The Opioid Crisis Isn’t Over

Guest Opinion

By Karen Mulvahill | July 22, 2023

The current size of the opioid epidemic and its stratospheric growth make it likely that if you don’t know someone who suffers from addiction now, you will eventually.

The opioid epidemic was declared a public health emergency by the CDC in 2017. Overdose deaths were five times greater in 2021 than in 2000. According to the Centers for Disease Control’s (CDC) National Center for Health Statistics, there were more than 100,000 overdose deaths from April 2020 to April 2021, an increase of nearly 30 percent in a single year. In 2022, Grand Traverse County reported 23 fatal overdoses.

To understand how we got to this point, I read Sam Quinones’s Dreamland and Beth Macy’s Dopesick, two excellent references. It all started when Purdue Pharma invented a painkiller, called it OxyContin, and began marketing it aggressively to doctors. The company claimed that, when used to treat pain, Oxy was not addictive. Incredibly, the doctors believed this, aided by a line in the drug’s marketing materials that suggested Oxy was less addictive than other painkillers. This language had been approved by an FDA official who left the agency shortly afterward for a lucrative position at—you guessed it—Purdue Pharma. In reality, OxyContin was—and is—extremely and quickly addictive.

Consider this common scenario. A person treated by a doctor they trust takes Oxy for their pain and becomes addicted (which can happen in a timeframe as short as five days). This person tries to stop and feels so sick they cannot get out of bed unless they take the drug or its substitutes. “Using drugs repeatedly changes the brain, including the parts that help exert self-control. That’s why someone may not be able to stop using drugs, even if they know the drug is causing harm, or feel ready to stop” (U.S. Department of Health and Human Services).

After years of deceitful marketing and abusive prescribing, the FDA and doctors backtracked. Fewer prescriptions were written, and desperate addicts turned to the street where Oxy was scarce and expensive. Heroin coming in from Mexico provided a cheap and plentiful substitute. “79.5% of new heroin initiates…reported that their initial drug was a prescription opioid.” (Richard C. Dart et al., New England Journal of Medicine, Jan 15, 2015)

Then came fentanyl, an opioid 50 times more potent than heroin and way cheaper to manufacture. Fake OxyContins and heroin, as well as cocaine and methamphetamines, began to be laced with the cheaper drug. Dealers mixed them without caring much about consistency or strength. People died. More and more often.

Between 2012 and 2019, the CDC reported, cocaine-related death rates tripled, and those involving methamphetamines rose six-fold. Fentanyl was the driver. Just two milligrams of fentanyl are enough to kill someone.

The life of an addict can be a horrible merry-go-round of getting high, looking for money, and buying more drugs to stave off the symptoms of withdrawal. “You’re throwing up. You have diarrhea. You ache so bad and you’re so irritable that you can’t stand to be touched. Your legs shake so bad you can’t sleep…And believe me, you’ll do anything to make that pain go away.” (Debbie Honaker, interviewed by Beth Macy in Dopesick.)

The ability to quit is incredibly difficult. Users are typically in and out of rehab multiple times before they finally can quit. “It takes the frontal lobe, the insight and judgment part that’s been shut down by continued drug use, at least ninety days just to start to come back online and sometimes two years to be fully functioning.” (Dr. Steve Loyd, quoted in Dopesick.)

The cost to our society is not just the individual tragedy when a loved one becomes addicted and changes into a person you no longer recognize. (Or they die.) It’s also the cost of the crimes associated with use and sales of drugs. And it’s the opportunity cost in terms of the lives of people who could’ve been productive contributors to our society. The economic toll of the opioid crisis reached nearly $1.5 trillion in 2020, up 37 percent from 2017 numbers, adjusted for inflation.

What can we do to curb this epidemic? Providing more funding to establish new treatment centers is critical. (In 2023, Grand Traverse County commissioners took steps in this direction when they approved funding for a new center for mental health and substance use services). Ensure that health insurance is available and will cover treatment costs. Initiate discussions with young people about the danger of taking even one pill at a party. Limit your intake of prescription pain meds to a few days, if possible, and dispose responsibly of unused pills. The growth of this epidemic is so staggering that there is no time to delay.

“What each of us can do is expand our circle of compassion and empathy, and urge others—including our elected officials—to do the same.” (Travis N. Rieder, In Pain: A Bioethicist’s Personal Struggle with Opioids)

Karen Mulvahill is a writer living in northern Michigan.