. This aggressive and misleading marketing contributed to a sharp increase in the availability of opioids. Despite these claims, many people who are prescribed OxyContin moved from legitimate use to dependence and then abuse.
Over the next decade, the prescription of opioids painkillers exploded. Individuals who lost access to legitimate sources turn to heroin as a cheaper and more accessible alternative. Data from a decade of research showed that the initiation of heroin usage was 19 times higher among those who have already tried another opioid. In addition, a study in 2012 found that 86% of injected heroin users had used opioids before trying heroin. Notably, injected drug use also increases the chances of contracting infectious diseases.
Opioid Crisis Caused Massive Losses
As a result, deaths from overdose involving heroin tripled between 2010 and 2015. Then in 2014, potent synthetic opioids like Fentanyl entered the drug market in large amounts. British Columbia, Ontario, and Alberta have been hit hard by this surge.
In 2016, 931 people from British Columbian died from opioid drug overdose with fentanyl detected in 60% of those deaths. That is three times the number that died from motor vehicle accidents in the same state.
The biggest issue is that illicit drugs especially heroin have been cut with fentanyl. Fentanyl is a prescription opioid that is 50 times stronger than heroin and 100 times stronger than morphine. It is a drug best kept in a locking medication bag never to be opened. Fentanyl is easily produced and relatively cheap so it became a lucrative business for drug cartels. Most of the production of Fentanyl takes place in China and then distributed through illegal channels.
Should Opioid Prescriptions Be Stopped?
The existence of the opioid crisis does not necessarily mean physicians should stop prescribing opioids. Opioids provide quality of life for many people who take them responsibly by keeping them in small locking bags for medications. Suddenly removing access to opioids from those that depend on the drugs can easily push people towards more dangerous alternatives.
Is Opioid Addiction Preventable?
Health care providers should be well aware of the long-term effects of opioids and their associated risks including addiction. Health care provider should also advise patients on taking preventive measures regarding prescription. Keeping opioids in a locking container or small locking bags for medications can be recommended to avoid mishandling. If patients start to show symptoms of addiction, medical professionals should intervene and give them access to therapeutic and rehabilitative assistance.
What Can be Done?
There are many variables but any solution requires controlling the distribution of prescription opioids and expanding access to medication-assisted treatment. In Toronto, police started keeping tabs on life-saving drugs that can reverse the effects of a Fentanyl overdose. All measures must be taken to put a damper on the growing number of overdose deaths.
If you or someone you know regularly uses prescription opioids, you should be aware of the signs of an overdose. These include sleepiness, slow heartbeat, difficulty breathing, and cold clammy skin. In all cases of suspected overdose you should immediately call the healthcare helpline.
What’s the Verdict?
Are pharmaceutical companies responsible for the opioid crisis? Being the enablers, pharmaceutical companies are responsible for the opioid crisis with their aggressive push on the use of opioids with little regard for other pain management strategies. Nonetheless, the federal government is also partly to blame for letting it get out of hand. People should be held accontable.