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Angela Langford

English Composition 1201

Professor Vicki Stalbird

19 March 2019

The Worst of the Worst Crisis

Opioids is a huge growing problem in the United States. Where does the problem

start? Who is at fault? There are an upwards of at least 47,000 deaths a year due to the opioid

epidemic. Dayton, Ohio is one of the leading areas affected by the opioid epidemic. The crisis is

affecting almost everyone. The effect is different whether it is medical professionals, everyday

suburban family, or drug addicts ect. The blame is everywhere nobody knows who is truly at fault

for this epidemic. The answers need to be found and evaluated. The deaths are growing and the

families have to deal with tragedy. Where does the problem stop? History of the Opioid Epidemic

written by Lindsey Liu states that the “opioid epidemic has occurred in three waves. The first wave

began in 1991 when deaths involving opioids began to rise following a sharp increase in the

prescribing of opioid and opioid-combination medications for the treatment of pain” (Liu). This

started in 1991 and has continued for 28 years, it needs to stop before another 28 years. How can

it be prevented from continuing? The blame needs to be pinned to someone and the doctors,

hospital, solutions, celebrities, and stress are part of the blame, action needs to be taken with

leaders to change laws on opioids.

In the video “The History of Opioids” states the entire history of opioids back to

when they were first written down. Opioids were created before 34 B.C. But the science behind

opioids became more popular in the 19th century. The opioids were sold legally to all and then

when searched how addictive the chemical in opioids was known as morphine a new drug was
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created to help solve the opioid addiction called heroin and the problem just grew worse. The

epidemic was huge at that point and governing officials banned the use of heroin and morphine in

1905. In the year 1910 Britain and China worked together to take down the opioid China Britain

trade. The narcotics act of 1914 was put in place to prevent doctors from prescribing frequently.

The narcotic division of the government banned the sale of all legal narcotics, which did not stop

the use of opioids. There was still a growing want for the drug and profit to be found many resorted

to underground drug trade. There is so many more parts to the drug use and many doctors fought

to be able to prescribe opioids again. The use of opioids was reinstated but not without regulations

and tight leashes.

What are opioids that is the question that needs to be answered before the who to

blame question can be answered. According to the National Institute of Drug Abuse, “opioids are

a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain

relievers available legally by prescription...All opioids are chemically related and interact with

opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when

taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition

to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed,

or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead

to dependence and, when misused, opioid pain relievers can lead to addiction, overdose incidents,

and deaths.” Opioids are described as the most addictive prescription created. The only real way

to cure an overdose so far is naloxone and full detoxification.

Doctors are notorious for giving opioids as a pain medication after surgery and to

take home. Do the patients abuse the opioids when they arrive home or were they over prescribed.

Opioids are proven to be extremely addictive drugs. Allison Pitt explains in “Modeling Health
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Benefits and Harms of Public Policy Responses to the US Opioid Epidemic” that Opioids are being

subscribed and not always necessary. The source is well at explaining why not to have opioids and

why they cause so much harm to the body. This is very important when understanding who is at

fault for being in the opioid crisis in the United States. Are family doctors doing their part to stop

a problem they may have started? Jennifer Middleton goes into the fact that family doctors can

help people fight the addiction especially since there patients trust them more than a doctor at the

ER. When going to a family doctor it often is more familiar and comfortable. The person addicted

needs that more than a doctor they have most likely never met except after an overdose has already

occured. The doctors are also the ones that prescribe the medications like opioids but not normally

the family doctors so people may have a hard time trusting that as well, in the article “How Family

Physicians Can Combat the Opioid Epidemic.” The opioid crisis may not have started because of

doctor but they surely can take the blame for some of the crisis that is happening in the United

States.

Hospitals get the main portion of the overdoses due to the resources that they have

and being when a family member or friend finds the overdoser the first person that is called is 911.

Many times naloxone is administered. The National Institute on drug abuse explains in the article,

“Opioid Overdose Reversal with Naloxone” states “Naloxone is a medication designed to rapidly

reverse opioid overdose. It is an opioid antagonist—meaning that it binds to opioid receptors and

can reverse and block the effects of other opioids. It can very quickly restore normal respiration to

a person whose breathing has slowed or stopped as a result of overdosing with heroin or

prescription opioid pain medications.” Naloxone kind of seems like it may be a part of the problem

as well because not that it necessarily glorifies overdose it make it less scary that you will die. It
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gives addicts hope that they will be fine even if they overdose so why not do opioids or heroin. It

may not be the main cause for the opioid crisis but it is surely up in the possibilities.

