The Destructive Path of the U.S. Opioid Epidemic

Opioid abuse. The term brings forth dozens of images: people popping prescription pills or injecting illegal substances into their bodies; life on the streets, where they literally beg, borrow or steal with the goal of making enough money to buy their next fix; overdoses where they hang on the very edge of life while first responders or maybe another addict, gives them an opioid overdose reversal medication like Naloxone (Narcan®); and death, whether it comes in the shadows of an alley, sitting in a car or lying on a gurney in a hospital’s emergency room.

However, there is more to the U.S. opioid epidemic than these images project. The impact on families and communities has been devastating and long-lasting. In some cases, the addiction has trickled down to younger generations, creating a cycle that seems never-ending. Countless questions remain unanswered concerning the actions that should be taken towards those addicted, how/if this epidemic can ever be brought under control and what legal resources exist to hold responsible parties accountable.

What are opioids?

To understand the impact of opioids on people here in the United States, it is important to know what opioids are. Opioids are drugs that are developed from opium, hence the name. Opium dates back to 3400 B.C. and according to the Drug Enforcement Administration, it is a product of the poppy plant. Many people assume that it comes from the flower, but opium is actually made from the seedpod. It starts out as a milky white fluid referred to as opium gum. People scrape this gum off the pod, dry it and then package it for later use.

The Atlantic states that the Egyptians, Sumerians, Greeks, Romans and Arabs used opium to treat people with internal diseases and as a sedative. Opium was mixed in 1527 with other substances to create Laudanum, a drug that manages pain. Morphine, discovered in the 1800s, was immediately embraced as a treatment for pain by American doctors. When the Civil War broke out, morphine was given to severely injured soldiers and addiction soon occurred – a condition termed “Soldier’s Disease.”

Heroin was the next opioid to hit the medical field in 1898. A watered-down version of morphine, it was offered by Bayer as a substitute for morphine and as a cough suppressant. It became an illegal drug in 1924 when The Heroin Act was passed. However, the legal movement by Congress did not fully stop the use of opioids. Other opioids were developed and administered to patients for pain control, but doctors were reluctant to do so and often used them as a last resort.

Since the late 1970s, several opioids have been developed, and these include the following:

  • Vicodin®
  • Hydrocodone
  • Methadone
  • OxyContin®
  • Percocet®
  • Demerol®

Prescription opioids are used today to treat people with severe pain stemming from an accident or from a medical condition such as fibromyalgia, degenerative disk disease, arthritis, pinched nerve, cancer and migraine headaches.

Thousands of deaths

According to the U.S. Department of Health and Human Services, more than 42,000 people died from opioid overdose in 2016 – an average of 116 every day. Out of that number, 17,087 were caused by prescription opioids. Other statistics include:

  • Opioids were labeled as the No. 1 cause for injury deaths (motor vehicle deaths in 2016 amounted to 40,200).
  • Opioid addiction affected 2.1 million people
  • Prescription opioid misuse was a problem for 11.5 million people
  • 1 million people had “misused prescription opioids for the first time”

Statistics from the Centers for Disease Control and Prevention show a steady increase in the number of opioid overdose deaths between 2000 and 2016. The CDC also states that overdose death rates are up among adults of all ages, races and genders. Going back even further, since 1999, there has been a 5 percent increase in deaths related to opioid overdose and the consistent growth indicates that numbers may continue to climb. Today, Seattle, Washington; Portland, Oregon; New Hampshire; Ohio; the Appalachian region; New Mexico and other areas across the country are reporting rapid increases in the number of people who have become addicted and the number of deaths attributed to opioid overdose.

Devastated Parents

Sadly, the story of opioid abuse does not end after an opioid addict passes away. Families are already broken physically, emotionally, mentally and financially. It is not uncommon for parents to exhaust their finances to try and save their child who is addicted; they pay tens of thousands of dollars on rehab programs, settling bills with drug dealers, medical care for overdose treatment and legal fees. Many are forced to file for bankruptcy because their savings and their retirement is gone.

If the financial drain was not enough, parents must watch helplessly as their child slowly changes into a person they don’t recognize. Parents go through cycles of pain, anger, worry and fear, knowing that at any moment, a knock could sound on their door and a policeman will be standing there with the news that their child has died. This figurative pendulum hanging over their heads creates long-term effects on their physical and psychological health. Some struggle with anxiety, some find themselves dealing with high blood pressure or other stress-related issues.

Children of Addiction

Countless children are also victims of the opioid epidemic. Hospitals in many states have put together special units for babies that are born addicted to opioids. Treating them is challenging because street opioids are commonly mixed with other substances that are more dangerous than the opioids. For these babies, they will never know their parents. Grandparents, aunts, uncles and others are left with the responsibility to care for them. Babies that are born addicted, face years of therapy to combat the effects of the drugs in their system and the long-term outcome for these children is unknown.

Children of those addicted to opioids must be taken away for their own well-being and safety. Documentaries on these children relate stories of children witnessing their parent or parents injecting drugs, under the influence of drugs and even overdosing. Sometimes, the children are in the care of other family members who are addicted. One image that went viral in 2016 was a minivan in Ohio where a couple slumped in the front of the vehicle while a four-year-old boy was sitting in the back seat. According to CNN, the photo was posted on the local police department’s Facebook page in an effort to warn people about the effects of using heroin. The woman was the boy’s grandmother, who had recently been granted custody of him.

