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the history of opioids
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The History of Opioids and The Growth of The Opioid Epidemic

The opioid addiction epidemic in the United States has been well documented over the last several years. It’s unfortunate that something with what started as good intentions has now pained so many lives. In the following article, LICR will provide an overview of the history of opioids, the current epidemic we find ourselves in, and what the future holds for many of those afflicted.

The Opioid Epidemic

To review the current state of the opioid epidemic, we must first understand and acknowledge the construct of prescription opioids and how they came into use. Opioids are used for their function to target brain receptors which regulate pain and emotions. Natural opioids, often referred to as opiates, are derived from the opium poppy plant but the prescription opioids we are familiar with today are man-made constructs off of these natural proponents. These man-made drugs come in the form of Semi-Synthetic opioids; drugs such as heroin and oxycodone which are synthesized rom natural occurring opium products, and Synthetic opioids; drugs such as methadone and fentanyl which are made entirely in a lab, the potency of which is about fifty times more than the semi-synthetic opioids. These varying types of opioids have been manipulated and morphed over the years, represented to aid those in need but only to set habitual users back in perpetual ways. The figures below from the Congressional Research Service illustrate the growth of opioid death totals over the last 20 years:

Deaths have been on a continual and consistent rise since the 1990’s, more than doubling from 1999-2010, but with the rabid influx and dangers associated with synthetic opioids such as fentanyl, have more than doubled yet again from 2015-2020 and only appear to be rising more and more. This plague of lost life continues, but we will review how it became this way, and what are those steps being taken to reduce such impacts.

Brief History of Opioids

The history of opioids is vast, when looking to the early recreational use of opium, but in relation to the opioid epidemic we exist in today, the start of opioids as prescription drugs can be traced back to 1987, when MS Contin (morphine sulfate) was the first approved formulation of opioid pain medicine approved by the FDA. Other opioids came in to market, but the rapid growth of the entire opioid category stemmed from the drug OxyContin (oxycodone controlled-release) and the marketing efforts of Purdue Pharmaceuticals. An aggressive and misleading marketing campaign (which we will detail below) drove sales of OxyContin from $48 million in 1996 to $1.1 billion in 2000, an over 2000% growth, spiking use and prescription drug volumes to new heights. The questionable and illegal tactics utilized by Purdue Pharmaceuticals have been listed below:

  • Misinformed Studies: Sales representatives pushed the message that the risk of addiction was “less than one percent.” They claims cited studies which were not consistent with daily and long-term users of opioids. More recent studies revealed the risk of addiction in as high as 50% depending on specific criteria.
  • Use of Non-FDA Approved Materials: In 1998, Purdue Pharmaceuticals distributed over 15,000 copies of an OxyContin video and promotional material which was never submitted to the FDA for review. Upon that review, the FDA ruled that the video materials made unsubstantiated claims, however, the ruling did not come until 2002.
  • All Expenses Paid Symposiums: As a marketing tactic, Purdue held more than 40 national pain management conferences, paying all expenses for attending physicians, pharmacists, and nurses, highlighting the misleading information detailed above.
  • Targeting Frequent Prescribers: Purdue ethically targeted avid writers of the OxyContin prescriptions, putting more product in the hands of professionals who were unconcerned by any potential long-term side effects.
  • $40 Million in 2001 Sales Incentives: Sales representatives of Purdue Pharmaceuticals were given monetary incentives to drive sales, reaching substantial volumes as product and revenues grew exponentially.
  • Guilty, $634 Million In Fines: In 2007, Purdue Fredrick Company Inc., an affiliate of Purdue Pharma, plead guilty to criminal charges of misbranding OxyContin by claiming that it was less addictive and less subject to abuse diversion than other opioids.

These points allude to a slew of misleading and illegal remarks which were the forefront of the epidemic we live in today. It helps to acknowledge the past but to dwell on these facts would only prolong their lingering effects. It’s time to look forward to the future plans against opioid addiction.

Positive Steps In The Fight Against Opioid Addiction

Awareness has reached a tipping point. More and more individuals are educating themselves against the opioid epidemic. Physicians are aware of the addictive side effects, and fentanyl is now a household name to be aware of for recreational drug users. These are key elements to keeping individuals in our country safe, and the government has been leading that charge in aiding individuals afflicted with addiction. The following are only a snippet of the efforts made by the U.S. Government:

  • Comprehensive Addiction Recovery Act of 2016
  • Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act
  • Fentanyl Sanctions Act
  • Blocking Deadly Fentanyl Imports Act
  • Congress Adding Funding to The Following Programs:
    • American Rescue Plan Act of 2021
    • Over $1 billion annually since 2018 to the Substance Abuse and Mental Health Services Administration for a new State Opioid Response grant program.

These steps and the steps of the community at large continue to inspire hope in the fight against opioid addiction. We hope you found this information helpful If you or a loved one needs any additional assistance with addiction treatment services, please reach out to Long Island Center for Recovery at 631-728-3100, and we’d be happy to assist you or your loved ones in any way possible.

References:

Congressional Research Services: The Opioid Crisis In The United States: A Brief History
https://crsreports.congress.gov/product/pdf/IF/IF12260

National Library of Medicine: The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

  • “OxyContin Marketing Plan, 2002.” Purdue Pharma, Stamford, CN, 2002
  • Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem. Washington, DC: General Accounting Office; December 2003. Publication GAO-04-110 [Google Scholar]
  • Orlowski JP, Wateska L. The effect of pharmaceutical firm enticements on physician prescribing patterns. There’s no such thing as a free lunch. Chest 1992;102:270–273 [PubMed] [Google Scholar]
  • Meier B. Pain Killer Emmaus, PA: Rodale Press; 2003:99 [Google Scholar]
  • Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med 1980;302:123. [PubMed] [Google Scholar]
  • Perry S, Heidrich G. Management of pain during debridement: a survey of US burn units. Pain 1982;13:267–280 [PubMed] [Google Scholar]
  • Hojsted J, Sjogren P. Addiction to opioids in chronic pain patients: a literature review. Eur J Pain 2007;11:490–518 [PubMed] [Google Scholar]
  • United States Attorney’s Office Western District of Virginia [news release]. Available at: http://www.dodig.osd.mil/IGInformation/IGInformationReleases/prudue_frederick_1.pdf.

 U.S. Food & Drug Administration: Timeline of Selected FDA Activities and Significant Events Addressing Substance Use and Overdose Prevention

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