Powder, Needle, Pill: The Opioid Crisis In America

Reason For Choosing This Topic

The story I’m about to tell is a real personal event. I have changed names to preserve the identity of those actually involved.

On October 31, 2014, I went to my aunt’s house to go trick or treating. While at my Aunt’s house, my uncle, Caleb, said he had to go down the street to his house. 30 minutes had gone by and Caleb still had not returned. Everyone immediately thought the worst. But it couldn’t be that, he’s been clean for the past couple months. Caleb seemed so happy spending the night with family, including his 7 year - old daughter and 1 year - old son. Caleb’s girlfriend went to check on him and our suspicions were confirmed. She screamed from down the street for my other uncle, Scott, who has medic training. Scott sprinted down the street and saw Caleb passed out on the bathroom floor with a needle in his arm. Scott had to keep him alive until the ambulance arrived with naloxone to save him. While all of this was happening, his kids were playing and giggling, clueless that their dad was on the brink of death a couple houses down. Almost all the adults went to the hospital to follow Caleb, while my aunt, cousin, and I were left to take care of the kids. I couldn’t help but to look at Caleb’s kids and wonder how he could continually leave them. He spent years out of his daughter’s life because he was in prison for opioid related crimes. He missed the beginning part of his son’s life due to another incarceration regarding opioids. I just can’t imagine something so addicting that you are willing to surrender the most precious memories in life, your kids. Caleb survived this incident, but today he has overdosed over 20 times. One of these times, he might not be so lucky.

Definition: What is Opium? What Are Opioids? What Are Opiates?

According to Brittanica (2 February 2018), opium is a substance obtained from the seeds of the opium poppy plant, which can be turned into a variety of different substances. JustBelieve (2018) states, opiates are substances that are made from opium. Morphine, codeine, and heroin all include raw opium, which classifies them as opiates. The opium in these substances is what provides the pain relieving aspect to the drugs. Opioids, on the other hand, are synthetic or partly synthetic substances manufactured to work in the same way as opiates. There are many different opioids, but some of the more commonly known ones include Methadone, Percocet, OxyContin, OxyCodone, Vicadin, and Fentanyl. Because of the widespread use of these drugs, opiates and opioids are now both being referred to as opioids.

How They Work

JustBelieve states that opioids do not make pain go away, instead they alter the way pain is perceived. They do this by attaching onto opioid receptors in the brain, causing the brain to interpret inaccurate pain levels. Because they have this effect on the brain, opioids cause the following reactions: reduced anxiety, drowsiness, enhanced mood, suppressed breathing and heart rate (Britannica, 27 February 2018).

According to Britannica (27 February 2018), after a person uses opioids for too long, they start to develop a dependence for the substance and build up a tolerance against the substance. This is especially dangerous because when someone lessens their intake or stops abusing all together, and tries to take the same amount previously taken before stopping, an overdose is likely to occur.

Local Affect

Unfortunately, the opioid crisis is affecting Adams county and those surrounding greatly. According to Davin Jurgensen (18 April 2016), writer for the Evening Sun, “Police discovered 91 packets of heroin during a traffic stop in North Codorus Township in March. That same month, a 19 year old Hanover man and 25 year old New Oxford woman were arrested and charged after officers found 16 vials containing small amounts of heroin.” York and Adams County participate in The University of Pittsburgh’s School of Pharmacy's website that collects data on drug overdose situations. On April 11, 2018, when I first looked at this website, 4 deaths had already occurred in Adams county and 6 had already occurred for York county. In the last two years, 318 people have died from overdoses in Adams and York County. Today, one month later, the total number of deaths for 2018 in Adams and York County is 29. A majority of these deaths came from young, white, men.

Locally/State Is Helping

Many places are changing policies and offering help to Opioid addicts. For example, according to Wellspan, they have changed how prescription drugs are prescribed and monitored. They also are making sure patients are educated on the medication being prescribed. Let's take a look at the Wellspan Controlled Substance Agreement. As you can see, the agreement states the risks of opioids and has an agreement section between the medical personnel and patient. Both the patient and medical personnel prescribing the opioids must sign the agreement.

State wise, PA does an event called the PA Drug Take Back Program. This is a way for citizens to properly prevent the misuse of prescription drugs. Did you know twice a year, our school is a location for the PA Drug Take Back Program? The most recent PA Drug Take Back at our school was on April 28th. Additionally, any police department and the Adam’s County Court House are permanent local prescription drop offs. For more information on how and where to drop prescription drugs off, visit this website: http://www.ddap.pa.gov/Prevention/Pages/Drug_take_back.aspx.

National Affect

Nationally, the U.S. Department of Health and Human Services (6 March 2018) states in 2016 three out of five drug overdose deaths were caused by an opioid. Opioids kill approximately 116 people in the U.S. everyday for a total of 42,249 lives lost yearly. This epidemic cost the U.S. 504 billion dollars. These numbers are even higher now than what’s reported due to the worsening epidemic.

Nation Is Helping

President Trump has taken a strong stance against opioids. The white house official website states that in late October, President Trump declared the opioid crisis a nationwide public health emergency. Since then, the Trump Administration has implemented education and prevention techniques to combat the epidemic. They led the most successful drug take back day ever, collecting over 456 tons of drugs. The Administration also got organizations like the Department of Veteran Affairs to release to the public their opioid prescription rates to better educate the public. President Trump proposed a new budget that would give $3 billion more to the Department of Health and Human Services to fight the opioid epidemic in 2018, and $10 billion more in 2019. The Food and Drug Administration is fighting the epidemic as well by adding more opioid labeling to better show the doctors and consumers the potential dangers of taking opioid painkillers. The FDA is also constantly reassessing the risks and benefits of continuing to prescribe opioids to the public.

Solutions - What is working? What is not? What could work?

Right now there are two mainstream drugs to help a user off of opioids, Suboxone and Methadone. These current methods are not useful. When put in a study, Suboxone was less effective than a placebo unless the subject was given extremely high doses. While Suboxone is insufficiently affecting the users, Methadone is often portrayed to be just as bad as heroin. Projectcbd states that medical cannabis is helping the opioid epidemic. When a state passes a medical cannabis law, the number of opioid overdoses goes down on average of 24.8% the next year, with the rate continuing to decrease each year after that. This could be attributed to a few things. If people get prescribed cannabis instead of opioids, they will not be exposed to the opioids in the first place. This may not seem like a big deal, but according to DrugAbuse (2018 March), 21-29% of people prescribed opioids misuse them, and 8-12% of people prescribed them will develop an opioid disorder, and 4-6% of the same population go on to try heroin. 80% of people that try heroin have done so because they were addicted to prescribed opioids. If people are already on opioids, cannabis can also treat almost all of the withdrawal symptoms of opioids. Even if cannabis is not used to completely get off opioids, it still has an affect on them. Taking opioids and cannabis together, causes the opioids to have a greater effect while taking a lower dose. Doctor Dustin Sulak, who is a doctor of osteopathy, conducted a study with his patients testing cannabis with opioids. Over his medical career he found that, the vast majority of people taking prescription opioid painkillers were never happy with their amount prescribed. After a couple months almost everyone would ask for a higher dosage because they would become tolerant to the prescriptions. Dr. Sulak decided to go to the few that were content with their dosage and find what made this group able to stay on the same dosage, for some of them up to 10 years. He found out that all of the people were supplementing opioids with cannabis. This means instead of someone increasing the opioid dosage to get a greater effect, they can substitute risking an overdose for cannabis. Because of this, opioid users can maintain the same doses for long periods of time, instead of having to continually up their doses to counteract their tolerance building up.

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