An Unnecessary Epidemic

By Royalle Hurney

The FDA’s general description of OxyContin states that it is “A long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.”1

So, even if you aren’t addicted when you start the medication, there is a high chance that you can become addicted, and you could possibly turn to illegal drugs, such as heroin, or synthetic opioid drugs, such as fentanyl, to sate your ever-increasing urges.

I specifically mention OxyContin and the extreme drug use that can stem from it is because of its part in the scandal of one of the major players of the opioid epidemic, Purdue Pharma. This company manufactured OxyContin and has been accused of distorting the truth about the harmful effects and risk of addiction to this drug. Purdue Pharma has also managed to make a profit of over $35 billion from the sale of OxyContin.2 This company, intentionally or not, has been able to profit off of the pain and suffering of patients who have had to resort to taking opioid medication, unwillingly turn into addicts, and ultimately die from overdose.

I want to emphasize that Purdue Pharma sold the drug, promoted, and profited from it, however, other regulatory agencies also had a role. The FDA had a say in how the drug was regulated,3 as did the Drug Enforcement Administration (DEA). A former employee of the DEA, Demetra Ashley, who now consults for Purdue Pharma, was subpoenaed regarding the DEA’s misrepresentations of the risks of opioids.4 It seems that the governmental regulations that we have in place are not up to par, and that there is a high possibility of conflict of interest that complicates things further.

This manipulation of drug information, the lack of resources for those taking the drugs, and the drugs’ highly addictive nature combat the common misconception that all overdoses and addictions are an autonomous choice – that people can just say no. This is a narrative many people believe, but in reality, those with opioid addictions have not started out wanting to be addicts. They take the medication in hopes of pain relief, and when the pain is still there, they think it is okay to take more. When they no longer have a prescription, they turn to other prescribers or to illegal drugs which can contain other harmful ingredients. They end up overdosing because the drug is no longer providing relief at manageable doses. The individual has not chosen to be addicted; the drug has catalyzed a fatal addiction.

The Center on Longevity conducted an interview with Dr. Keith Humphreys to explore the issues addressed above. Dr. Humphreys expressed his concerns with drug abuse throughout the lifespan in general, as well as with government policy regarding abuse. In the interview he stated that, in regard to the legal practices of drug administration:

We are quite poor with regulating the pharmaceutical industry. We’re in the midst of an opioid epidemic that was started by companies – legal companies. We should have been regulating them tightly – we control their licenses, they are subject to lots of monitoring – nonetheless, because of the way our political system works being very responsive to corporate donations, we’ve let them start the deadliest epidemic we’ve seen since AIDS. Actually, worse than AIDS.

It seems as though parts of our political system have welcomed bribes in order to keep power and to allow an epidemic which not only causes harm to the people affected by drug abuse, but to the country as a whole. When healthcare coverage has to start paying for treatments, rehabilitation, and counseling to victims and victims’ families, our country loses economic resources. This also assumes that people are covered with medical insurance in the first place.

The average number of fatalities that occur because of an opioid overdose has now reached 130 people per day.5 The Sightlines project noted that from 1999-2011, illicit drug use saw an increase across all age groups except those 35 to 44.6 These numbers I am sure have increased with the recent epidemic, though Sightlines will need to conduct further research on the subject to quantify.

Those taking opioids may also have been prescribed benzodiazepines, or “benzos,” which are most commonly prescribed for sedating a patient who has symptoms of anxiety. Unfortunately, when benzodiazepines are mixed with opioids, it leads to a higher chance of overdose due to suppression of breath from the sedation qualities of both drugs. Consequently, over 30 percent of overdose deaths have been shown to include both drugs in the body at the same time.7

We have shown how opioid addiction is a pressing, and complex issue. But what can we do to help?

According to Dr. Humphreys, besides becoming politically engaged and fighting for what we think is right, we should also learn to use the drug Naloxone, which is a rescue drug to those who are experiencing an overdose.8 But what is Naloxone, and are there other treatments that can help those addicted to opioids before an overdose occurs?

Well, there are actually four different drugs that can help combat opioid addiction: naloxone, buprenorphine, methadone, and naltrexone.

Naloxone is specifically used once an overdose has occurred, and is essentially an emergency drug for when the victim has stopped or slowed breathing. According to the National Institute on Drug Abuse, there are three types of naloxone, two of which can be given to someone who has overdosed by anyone around, and one that must be given by a medical professional. The two that are easily accessed by the public include an auto-injectable and a nasal spray. These can be found in some states such as California in outpatient settings, and they can be picked up without a prescription. Of course with any overdose, you should immediately get emergency medical help in addition to using this drug. To be clear, Naloxone is the only non-prescription emergency overdose medication, while buprenorphine and naltrexone are drugs used to help treat the addiction.

Buprenorphine works to stop cravings for opioids, which helps with the reduction of opioid use so that people can take safer, smaller doses. This drug works by lessening the feeling of being “high” that one would get while using opioids, and continues to do so with more doses of the prescription.9 Buprenorphine can be prescribed by a medical physician, but you do not need to stay in a clinic to take the drug. This is different than drugs such as methadone, which require patients to be treated in the hospital.

The drug naltrexone is similar to buprenorphine in that you can take it at home, but it does not produce a lessened high. Naltrexone instead stops the effects of a high completely, and in this way helps addicts to stop taking opioids as they no longer experience the same effects.10

In addition to advocating for better policies and taking the action steps above to reduce overdose deaths, the main takeaway point is that addiction is here. It is an epidemic, but we can help those who are suffering, and those who are can obtain help and overcome their struggles. We can all work together to help those addicted, and we need to create a supportive environment in order for treatment to work. Medication is only a step in the recovery process; support from counseling, family, and friends is also extremely important to see success.

    2Strickler, L. (2019, March 20). Former DEA official now working for OxyContin maker Purdue Pharma.
    3U.S. Food & Drug Administration. (2018, March 28). What Does FDA Regulate?
    4Strickler, L. (2019, March 20). Former DEA official now working for OxyContin maker Purdue Pharma.
    5Centers for Disease Control and Prevention. (2018, December 19). Opioid Overdose: Understanding the Epidemic.
    6Stanford Center on Longevity. (n.d.). Spotlight on Drugs and Alcohol.
    7National Institute on Drug Abuse. (2018, April 04). Opioid Overdose Reversal with Naloxone (Narcan, Evzio).
    9Substance Abuse and Mental Health Services Administration. (2015, June 15). Buprenorphine.
    10Substance Abuse and Mental Health Services Administration. (2015, June 16). Naltrexone.