It began as a useful and highly potent pain-relieving medication, but opioids have quickly become a nightmare for millions of Americans. According to The National Institute on Drug Abuse, “In 2017, more than 47,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.1 That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder.” The use of these drugs, legal or otherwise, has quickly become a federal crisis.
Throughout this article, we’ll examine the use of opioids throughout history, and compare the two faces of the opioid crisis in the United States. The use of prescription drugs which causes a passive addiction, and the use of illegal drugs, which has become an active addiction. We’ll also discuss treatment, including online addiction counseling, which provides help to those in rural and urban areas across the country.
A Brief History of Opioid Use in America
The first record of opium, the original opioid, being prescribed for medicinal use was as far back as 8000 years ago. A publication on Neurology.com advises, “8000 year-old hardened Sumerian clay-tablets are the earliest prescriptions of opium. Ancient Greeks, Indians, Chinese, Egyptians, Romans, Arabs, people in middle ages, Europeans from renaissance to now, knew opium as an ever-approved next-door medicine-a panacea for all maladies.” The drug was used through wars as a pain reliever and experimented on to create more potent forms and methods of application. By the late 1800’s heroin was born. It was three-times stronger than morphine and therefore had a greater potential for addiction.
Despite the understanding that opium, morphine, and heroin are addictive substances, the opioid crisis began out of misinformation. In fact, up until the 1920’s heroin, which we now know as an intensely addictive illegal drug, was sold to children and adults as everyday cold medicine. By the mid 1920’s it became apparent that this drug was hurting more than it was helping, and it was swiftly outlawed.
Armed with the knowledge that opium-based drugs shouldn’t be prescribed lightly, it’s shocking to know that much of the opioid crisis was inflicted by the medical community. Pharmaceutical companies in the 1990’s assured doctors and patients that morphine wasn’t addictive. That opioid-based drugs were safe, natural painkillers which could be used without concern for future dependencies.
Unfortunately, we know this to be a myth. As more Americans became dependent on morphine, and its relatives, it became apparent that doctors needed to minimize the availability of the drug. This left many, who had already become addicted, without a source of medication. This in turn, left them to seek out their own form of pain relief, sometimes in illegally obtained doses of prescription medicine, others in the form of heroin.
And so, the medical system failed the American people, and left millions addicted and tens of thousands dying of overuse. The National Capital Poison Center writes, “Deaths due to heroin-related overdose increased by 286% from 2002 to 2013, and approximately 80% of heroin users admitted to misusing prescription opioids before turning to heroin.” This brings us to today, and the use of prescription and non-prescription opioids.
How Other Countries are Impacting the Opioid Crisis in America
While we can turn much of the blame for the current opioid predicament on the medical community and overzealous pharmaceutical representatives, this isn’t the whole story. There’s still the question of where the American people are obtaining so many illegal drugs in the first place. If the medication is being more properly regulated and doctors are aware of the addiction and fatality figures involved in opioids, how are they so prevalent among the general population? This brings us to the international factor impacting the current crisis.
There’s a lot of confusion regarding the delivery of drugs into the United States and where the majority hails from. While television programs and movies lead us to believe that it comes up through the Northern Triangle of Central America, most heroin and illegal opioid products creep in through Mexico and Afghanistan. The Advocacy for Human Rights in the Americas reports, “U.S. officials estimate that 90 to 94 percent of heroin consumed in the United States today comes from Mexico, which is now producing about 70 tons per year. Another four to six percent comes from Asia, principally Afghanistan, the origin of most heroin consumed elsewhere in the world. About two percent of heroin that reaches the United States comes from Colombia, and a negligible amount is made in Guatemala.” This leads us to ask, “couldn’t we just increase border control and halt drug smuggling in its tracks?” Surely, placing more officers at border crossings could contain the issue of illegal immigrants crossing into America with drugs, right? Wrong.
Drug smuggling has become a fine art, and the distributors of heroin pass through our borders unnoticed. There are 48 entry points officially used to accept deliveries and passengers into America from Mexico. This is where the heroin enters, right under our noses in transport trucks, hidden in plain sight with American Citizens, and concealed in passenger vehicles travelling “home from vacation.” It’s risky business, but it works, and roughly 50 tons are delivered into the U.S. each year, of which only about 6-7 tons are seized at borders.
China’s Role in the Epidemic
While Afghanistan is known to be the top producer of heroin, it’s not the only Asian country with hands in the opioid problem. China has been fingered as a huge benefactor in the delivery of heroin, and more dangerously, fentanyl.
Fentanyl is another synthetic opioid, manufactured to produce an intense and instantaneous high, up to 100 times more potent than morphine. While the drug could be used to obtain the same high as heroin, the problem lies in its potency. Users who believe they are taking heroin or morphine are duped into consuming a much higher dose of the euphoric drug if fentanyl is mixed into the medication. Fentanyl is another drug which began as a prescription aid, specifically to manage pain symptoms of patients who had become tolerant of the effects of morphine. However, seeing the monetary potential of the medication has increased its use as an illegal street drug.
