How did legitimate prescriptions to drugs like Vicodin, Percocet and Oxycontin lead to a nationwide opioid epidemic of such staggering proportions!



The National Epidemic of Addiction to Pain Killers, Heroin and other Prescription PillsOver the course of the past decade, and perhaps even longer, doctors have been prescribing opiates such as vicodin, oxycodone, dilaudid and morphine to patients with legitimate pain issues.  Patients most often initially take these medications as prescribed but over a short period of time build up a tolerance, so what was originally prescribed stops working to assist with pain management.  They find that buying pills on the street is extremely expensive and thus often turn to heroin, which is more affordable.  Not long after, individuals realize that they are addicted to opioids (also referred to as “opiates”) for not just pain management but because they have been taking them for so long.  So what may have started out as legitimate chronic pain may turn into a serious drug addiction problem for many.

It’s not as if these are all hardened drug addicts, crack heads, meth heads, heroin junkies and so forth. These are often times lawyers and doctors and housewives and airline pilots and on and on….

Newer opiates have recently come on the illegitimate market such as fentanyl, carfentenyl and tyfentenal.  These substances only have a legal use to tranquilize an elephant or hippopotamus for surgery.  It has been revealed that simply a quarter of a baby aspirin size is enough to kill a human.  Yet, many street drug dealers are now cutting heroin with these substances.

One of the key regions of the US affected early in the opioid crisis was central Appalachia, an area covering much of West Virginia and eastern Kentucky known for small towns, rolling hills and physically taxing industries, including coal mining, agriculture and lumber production. Here, the proliferation of opioids encouraged abuse and the pills came to be known as “hillbilly heroin”.

Even taken exactly as prescribed, they were addictive, blocking pain (without treating its cause) and reducing stress. But people also began grinding them up to snort or inject for a potent high.

At the time, it wasn’t understood how addicting these prescription pain medications were.  But they really hurt people here and across the nation. In the new millennium, addiction spread coast to coast. Seemingly harmless prescriptions to Vicodin and Percocet turned into the start, to so many people, of what was to be a lifelong addiction.

And as use of the drugs spread, the distribution of pills spilled out from primary-care doctors’ offices and hospitals to illegal deals on street corners. They were also sold in vast quantities through barely regulated “pain treatment centers” in places such as Florida, which became known as “pill mills”. People with spurious pain complaints flocked to feed their own dependency or sell the pills on.

Fast forward to today and America is losing almost 1,000 people a week to drug overdoses. Two-thirds of those are opioid fatalities – with the pill problem still pervasive, but with a rising number of heroin and fentanyl deaths.  Many of those overdoses came from the over use of oxycontin and morphine as well.

How bad is it?

  1. Drug overdoses are the leading cause of death for Americans under 50, and deaths are rising faster than ever, primarily because of opioids such as heroin, morphine and oxycontin.  President Trump identified this as a national state of emergency.
  2. Is the crisis about prescription pain killers or heroin?  The crisis has its roots in the overprescription of opioid painkillers, but since 2011 overdose deaths from prescription opioids have leveled off. Deaths from heroin, morphine and fentanyl, on the other hand, are rising fast.
  3. One way the opioid epidemic has changed is the latest iteration of the opioid epidemic has been especially deadly among adults in their 20s and early 30s.
  4. in the mid-1990s began aggressively marketing drugs like OxyContin. This aggressive and at times fraudulent marketing, combined with a new focus on patient satisfaction and the elimination of pain, sharply increased the availability of pharmaceutical narcotics. Pill mills began popping up around the country as communities were flooded with prescription opioids. Over the next decade, a growing number of people grew addicted to the drugs, whether from prescriptions or from taking them recreationally. For many, what started with pills evolved into a heroin addiction.
  5. At the same time, the heroin market was changing. The price plummeted. Newly decentralized drug distribution networks pushed heroin and counterfeit pharmaceuticals into suburban and rural areas where they had never been. Everywhere the suppliers went, they found a ready and willing customer base, primed for addiction by decades of prescription opiate use.
  6. Then in 2014, fentanyl began entering the drug supply in large amounts.
  7. Then shouldn’t America simply stop prescribing opioids?  No.  Opioids are a vital component of modern medicine that have measurably improved the quality of life for millions of people, particularly cancer patients and those with acute pain. But their efficacy in treating chronic pain is less clear, especially when weighed against the risks of overdose and addiction.


Some chronic pain patients now struggle to fill their prescriptions. Solving the opioid problem requires controlling prescription opioid distribution while maintaining access for patients with legitimate medical needs. Suddenly removing access to opioids from those who are dependent on them to function could easily push people to illicit opioid sources, like heroin, morphine, dilaudid and percocet.

Overall, it comes down to the fact that opiates are dangerous drugs when not taken exactly as prescribed.  This article has provided some information on the death rate associated.  For more information, go to the SAMSA website.


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