Drugs and medicine might sound like different things even though often it’s the same ingredients. Originally extracted from a poppy, opium has been a harmless medicine for decades. It’s been a help to many troubles, from the flu to a stomach ache. In the 19th century, people started to develop stronger forms from opium like morphine and heroin. In the world wars in 1900, opiates were already being used ruthlessly. After the 1960’s the problem of addiction exploded and good medicine became a difficult crisis. During the 2000’s, synthetic opioids have caused a global problem, especially in the U.S.

Opium is one of the first medicines in history. It affects the opioid-receptors in the brain and replaces the body’s natural endorphins, which weaken pain signals and boosts feelings of pleasure. Endorphins boosts happen naturally during eating, social interaction, sex, and good sleep. Opium puts all this in a tighter, stronger and faster package. The likelihood of getting addicted to opioids is bigger than any other drug we know. The ancient Greeks and Egyptians were using it to cure toothache and to calm crying babies. Arriving in the 1800’s, opium was a basic equipment in everyone’s home. It wasn’t seen as a problem yet and it was a big help to most of the health problems. A popular mix back then was also laudanum. It’s a tincture of opium and alcohol. You could buy this from basically everywhere. Mint and opioids were medicine for cholera and in case of pneumonia or an uneasy stomach, opium is what comes to help.

In 1803, a German pharmacist Friedrich Sertürner discovered morphine. Sertürner was the first to isolate morphine from opium. He called the isolated alkaloid “morphium” after the Greek god of dreams, Morpheus. Morphine is 10 times stronger than regular opium. In the 1830’s morphine was produced more and more and the availability got higher as well as the price got lower. While this already offered a great base for problems, there was one more substance to come. Heroin. Being 3 times stronger than morphine, it was believed to have lower risk of addiction. It was a ‘’miracle medicine’’ and was offered as a cure for morphine addiction. 

November 1996. James Campbell introduced the idea of pain being the fifth vital sign. The point of this was that if pain was addressed with the same seriousness as other vital signs, it would have a better chance of being treated properly. Pharmaceutical companies come in with OxyContin and the promotions of these drugs are safe and not that addictive. Paying physicians to be on the speakers side.

This ‘’miracle medicine’’ has backfired ruthlessly. 1 in 5 people prescribed an opioid, become addicted in less than 10 days. When comparing the disadvantages of different substances like violence, criminality and deaths, two things are always at the top: alcohol and opiates. Worldwide, about 0.5 million deaths are connected to drug use, more than 70% of these deaths are related to opioids such as Oxycontin and Vicodin. From all the opioid-users in the world, America has 80%. According to the altarum institute, the price for the opioid crisis rose to 1 trillion dollars between 2001 and 2017. The most common cause of death in under 50 year olds in the U.S. is accidental overdose. In fact the amount of prescribed opioids in the U.S. counted together would keep the whole nation high for approximately 3 weeks. American Society Of Addiction Medicine says that about 2-3 million Americans are addicted to either opioids or heroin.

While the doctors are prescribing these, the addiction keeps on growing rapidly. The number of drug overdose deaths increased by nearly 30% from 2019 to 2020 and has quintupled since 1999. Nearly 75% of the 91,799 drug overdose deaths in 2020 involved an opioid. Users aren’t the only ones suffering. Along with the families who deal with a close one’s addiction, over 20,000 babies are born every year dependent on both illegal and non-illegal drugs. That’s equivalent to one baby every 25 minutes.

Imagine the worst flu you’ve ever had in your life and multiply it with ten. That’s what opioid withdrawal feels like. And like so many people in recovery from addiction, they have relapses. Often multiple. People can’t just stop needing the drug when the prescription ends. Unfortunately, in those circumstances hearing about an overdose indicates that the drug in town is strong. Usually for an addict, strong equals good. Addiction becomes a matter of life and death every hour of every day. 

