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Reviewed by What is the opioid crisis? The opioid epidemic started in the 1990s and since then, has risen exponentially in the United States, becoming a nationwide epidemic. According to opioid epidemic statistics, of all the drug overdose deaths each year, the maximum percentage is associated with opioid drugs. The National Institute on Drug Abuse reports that more than 128 people die every day after overdosing on opioids.
Table Of Contents:
A growing number of lawsuits are arising against various pharmaceutical companies and wholesale distributors in response to the U.S. opioid epidemic. The lawsuits call for new laws to be crafted to control the distribution, prescription, and use of them. Every year, thousands of individuals succumb to death because of overdose, opioid induced hyperalgesia and addiction.
Learn more about their history, reasons for the crisis in the U.S., timeline, facts, government’s response to the crisis, and possible solutions to this disaster.
More About Opioids:
Dangers Of The Opioid Crisis
Opioids are known for a significant period as a class of pain-relieving drugs that originally came from the opium poppy plant. Some of them are made directly from the plant, while others are made by science experts in the lab using the same chemical structure. It is essential to know the differences between opioids vs. opiates and understand that being potent painkillers, these medications are used to treat severe or persistent pain. Read more about opium effects to delve deeper into how these substances work and their potential consequences.
In the drug community, synthetic painkillers such as Fentanyl are much cheaper but much more addictive than Morphine. When combined with other drugs, they prove to be more dangerous.
Addiction to these drugs can increase the tolerance to the drug over time, which can cause the user to take larger doses to achieve pain relief. Overdosing on opioids can suppress respiration, which can even be fatal. Apart from overdose deaths, abusing the drug can cause depression, anxiety, relationship problems, loss of interest, and concentration, as well as other harmful effects on the community. According to statistics, thousands of individuals experience not only physical symptoms but psychological as well.
The increase in opiate prescription in the 90s triggered the first wave. When attempts were made to curb the situation, the abusers turned to Heroin which triggered the second wave. The second wave which began around 2010 witnessed a spike in deaths related to opiate abuse. The third wave was worse as it claimed many lives and destroyed many livelihoods. Here are the various waves of the opioid crisis in America and their impact on the health
First Wave Of Crisis
The first wave of the crisis began with the increased prescribing of opioids in the 1990s, and the number of deaths involving this drug and its combination. According to the information published on Poison Control, National Capital Poison Center, by 1999 86% of the patients were using them for non-cancer pain. The increase in its prescriptions was influenced by reassurances that were given to patients stating that the risk of its addiction is shallow. At that time, around 1999, there were communities where these drugs were readily available.
Second Wave Of Crisis
The second wave of the epidemic began around 2010 with an increase in OD deaths (increased by 286% from 2002-13) involving heroin. Early efforts to decrease the prescription of this drug started to take effect, but the abusers then turned to heroin, which is a potent and highly addictive opiate.
Third Wave Of Crisis
The third wave of the opioid epidemic began in 2013 with the increase in the number of overdose deaths involving synthetic opioids. Over 20,000 overdose deaths occurred from Fentanyl alone in 2016. The number of OD deaths is still high. Opioid deaths 2020 stood at over 69,000. To reduce the risks associated with opioids, the Centre for Disease Control and Prevention regulated guidelines for prescribing it for chronic pain. However, it was found that the opposition to rules was significant by the organizations that received funding from manufacturers.
Opiate Crisis During the Covid-19 Pandemic
The Opioid Crisis in America became worse during the Covid-19 pandemic. According to available data, the opioid deaths 2020 increased by 30% from the previous year. This was because people who could not cope with the debilitating effects of the pandemic resorted to substance abuse. Many abusers also had their regular source of drug supply cut off due to the pandemic. Thus, they had to rely on new sources of supply. This was dangerous because getting new opioids could increase the risk of overdose. The new supply was likely to be stronger than the old ones the abusers were used to.
