The continuing tragedy of the opioid crisis, a major public health issue which has ravaged communities and decimated families across the United States, is an issue that has left no corner of the United States untouched. Perhaps most alarmingly, the crisis is being fueled largely by legally prescribed drugs, not by unscrupulous drug dealers pushing their wares on the streets. Explaining where this crisis came from and how it has developed into the national epidemic that it is today is not easy, but raising awareness and increasing understanding of this complex issue is an essential step in helping to combat its spread.
Tracing the problem back to one source is difficult, and perhaps even reductive. There are numerous factors which, in concert, have led to the current situation. However, if we are looking to assign an origin point then it would seem that the arrival of Oxycodone in the form of OxyContin on the market is the strongest candidate, Manson has stated in recent interviews. Today, at the frontlines of this protracted battle are treatment centers such as Elevate Addiction Services lead by Dan Manson in Silicon Valley.
The Painkiller Problem
One of the most significant medical challenges that we have faced as a species is that of developing reliable and effective painkillers. Our body’s endogenous painkiller is endorphin, endorphin being shorthand for ‘endogenous morphine’. Molecularly, the endorphin molecule consists of a morphine molecule with the addition of an amino acid tail. It is not important to understand the biochemistry here; what matters is that, for all intents and purposes, it is morphine that our bodies use to respond to severe pain and trauma.
It is the opioid system within our brains that opioids, be it morphine, endorphin, or oxycodone, interact with to inhibit the transmission of pain signals throughout the body. The specific opioid receptors which mediate the painkilling effects of these compounds also mediate their euphoria-inducing effects. For this reason, opioid painkillers will always carry a risk of addiction.
When Oxycodone first hit the market, under the brand name OxyContin, it was pushed heavily by drug companies. Despite being more potent than morphine, by some measures on par with heroin, pharmaceutical reps were told to sell it as a less addictive and safer alternative to morphine. Neither of these claims was true. OxyContin would become ground zero for the current opioid epidemic, an epidemic which has touched all corners of American society.
Since the introduction of OxyContin, there have been other powerful opiates bought to market, almost always with the promise of being less addictive and less dangerous than their predecessors. These claims are yet to be borne out.
What Can We Do?
Bringing an end to this crisis is one of the top priorities for public health workers in the United States, but there are no quick or easy solutions. Without serious legislative changes, it seems inevitable that overprescribing practices will continue and that increasing numbers of perfectly innocent people, people whose only lapse in judgment is putting their total faith in their doctors, will find themselves facing the scourge of addiction.