The Opioid Crisis Episode 1

The podcast discusses the opioid crisis, starting with an overview of what it is and why it matters. It explains the misuse of opioids and provides definitions for natural, synthetic, and semi-synthetic opioids. The history of the crisis is discussed, with the first law restricting narcotic use in 1915. The timeline of the crisis includes a surge in heroin use in the 70s and 80s, a decline in the 90s and 2000s, and a resurgence in the 2010s with synthetic opioids. The podcast highlights the link between prescription painkillers and heroin use, as well as the increase in overdose deaths among young people. The episode concludes by mentioning that the next episode will examine the key players in the epidemic. Since 2017, there have been more opioid-linked deaths than car crashes. Hi, I'm Riley Mitchell, and this is my podcast on the opioid crisis, segment on world views with Riley Mitchell. My podcast series will feature episodes on different elements of the opioid crisis, starting off today with an overview of what the opioid crisis is and why it matters. Today we'll be hearing a brief history and overview of the opioid crisis, including a timeline. First, let us start off with some terminology that will be important throughout this podcast. The first definition I'll be talking about is the misuse of opioids. That means use in any way that was not the way in which a doctor prescribed. A used disorder is reoccurring problems that cause serious effects on one's life. Natural opioids, or opiates, come from opium poppy plant. Synthetic opioids are made in the lab, and semi-synthetic are synthesized from natural products. The issue of opioid misuse and abuse has been present for hundreds of years. The first law restricting narcotic use was in 1915, called the Harrison Narcotic Act. In 1915, addiction was already prevalent in everyday homes and families, as it started mostly with soldiers in the mid to late 1800s. It heavily escalated from that point on. As the Guardian states, quote, more than a century later, Americans are fighting some of the same demons, end quote. As for the past 50 years, let's begin with the general timeline of the opioid crisis, from the time that candidate and then president Richard Nixon declared a war on drugs, before diving into analysis of this. According to the New York Times, if we track back to the 70s, we can see an uptick in the use and regulation around opioids, especially heroin. There was harsh penalties and a surge in arrests for those using opioids, as well as forced treatment. Rockefeller proposes the harshest drug laws in the nation in New York, while Washington, D.C. took more of a medical approach, which worked well. Nixon started by trying to use methadone and taking large, the public health approach, but there continued to be more police, more prison, and longer sentences. Smaller approaches for combating heroin use happened in major cities, such as Baltimore, which began a clean needle exchange. The rest of the country, however, was not on board with this method, even though overdose and HIV rates plummeted when they did the clean needle exchange. Throughout the 80s, the federal government continued to try to punish away the problem. Then, from the 90s to the 2000s, the epidemic began to peter out. As examined in PLOS Medicine and the Congressional Research Service, this was until the 2010s hit, and the heroin epidemic came back in record numbers. In 2016, those synthetic opioids, as I described, surpassed other opioid-related deaths, which is considered the third wave of the opioid crisis. These forms of opioids were 50 times stronger than heroin. There was a surge in overdoses in suburbs, and the overdose rates were equal for both men and women, which predominantly had been men in past years. Widespread use of prescription painkillers was happening, and prescription sales timed four times in 11 years, from 1999 to 2010, which was called the first wave of the most recent opioid crisis. Four in five heroin users started out by misusing prescription drugs, and 3.8% of adolescents and 15.8% of young adults who have used opioids have misused them. Those who used other substances, such as cocaine, hallucinogens, heroin, and inhalants, have a higher rate of prescribed opioid misuse. Opioids are responsible for 12% of deaths in 2016 for 15 to 24-year-olds. This is a four-fold increase from 2001. Deaths from overdose rates have been in all time of 12.1 per 100,000 users. This number is not specific to opioids, but a majority of those deaths are opioid overdoses. While this timeline seemingly has many surges and declines, the misuse and abuse of opioids has been present throughout the entirety of American history. Particularly right now, we are seeing record high numbers of deaths in the past five years. When considering these facts I have just given to you, it is important to think of them as more than just statistics. They come from real life and real people. Continuing in my next episode, I will include the why of this issue. We will discuss the examination of all the key players in the epidemic. This ranges from doctors to drug companies, marketing and drug cartels, pain management and the patient-doctor relationships, risk factors that lead people to abusing opioids, such as mental illness, and overprescription. Thank you for listening to today's episode.