Causes Of The Opioid Epidemic In The USA
When it comes to their overall popularity, there are many parties responsible for the crisis. In recent times, there were no regulations on the use of this drug, which resulted in its widespread marketing and prescribing for many ailments, such as toothache, diarrhea, and more. There are three main causes of the epidemic:
Poor Prescription Standards
Another underlying cause of the epidemic was the poor prescription standards provided by the government. Due to previous prescription standards, a lot of doctors used to prescribe opioids to patients who did not even require them and in quantities much larger than it was needed. The absence of strict regulations on these drugs and minimal responsibility put on doctors by the government led to the next cause of the epidemic.
Opioids Overprescription
According to an estimate by the Washington University School of Medicine, 4-20% of the pills were prescribed in the United States for non-medical reasons. U.S. doctors write more than 80% of prescriptions of the medication worldwide. Such an enormous rate of prescriptions is a result of poor awareness and downplayed risks of these pills.
Dangers Hidden By The Drug Manufacturers
In the late 1990s, some pharmaceutical companies assured medical professionals that their medicines were almost 100% safe, and patients would not become addicted to the prescribed opioids. Doctors started to prescribe these medications at greater rates, and across the whole country, which then led to the misuse of these medications. They were commonly prescribed for mild and moderate pain management, and this fact skyrocketed the number of abusers. Due to the crisis, multiple lawsuits have been filed by affected patients, cities, and states.
Epidemic Statistics And Facts
Initially, it was not clear that these medications could be highly addictive, but each year the overdose deaths statistics became more and more shocking. In recent years the opioid overdose deaths rates were prominent. In 2017, more than 47,000 Americans died as a result of the overdose on opioids. According to a report on the National Institute on Drug Abuse, around 1.7 million people also suffered from substance use disorders in 2017, which were related to prescription pain relievers.
According to a 2018 report published by the US National Center for Biotechnology Information (NCBI), as of October 16, 2017, the US Government declared the epidemic as a public health emergency. Information by the Centers for Disease Control and Prevention indicates that in 2018, the crisis went up by 5% with death rates involving synthetic opiate use accounting for 15%. In 2019, 70% out of over 70,630 deaths included opiate use according to information from the CDC. Over 94,000 deaths have been recorded in 2020, according to JAMA Network. This is why the government is taking steps to eradicate the problem.
States With The Highest Rates Of Overdose Deaths From Opioids
| YEAR | TOP 3 STATES | TOTAL NUMBER OF DEATHS DUE TO OVERDOSE FROM OPIOIDS |
| 2019 | Pennsylvania | 4,377 |
| Ohio | 4,251 | |
| Florida | 5,268 | |
| 2018 | Florida | 4,698 |
| California | 5,348 | |
| Pennsylvania | 4,415 | |
| 2017 | California | 4,868 |
| Florida | 5,088 | |
| Pennsylvania | 5,388 | |
| 2016 | California | 4,654 |
| Ohio | 4,329 | |
| Pennsylvania | 4,627 |
OD Deaths From Opioids In The Last Five Years
According to the data from the Center for Disease Control and Prevention, from 1999 to 2017, almost 218,000 individuals died in the United States from a prescribed opioid OD. The rates increased significantly in 15 states, with the largest changes in Ohio (19.1%), Maine (18.7%), and North Carolina (28,6%). The highest prescription rate of 81.3% was in 2011.
| Year | Number Of Related OD Deaths in the US | Male | Female |
| 2019 | 45,489 | 32,131 | 13,358 |
| 2018 | 42,518 | 29,618 | 12,900 |
| 2017 | 47,600 | 32,337 | 15,263 |
| 2016 | 42,249 | 28,498 | 13,751 |
| 2015 | 33,091 | 11,420 | 21,671 |
The epidemic was expected to continue to worsen and grow because of the increase in deaths, which involve opioids, but 2018 is remarkable by the slight decline in overdose deaths, according to CDC data.
