By LYLE R. FRIED, CAP, ICADC, CHC In Heroin Addiction
Posted July 27, 2017
The United States has a rapidly escalating public health crisis: opioid addiction. Opioids include heroin, fentanyl, and prescription pain medications like hydrocodone, oxycodone, morphine, codeine, and others.
According to the Centers for Disease Control and Prevention, deaths from opioid overdoses have been rising since 1999. The largest increases, however, have happened more recently.
Based on preliminary data compiled by the New York Times, drug overdose deaths in 2016 likely exceeded 59,000. This marks the largest annual increase ever recorded in the United States, but evidence suggests that the numbers will be even higher in 2017.
For Americans under 50, drug overdose is now the leading cause of death.
These numbers don’t specify what percentage of overdose deaths were linked to opioids. But based on recent trends and statistics, it’s likely that opioids were involved in the majority of these fatal overdoses.
How Does Opioid Addiction Start?
Opioids are not only one of the most frequently abused substances; they’re also one of the most frequently prescribed.
The National Institute on Drug Abuse (NIDA) states, “Taken as prescribed, opioids can be used to manage pain safely and effectively.” Far too often, however, this is not what happens.
Opioids temporarily relieve pain, but they also produce feelings of relaxation, contentment, and even euphoria. Many people who take opioids—even, initially, as prescribed—begin to enjoy and depend on the effects opioids produce.
Generally, over a period of weeks, users begin to develop a tolerance. The originally prescribed dose no longer produces the same effect. As a result, some people begin taking more and more pills.
Because these are legal prescription pills, some users may feel that taking “just a few more” is harmless. But these drugs are habit forming. Physical dependence can form within days, causing withdrawal symptoms when opioid use is stopped. In fact, prolonged use causes chemical changes in the brain, resulting in cravings and drug-seeking behavior.
Often, pills alone can no longer produce the high that users crave. At this point, some transition to drugs like heroin and fentanyl, a synthetic opioid that is 50 times more powerful than heroin.
Fentanyl can be prescribed, but it’s increasingly being illegally manufactured. Manufacturing fentanyl is cheap, so it’s often sold as heroin or used to make counterfeit versions of prescription medications like OxyContin.
The path from prescription pills to heroin and fentanyl is more common than many people realize. According to NIDA, in three recent studies of young people who inject heroin, nearly 50% reported that their addiction began with prescription pain medications.
Both heroin and fentanyl are cheaper and more potent than prescription pills, which is another reason some make the switch.
Since legal opioids are prescribed so frequently, they’re also very easy to obtain illegally. Teenagers can find them in medicine cabinets, get them from their friends, or purchase them on the Internet. High school and college students may “casually” take opioids at parties before a more serious problem develops.
Of course, heroin and fentanyl are not always the culprits in fatal opioid overdoses. Sometimes, people overdose on prescription pills, often in combination with alcohol.
The truth about opioids is that addiction can happen to anyone. And it can start with something as innocuous as a legally prescribed bottle of pain medication.
What’s the Solution?
As a result of increasing opioid abuse and deaths, officials have cracked down on prescription painkillers. “Pill mill” doctors, for instance, have faced prison sentences, paid fines, and lost the ability to practice medicine.
Far from resolving the problem, however, the prescription pill crackdown resulted in users turning to alternatives like heroin. Florida, for instance, started shutting down major pill mills in 2010. From 2010-2015, deaths from oxycodone dropped by 69%. At the same time, heroin deaths skyrocketed, more than doubling in 2014 alone.
It’s more likely that the solution lies with lessening the stigma associated with drug addiction and getting more opioid users into treatment. A heroin habit can start with something as simple and common as a knee injury or peer pressure at a high school party.
Confronting our opioid crisis is an enormous task, but we can begin with small steps like showing kindness, empathy, and support.