There may be solutions to opioids that are natural. Many state that marijuana is a

natural painkiller that is harder to get addicted to but much more effective. “A 2011 study that

evaluated 56 patients found that those using CBD experienced far less pain and stiffness than those

using traditional pharmaceuticals”(13). Jacob Teitelbaum wrote in “THE OPIOID EPIDEMIC:

Finding Natural Solutions to This Deadly Crisis”,wrote that statement and “ unlike opioids, the

majority of herbs and nutrients listed here target inflammation—the underlying cause of most pain.

Plus, they are non-addictive and have been clinically shown to be both safe and effective” (11).

The alternatives are safer and most are not addictive at all and will not harm the body. However,

for some reasons doctors tend to not want to prescribe the natural medication. Now in some states

using marijuana is illegal even for medicinal purposes. But if doctors saw the wide benefit to

natural drugs, they may try to advocate for legislation to be passed for more natural drugs to be

used. Natural is maybe the solution that is needed to fight the opioid crisis. It is one of the many

solutions.

Celebrities also glorify the use of opioids in a certain way. But should it really?

Jacob Teitelbaum wrote in “THE OPIOID EPIDEMIC: Finding Natural Solutions to This Deadly

Crisis”, “The opioid crisis rocketed to public awareness with the untimely death of Prince,

followed by the recent news of Tom Petty’s overdose. Both musicians suffered from chronic hip

pain, conditions for which opioids were prescribed. While the mention of some opioids, like

heroin, evoke visions of junkies desperate for a fix, the truth is that an addiction to opioids can

happen to anyone—rich or poor, young or old, rock star or soccer mom.”(10)The article relates

back to celebrities that have died of opioid epidemic and that it can happen to anyone. The start
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of the addiction is being given pain medicine after a surgery or something similar to that. Opioids

affect the brain as a whole and are rough to say the least. Addressing that is important to understand

how people go from a soccer mom with a bad back but still normal to dead on an overdose. Another

part of the epidemic is stress.

Stress is what makes people feel the need to let loose and maybe get a high to feel

nice. Again Teitelbaum wrote “stress can increase the initial desire to take opioids and intensify

the urge to keep taking them. But over time, the more you want, the more you need—and these

escalating doses create changes in the brain so that it functions more or less normally.”(11)

Everyone is experiencing stress. Some experience stress and feel the need to get high with

whatever is on hand in the cabinet. Everyone has prescriptions on hand and opioids are common

if anyone in the house has had a surgery. However with opioids being so addictive it is easy when

misused to be hooked. Now it is easy to describe what makes the addiction happen, or solutions

but how it has risen to this point.

The crisis has risen to a new high in the last few years. David Smith wrote “The

surge in prescription narcotic and subsequent heroin addiction has prompted the U.S. Department

of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC)

to declare abuse of prescription opioids an ever-expanding epidemic in the United States (CDC

2015a; HHS 2015). Between 2002 and 2013, drug overdose rates quadrupled (CDC 2015b),

exceeding overdose deaths from heroin and cocaine (Volkow et al. 2014). Heroin overdose deaths

are increasing as patients shift to cheaper and more accessible heroin from the opioids that their

physicians prescribe”(95) in “Medicalizing the Opioid Epidemic in the U.S. in the Era of Health

Care Reform.” People were receiving prescription opioids for much pain from doctors, but when

the price started going up then people resorted to new alternatives for pain meds stronger than
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store bought over the counter ibuprofen. With needing to go to someone like a drug dealer the

grade of opioids maybe worse. It is not necessarily pharmaceutical grade. This makes the danger

go up because of the addictive chemical being higher than average grade. Who is to blame is still

the question that needs to be answered.

The game is all about blame. Everyone has someone they blame but is it really the

correct person to blame. Arthur Lipman wrote the article “The Opioid Abuse Blame Game” about

Most people state to believe addiction all starts with a prescribed pill and then led to the want for

more. Which in turn supports the idea that doctors and medical professionals are to blame for the

opioid crisis. “Over three quarters of opioid abusers started with prescription opioid tablets or

capsules (the pill dosage form is rarely if ever used today), it is unclear that many of those were

medications prescribed for the persons who become abusers”(2). The blame falls on the doctors

but maybe the pharmaceutical companies also.