Response Of U.S. Government And NGOs To The Crisis
Since the crisis broke out in the 90s, there have been a number of responses both from the US federal government and private stakeholders. Through the Department of Health and Human Services, the government has introduced five major ways to combat the menace in the community. The FDA joined the fight by introducing directives to ensure the public is educated on substance abuse, especially, abuse. Other agencies like the Health Resources and Services Administration have channeled their resources in curbing this danger which has seen positive results. Information from the CDC shows there has been a 3.3% decrease in overdose death counts.
HHS Response To Epidemic
With this scenario, the United States Department of Health and Human Services is responding to the crisis by using its efforts on five major pointers:
- Improve access to recovery, treatment, rehabs, and prevention services to minimize all the consequences associated with addiction.
- Target the availability of overdose reversal drugs with a particular focus on populations prone to higher risks.
- Strengthening the understanding of the epidemic through better public health data and surveillance.
- Support research that leads to the development of new treatments to reduce opioid-related health issues.
- Advancing the practice of pain management to enable evidence-based care that reduces the burden of pain for users while reducing the usage of opioids.
FDA Response To Opioid Crisis
The U.S. Food and Drug Administration took another approach to this epidemic, which requires manufacturers of long-acting opioids to sponsor educational programs for patients prescribed with their medication. In March 2019, two FDA specialists suspended new approvals.
HSRA Fighting The Epidemic
The Health Resources and Services Administration is addressing the crisis by expanding access to care settings, increasing opiate use disorder training in primary care, treating side effects of these drugs, and addressing opioid withdrawal symptoms. A department under the HRSA provides $100,000 to telehealth programs that educate people in rural areas on the dangers of substance abuse. The HRSA also formulates policies and provides support to agencies in the fight against the epidemic. The governmental agency is also concerned with connecting stakeholders with resources to aid the prevention of opioid-related deaths.
NACCHO Addressing The Crisis
The National Association of County and City Health Officials supports local health departments to respond to the epidemic by implementing evidence-based programs and policies and looking for safe opioid alternatives. For instance, NACCHO announced a new initiative aimed at helping local health departments implement strategies to detect and respond to overdose spikes. The initiative was also designed to work during the Covid-19 pandemic. In addition to this, various U.S. states have also passed legislation to stop the high-risk prescribing practices such as giving high doses for the long term, helping individuals understand how opioids work, and more.
Opioids, because of their highly addictive properties, are the most abused prescription drugs in the United States. The crisis in America originated because of the over-prescription as well as their availability from illegal sources.
Lawsuits Against Opioid Manufacturers As A Means Of Opioid Epidemic Solution
The state, local governments, and injured individuals continue to bring lawsuits against the manufacturers, pharmaceutical companies, marketers, and providers for their roles in the crisis. Though these companies have caused more harm, there has not been much effort in terms of lawsuits against them. However, things are gradually changing as more people are becoming aware of the shady dealings of some of these multibillion-dollar industries. More companies are facing opioid lawsuits by the day. Available data indicates that these lawsuits are gradually yielding positive results and have helped in the reduction of the epidemic.
Florida Opioid Lawsuit
Data shows that an opioid lawsuit was filed against some manufacturers and providers by the Florida Attorney General. The defendants included companies such as Purdue Pharma L.P., Endo Pharmaceuticals, Cephalon, Inc., Insys Therapeutics, Inc., Allergan (formerly Actavis), and some others. This also includes Janssen Pharmaceuticals, Inc. which is a subsidiary of Johnson & Johnson. The lawsuit was filed in May 2018 and the opioid trial is still ongoing. No opioid settlement has yet been reached.