There are two avenues being noticed by U.S. drug officials, where fentanyl is coming into America. One is as a direct pre-made substance from China, the other in chemical components through Mexico. The Mexican distribution is a kind of, “make it yourself” blend of medicinal chemicals, which if mixed improperly are deadly. The China product comes whole and ready to use. Both are dangerous, both are illegal, and both are influencing the ongoing opioid epidemic in North America.
Much of the product being distributed from China is coming directly to the United States through the mail and other obvious portals. It’s shipped by order through the “dark web” and other “black market” resources. It’s then cut into other drugs, sometimes real, sometimes fake to make a buck. This drug money is coming at a price much higher than the fentanyl they buy to create it, however. It’s coming at the price of thousands of American lives.
A Closer Look at the Two Faces of Opioid Use
As we mentioned above, there are two forms of opioid use, each with the risk of addiction. The passive addiction route involves the use of prescribed medications by a doctor. It’s considered passive in that the addict isn’t actively seeking drugs, but rather is being administered a prescription for pain and related symptoms. As the use of opioid-based medications continues, dependence becomes an issue. Patients become more tolerant of the dosage they’re using and require more to feel the same level of relief. As the dose is increased, tolerance also rises, and dependency worsens. It becomes an issue where patients are requiring dosages above the legal amount medical professionals administer. Sometimes patients become so dependent that long after their need for the prescription has passed, they feel the urge to use and even take desperate measures to appease the urge. This is where passive addiction can turn into active addiction.
Active addiction, as the name implies, is the active seeking of opioids to dull the need for drugs. Active addiction involves the purchase and use of illegal drugs, both prescription and otherwise. Purchasing these drugs on the street has dangerous implications, aside from just the illegal act itself.
As street drugs have no real means of being monitored or regulated, the drugs are offered at varying strengths, and more recently, cut with another substance to save the dealer money while still providing a high. This becomes extremely dangerous, as one of the drugs used for this cutting process is fentanyl. When an addict takes a dose of opioid medicine believing it to be morphine or heroin, and what they receive instead is fentanyl, there’s the trouble of dosage control. Fentanyl is such an intense and fast acting drug that it is exceedingly easy to overdose on. This is, if the fentanyl was even true fentanyl and mixed correctly. There’s also the case that these cut drugs are mixed with something that was once fentanyl but has been cut and cut again with other chemical agents.
Along with all this opioid use and misuse, you would think that huge amounts of money are being poured into the recovery process, but you’d be wrong. Most of the financial aid given to the opioid crisis are to quit distribution, managing smuggling, and clear the streets of dealers. Very little of the money collected for the cause is used to treat and manage addiction. This leaves millions of Americans dependent on a drug that is highly deadly and in large supply. In fact, only about 2 cents of every dollar spent on drug addiction goes toward treatment and prevention.
So, while we see that there is a huge international impact on the opioid crisis in our own country, there are also internal issues which need to be rectified before this crisis becomes manageable. It’s apparent that we need to find a way to better manage the import of illegal substances into the U.S. However, before we look to the rest of the world and their impact on drug abuse, we should also look within and support our citizens where they need it most. In prevention and rehabilitation.
Seeking Help for Opioid Dependency
Drug addiction recovery is a lifelong process. Addiction can’t be cured, and so it’s incredibly important that patients ask for help and use every resource at their disposal to stay clean. Most who are addicted undergo a treatment plan will relapse at some point throughout their lives. Using alternative forms of rehabilitation and recovery can help decrease the chances for relapse.
One of the most prominent and easily obtained forms of recovery is called online addiction counseling. With online counseling, addicts have access to help 24/7 from anywhere in the world. Whether at the office, at home, or on vacation in Peru, there is somebody to lean on. Through this channel, addicts work one on one with a recovery coach who is assigned to them. This coach helps in many ways, from being an ear in times of temptation, to a voice of reason during the rehabilitation process.
Opioids are one of the most difficult drug addictions to overcome. The detoxification process causes incredibly intense withdrawal symptoms. These symptoms are painful and can even cause death if not properly monitored by a medical professional. In cases of extreme opioid addiction, an inpatient facility is helpful. The around the clock care which is provided by medical professionals keeps patients safe and as comfortable as possible as they detox. Once you leave an inpatient treatment center, there’s a risk of being triggered and feeling the need to use again. This is where online counseling could help save a life.
If you’re interested in learning more about rehabilitation, detoxification and online addiction counselling, speak to your doctor. There are many options for addiction recovery. You are not alone, and you are not a lost cause.