Michael Purcell wrote the article “Settling High: A Common Law Public Nuisance

Response to the Opioid Epidemic” on the article discussing what an opioid is and how the problem

has accelerated so awful. It is also a valuable article due to it describing how the drug interacts

with the body. Schools and hospitals are not doing their part to educate adults and adolescents on

how bad opioids are for the body and addictive. The crisis is costing the government and

communities a great deal of money. To invest more money in the education is not an option they

are exploring at the moment. Doctors could take the responsibility of explaining the risk and

explaining alternative options to the patients. They have a public duty to educate people on the

risk of taking opioids for any period of time. Doctors are trusted individuals and people often trust

they are doing what is right for them. That trust can be abused and needs to be evaluated

sometimes. In North Carolina the law makers there are turning a new leaf taking initiative and
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educating the population on just how the crisis may affect them. “How North Carolina Hospitals,

Health Systems, and Care Providers Are Uniting to Fight the Opioid Epidemic” written by Kumar,

Jai, and Larry Greenblatt is writing an article on how a state is taking action to stop the epidemic.

The state wants to take the time to explain how to be safe taking opioids, how they affect your

body, and how overdoses occur. North Carolina is has the second highest rate of overdoses as

stated in “Opioid Related Overdose Deaths”. They also wrote that “in 2016, there were 1,505

opioid-related overdose deaths--- in North Carolina—a rate of 15.4 deaths per 100,000 compared

to the national rate of 13.3 deaths per 100,000 persons. Since 2010, when the rate was 8.1 deaths

per 100,000 persons, the rate has almost doubled. From 2010 to 2016, the number of heroin-related

deaths increased from 39 to 544 deaths and the number of deaths related to synthetic opioids rose

from 170 to 601 deaths.” Even with North Carolina.

The blame can be put on the doctor or opioid makers but are there maybe an

alternative to this idea? Maybe a nice drug dealer or your parents. Blame who? Doctors should

take a big chunk of the blame, however that is not saying that the drug dealers are not to blame at

all. Drug dealers are trying to make a quick dollar and do not care if the person lives or dies. They

may even lace the opioid to make it more addicting, but the average person won’t approach a drug

dealer without a prerequisite. This being said it makes it still the doctors fault for being what gets

the person addicted and have the urge to need more and seek a dealer to get the high they so

desperately crave.

Doctors are rarely blamed for the crisis at hand but that needs to change. The

Doctors are the ones that tend to be the reason a person starts the addiction. Action needs to be

taken to solve the epidemic and make it have less of an affect on the overall population. The

National Organization for Drug Abuse needs to push for legislation to be passed for doctor to need
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to find alternatives that may be healthier for the patient, or less addictive. There are options out

there that just need to be tested, opioids are easy since they are already proven to be effective at

defeating the pain. Easy is not always best however. State governments could take a stance towards

defeating opioids and the abuse behind them.

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They are trying to express how bad the opioid epidemic is and which states are the worse.

You could argue the image is arguing that the smaller states tend to have the highest overdose

death rate. The larger states tend to be the lightest colors in this image which says something

because like California and Texas are extremely populated and have the lowest death rate.
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Works Cited

History of the Opioid Epidemic: How Did We Get Here?,

www.poison.org/articles/opioid-epidemic-history-and-prescribing-patterns-182.

Kumar, Jai, and Larry Greenblatt. “How North Carolina Hospitals, Health Systems, and

Care Providers Are Uniting to Fight the Opioid Epidemic.” North Carolina Medical

Journal, vol. 79, no. 3, May 2018, pp. 177–178.

Lipman, Arthur G. “The Opioid Abuse Blame Game.” Journal Of Pain & Palliative Care

Pharmacotherapy, vol. 30, no. 1, 2016, pp. 2–3.

Middleton, Jennifer L. “How Family Physicians Can Combat the Opioid Epidemic.”

American Family Physician, vol. 96, no. 6, Sept. 2017, pp. 357–358.

“Opioid Overdose Reversal with Naloxone (Narcan, Evzio).” NIDA, National Institute on

Drug Abuse, 4 Apr. 2018, www.drugabuse.gov/related-topics/opioid-overdose-reversal-

naloxone-narcan-evzio.

Pitt, Allison L., et al. “Modeling Health Benefits and Harms of Public Policy Responses

to the US Opioid Epidemic.” American Journal Of Public Health, vol. 108, no. 10, Oct.

2018, pp. 1394–1400.

PURCELL, MICHAEL J. “Settling High: A Common Law Public Nuisance Response to

the Opioid Epidemic.” Columbia Journal of Law & Social Problems, vol. 52, no. 1, Fall

2018, pp. 135–177.

Smith, David E. “Medicalizing the Opioid Epidemic in the U.S. in the Era of Health Care

Reform.” Journal Of Psychoactive Drugs, vol. 49, no. 2, Apr. 2017, pp. 95–101.
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Teitelbaum, Jacob. “THE OPIOID EPIDEMIC: Finding Natural Solutions to This Deadly

Crisis.” Chiropractic Economics, vol. 64, no. 16, Oct. 2018, pp. 10–14.