Oklahoma Opioid Lawsuit
The Opioid Lawsuit, Oklahoma includes the Johnson and Johnson opioid lawsuit and the Teva Opioid Lawsuit. The charges against Johnson & Johnson include misrepresenting the risk of addiction to doctors, manipulation in medical research, and buying of poppy-growing companies in Australia which supplied the raw materials for making their medicines. Johnson & Johnson is alleged to have assisted in the growing epidemic for which they have been sued to pay an opioid settlement.
The Teva Opioid Lawsuit alleged that Teva Pharmaceutical Industries, Ltd. had misled doctors and patients by marketing them as safe to be consumed in the community even for regular aches and pains. The allegations further included the company’s failure to warn against the addictive qualities of their drugs which helped in the rise of the epidemic.
In 2019, an opioid settlement of $465 million was awarded against Johnson & Johnson. The company was held liable for the Oklahoma crisis. However, in 2021, a supreme court ruling tossed out the landmark opioid trial case. It was a 5-to-1 decision in which the company was absolved of all liabilities for the crisis.
Mckesson Opioid Lawsuit
An opioid lawsuit was filed against Mckesson Corporation alleging that they were responsible for the distribution of a whopping 1.2 million doses of Hydrocodone and Oxycodone in the state of West Virginia from 2007 until 2012. In the opioid trial, Mckesson did not admit to any wrongdoing in this regard, but they agreed to an opioid settlement in which they paid $37 million to support various state endeavors for opioid addiction help including rehabilitation programs, mental health support, and job training.
Opioid Epidemic Solutions
According to a research paper by Grantmakers in Aging, West Virginia is one of the states that was hit hardest by the opioid epidemic. The hospitalizations related to the epidemic have doubled ten years for adults (65 years) and tripled among adults aged 45-64 years. With a similar epidemic scenario in other states as well, here are some crisis solutions to look at:
New Opioid Prescription Guidelines
Implementation and strictly following the new CDC guidelines can help medical professionals to decrease the number of dependent patients and slow down the epidemic by shortening the administration time and prescribing amounts.
Abuse-Deterrent Opioid Formulations
Introduced in 2010, opioids with abuse-deterrent formulations are now available. These formulations usually use physical or chemical deterrents that discourage the misuse done by insufflation or injection. To prevent the epidemic growth, the doctor should consider these formulations.
Increased Awareness Regarding The Opioid Harm
Some states are on the frontlines of the OD epidemic, and the best approach to prevent the epidemic is to make individuals have a better understanding of the epidemic. The state government, health departments, and public health centers should launch awareness campaigns and make people aware of the harm and the crisis around them.
Improving Access to Treatment and Recovery Services
One of the main causes of death is the lack of access to treatment and recovery services. Increasing these facilities and making them easily accessible especially to rural folk would help in the prevention of fatal cases. Also, the HHS, a department under the NIH, is implementing plans to upgrade existing facilities to take up more cases. This will lead to a reduction in cases of overdose-related deaths.
Promoting the Use of Overdose-Reversing Drugs
Another way the Health and Human Services (HHS) department is combating this menace is by promoting the use of overdose-reversing drugs. As the name suggests these medications can reverse overdosing and save lives. The use of Naloxone is effective for treating overdose from medicines such as methadone, heroin, morphine, buprenorphine. Naloxone can save a life when it is administered immediately after overdose.
Save Yourself From Addiction
For the individuals or their loved ones who are suffering from the addiction to this drug, there are two classes of treatments available for them, including medical and behavioral. A doctor can prescribe both treatment options and come with different approaches to addiction treatment. However, some of the popular opioid dependence treatment includes such medications as:
These medications are more effective when combined with behavioral treatment. One should also know that behavioral therapy is not sufficient without proper medical treatment during detox done in the initial stages. The medications mentioned above are not completely safe. Some of them also have addiction potential, and the risk of abuse is still present. They can be taken only under medical supervision. Then there are government agencies and specialty-specific physicians who have released various measures and recommendations that are contributing to reducing the number of prescriptions. If someone is addicted, professional treatment should be considered.
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Page Sources
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