Mac Miller, Prince, Lil Peep, Tom Petty, and the list goes on. All of them died from fentanyl overdose. After getting dependent on opioids and ending up having to get it from the street, there’s a high chance of getting some boost from fentanyl. Fentanyl is a synthetic opioid and 50 times stronger than heroin. Fentanyl is explaining many of the overdoses mentioned. Due to fentanyl being so strong, as little as 1-2 grains of salt in size, can make anyone overdose. The margin of safety with fentanyl is much smaller than in other opioids, and much smaller amounts go a long way in the illegal drug market. For example, in 2016 at the Vancouver International Mail Center, a package was declared as printer cartridges. Inside the cartridges there was 1,000 grams of carfentanil. Another extremely potent opioid analgesic which is originally used in veterinary medicine to anesthetize large animals such as elephants and rhinoceroses. This amount has the potential for 5 million lethal doses. Even though drug dealers don’t intend to give lethal doses to their customers, they don’t have much quality control in the illicit labs. Illegally manufactured fentanyl is also found in other drugs like cocaine, methamphetamine, and heroin.

Opioid crisis isn’t just an accident or a problem with fentanyl. It’s also a result of poor medical practice and unethical pharmaceutical practice. In the 1970s, started ‘’the war on drugs’’ as a way to combat illegal drug use by greatly increasing penalties, enforcement and imprisonment of drug offenders. The toxic mix of the war on drugs and profit-driven medical system gets us to a place where overdoses kill more people than car accidents or gunshots. This idea was greatly expanded in 1981 with Ronald Reagan’s focus on punishment over treatment. While his wife Nancy Reagan spreaded another aspect with her ‘’just say no’’ – campaign which wasn’t welcomed very warmly and became more like  a pop-culture joke. Back in 2010, authorities began tracking down on doctors who’ve been over prescribing opioids. So millions of people who’d become dependent on this medicine, were suddenly cut off by their doctors. That’s where the real crisis gets worse. If you hand out hundreds of millions of pills, many people will get addicted.

Since its very beginning, the drug war has been targeted at ethnic minorities and the poor, but  now it’s targeting every single kind of neighborhood. The urge to dehumanize drug users, to punish rather than help them no matter the consequences has defined the drug war from the very beginning. Every year the war on drugs becomes the deadliest war of all. In 2017, the Department of Health and Human Services declared the opioid crisis a public health emergency. 

Opioid-dependency can be treated with methadone and buprenorphine. These maintenance treatments are given to the patient regularly in order to avoid withdrawal, lower the risk of overdose and to avoid street-drugs. Only half of countries provide access to this treatment and less than 10% of people that need it are receiving it. One way to deal with the crisis around the world is a concept of supervised injection sites. For example, a facility called Insite in North America. The main intent of these sites is for people who are going to be injecting something, have people around them in case of overdose or other injection related emergency. It also provides clean supplies to users in order to avoid infections and diseases from spreading. There’s also Naloxone, an antidote to opioids. It reverses the effect of an opioid overdose if given in time. Opioid overdose causes the breathing to stop. Naloxone reverses this effect. It has no harmful effects to people who don’t have opioids in their system and yet there are authorities resisting to be able to even carry it. Some countries like Australia, Canada, Italy, and the UK have Naloxone available in pharmacies without prescription. Then again other countries have generally limited access to Naloxone even in medical settings like ambulances.

Taika Soihtu

Sources:

Cdc – Understanding drug overdoses and deaths
Cdc – Understanding the opioid overdose epidemic

Who – Opioid overdose

Yle podcast – Pieleen mennyt historia – opiaattien historia

Altarum institute – economic toll on opioid crisis in u.s. exceeded 1 trillion since 2001

U.S. department of health and human services – declarations of a public health emergency
Dominican university- the war on drugs

NICH – New framework to Curb Births of Babies Born Dependent to Drugs

Youtube: TELUSHealth- Painkiller: Inside the opioid crisis