Doctors Overprescribing

For those who are not personally affected by the opioid epidemic, it is easy to point a finger at the person who is addicted and say that they made the choice to misuse a prescription drug. However, others blame the doctors prescribing these opioids and there is some merit to this claim. A recent report from the CDC states that doctors are still prescribing too many opioids to their patients, according to Consumer Reports. The findings of the report, which consisted of statistics from 2012 to 2015, include the following:

  • Opioids were being prescribed by doctors more than six times in some areas than in others.
  • The time period of opioid prescription usage went up, thereby increasing patients’ risk of harm.
  • In the last year of the study, the number of opioid prescriptions given out by doctors were enough to “medicate every American around the clock for three weeks.”

The Pittsburgh Post-Gazette reports that 608 doctors in the Appalachian region were brought before medical boards and disciplined for giving out too many narcotic drugs between 2011 and 2015. One patient in Pennsylvania admitted that he did not have any real need for a highly addictive pain killer, but was receiving a monthly prescription of close to 1,000 pills from a physician. A Kentucky doctor, who had lost 14 patients to drug overdoses kept prescribing powerful drugs to his patients. He was identified by investigators as a “top-five source of oxycodone prescriptions in Kentucky’s Appalachian east,” writing new prescriptions when his patients claimed they lost the previous one he gave them.

While opioids may have been the only option doctors had for managing their patients’ chronic pain, that is no longer the case today. Several over-the-counter drugs such as ibuprofen and Tylenol have been shown to be effective in lowering pain. Homeopathic treatments like massage, acupuncture and heat also may help. Despite these alternatives, physicians continue to prescribe opioids when patients complain of pain.

Aggressive Marketing Campaigns

While hundreds of doctors have contributed to the opioid epidemic, many claim that they were seduced by the manufacturers of these drugs. CNN points out that when Oxycontin® was launched by Purdue Pharma in 1996, the company engaged in an aggressive marketing campaign, claiming that its new opioid drug was not addictive. Physicians received 15,000 videos from Purdue Pharma that shared the story of six people who were treated successfully by Oxycontin®. Opioid prescriptions increased by 11 million after this campaign and the company targeted doctors further in medical journals through ads designed to convince them that the drug was safe to use.

Pharmaceutical companies have funded non-profit organizations to teach doctors more about pain management – and how opioids can help them in their care of patients. They also send out representatives to doctors’ offices, bringing free lunches, handing out expensive gifts and providing other perks to convince physicians to prescribe their drugs. The Washington Post recently stated that aggressive marketing by pharmaceutical companies centers on addictive opioids like fentanyl instead of on non-addictive over-the-counter drugs or those that contain tamper proof formulas to reduce risk of addiction. In fact, over $46 million was paid to almost 67,000 doctors by pharmaceutical firms between 2013 and 2015 for promoting opioids, especially fentanyl, to their patients and others. Fentanyl is used on patients with terminal illnesses, cancer and those who have had surgery, but has a high risk for addiction.

Lawsuits seek financial accountability

In 2007, Purdue Pharma, the maker of OxyContin®, was charged with misleading and defrauding physicians by the U.S. Justice Department. The company, which made $2.8 billion in revenue from the drug over a six-year period, reached a plea deal, according to The New York Times. In the plea deal, the company agreed to pay $600 million and three of its executives pled guilty to misbranding the drug. The investigation showed that scientific charts were faked, and that the company falsely claimed the drug had a lower risk of addiction than Percocet and similar drugs due to its time-release formula. Out of the $600 million settlement, $130 million was paid out for lawsuits filed by private plaintiffs and patients.

Over the last year, multiple lawsuits have been filed against pharmaceutical companies and others to hold them legally and financially responsible for the epidemic. These include the following:

  • The Charleston Gazette-Mail reported that Cardinal Health, a pharmaceutical distributer, settled an opioid lawsuit for $20 million in 2017 with the state of West Virginia for its distribution of millions of oxycodone and hydrocodone pills to the state over a period of six years. The city of Van, which has about 200 people, received 309,000 opioid prescriptions.
  • The Cherokee Nation filed a multibillion-dollar lawsuit against Cardinal Health, Walmart, Walgreens and other distributors in 2017. National Public Radio states that the lawsuit claims Oklahoma communities were flooded with pain killers, generating huge profits for companies. During 2003 to 2014, more than 350 tribal members died from opioid abuse.
  • In 2017, McKesson Corporation, another drug distributor, agreed to pay $150 million dollars for failing to report suspicious orders of opioid prescriptions. The U.S. Justice Department stated that the company is prohibited from sending shipments to Florida, Michigan, Colorado, Ohio and Colorado where the violations occurred.
  • New York City filed a lawsuit in 2017 against drug makers and distributors, including Purdue Pharma, Johnson & Johnson, Janssen, Cardinal Health and McKesson for their role in sending large amounts of pain killers to the city and for deceptive marketing.

Sadly, the effects of the opioid crisis facing families and communities across the nation are not going to be fixed overnight. However, there are legal paths available to hold those responsible accountable. Family members may be able to seek financial compensation for mental and emotional pain and suffering, medical expenses, and funeral costs as well as punitive damages.