Karla Mae Cochran
ENGL 1213 #2398 (Online)
13 May 2018
Owning the Opioid Crisis
There is an epidemic in America today due to the use and misuse of opiates. Approximately 180 Americans die every day from opioid overdoses, caused by drugs like heroin and prescription pain medications. Life expectancy has gone down for the first time in decades with overdose now being the leading cause of death for Americans under age 50 (Perin). These opiates usually find their way into people’s lives after an injury, surgery, or dental procedure in the legal, innocent form of prescription pain medications. People believe them to be safe as they come from the doctor. But the nature of opiates is that they stop being noticeably effective very quickly and require larger doses over time in order for the same effects to be achieved. At this point, doctors may prescribe stronger, more powerful drugs. Or they may decide to stop prescribing altogether. In the latter case, people may feel forced to seek alternative sources for opiates in the form of illegal drugs like heroin.
Opiates fall into two basic categories, legal pain medications and illicit drugs. The first category, prescription pain medications, are perceived by most people to be safe when prescribed and monitored by a doctor, and that only a few unfortunate people with predispositions towards dependence are at risk of becoming addicted. The second category, illicit drugs like heroin, are considered to be extremely dangerous and those addicted will likely need prescription opiates like Methadone to be treated. The current cycle ensures the continued use and abuse of opiates. In actuality, prescription opiates and illicit drugs like heroin are the same thing. The only tangible di?erence is who the opiates are supplied by and who manufactured them.
No matter what comes out of the recent lawsuits against Big Pharma, they are not solely responsible for the opioid crisis. Big Pharma represents drug companies who are in the business of supplying the demand for opiates. They seek to satisfy that demand with an effective product. However, the pharmaceutical companies have no control in how that product will be distributed and used. More drug manufacturers are acknowledging the problem with opioids and are attempting to find solutions to deter the opioid crisis. Purdue Pharma, manufacturer of the popular painkiller Oxycontin, issued an open letter stating several suggestions. They admit there are too many prescription opioid pills in people’s medicine cabinets. They support initiatives to limit the length of opioid prescriptions and believe doctors should utilize state Prescription Drug Monitoring Program (PDMP) databases before writing opioid prescriptions, which could prevent abusers from receiving multiple prescriptions from multiple doctors (Purdue Pharma L.P.). Purdue feels that with the right amount of changes to the way opiates are currently handled, they could continue their work manufacturing opiates and still make profits without causing unnecessary harm to the users.
Though users are starting to acknowledge that the long-term use of prescription pain medication is potentially dangerous, they believe they still need opioid pain medication to work and function. But with the changes being implemented by the Center for Disease Control’s (CDC) guidelines and the Food and Drug Administration’s (FDA) new plan to stem the opioid crisis, many users are worried they won’t be able to obtain their medications. Users believe they are being forced to suffer unfairly for something that has nothing to do with their legitimate pain issues (Graedon). They do not feel that everyone should be punished for the actions of addicts. Whether opiates are available to them or not, they will still have pain and therefore be unable to function and live the way in which they are accustomed. Understandably, this has made the users quite anxious about their future.
On the other side of this issue, the law has a responsibility to safeguard public health. The law can be divided into two areas on this issue: Legislation and Enforcement. Legislation regarding opiates is in place and falls ultimately to the Food and Drug Administration (FDA) to be enacted. The FDA has a plan to reduce the impact of opioid abuse on American families which primarily consists of improving the labeling process and seeking to improve treatment of both addiction and pain (FDA Opioids Action Plan).
Additionally, law enforcement has a front row seat to the opioid crisis as they are dealing directly with the victims of opioids. The Drug Enforcement Agency (DEA) and police departments around the country see the damage caused by addiction related crime and the faces of those who overdose. Law enforcement witnesses the aftermath of the opioid crisis and how the devastation has grown over the years. They believe this crisis is more of a public health concern than one of law enforcement and stipulate it is not a problem they can handle on their own (Perin). To combat illegal drugs, law enforcement can go after the dealers and even the cartels that manufacture and distribute illicit drugs. But if they keep with that strategy, in order to combat prescription opiates, they’d have to go after the doctors or pharmaceutical companies. But as they are restricted to work within the confines of the law, which doesn’t consider the actions of doctors or pharmaceutical companies criminal, the DEA and police are unable to make any meaningful impact on the opiate crisis.
Doctors are increasingly finding themselves accused of wrongdoing in the event of addiction and opioid overdose. They are torn between treating chronic pain patients with the opiates they desire and the ever-increasing possibility that they could be sued for wrongful death if their patient overdoses. Doctors believe there are alternative, less harmful treatments to opioids, such as physical therapy, diet and exercise, and non-addictive medications (Ahlberg). But doctors were duped like everyone else. They were told opiates were safe. For years, they found themselves stuck between pharmaceutical reps touting safe opiate cure-alls that come with perks like trips to the Bahamas, and angry, frustrated patients who just wanted their medicine right now and didn’t want to hear about treatments that may not work and surely wouldn’t feel as good as painkillers; it just became easier to pass out the opiates.
There will be no single entity coming forward to accept fault for the opiate crisis. In truth, the responsibility could be shared by Big Pharma, doctors, users and, surprisingly, even by the media. The media has been the single, greatest tool in cultivating the opioid crisis. They have been quick to stigmatize those users who eventually became addicted, portraying them as morally weak drug addicts who just wanted to “get high”, deserving whatever they got. The media perpetuated this perception instead of revealing the root causes of the epidemic. They withheld information about the dangers of opiates and the likelihood of users becoming dependent. It just doesn’t make any sense as to why they would do that, unless you consider who the media is and what it does.
Since media outlets make a good deal of their money from advertising, they must advertise products in a favorable light. They cannot show anything that would cause their sponsors to pull their advertising money. Another piece of the media’s revenue is from investors, and some companies buy so much of their stock they earn a controlling interest in the media outlet. “Every media outlet with the exception of CBS has drug company reps on its board” (Bentley). With drug companies not only paying for advertising but also having control over what is said, the media cannot or will not report objectively on opiates.
In addition, the media has always reported the cause of death of many celebrity overdoses, such as Heath Ledger, Michael Jackson, and even Elvis, as heart failure. Prince’s cause of death was listed as poisoning. Whitney Houston drowned. However, all these celebrities, and many others who died of mysterious circumstances, were using opiates and prescription pain medicine, but the media played that part of it down, with the exception of Tom Petty who’s cause of death was actually listed as overdose for some reason. The media altered the perception of opiates for the users, the doctors, and even the law so they would see opiates in a more positive, less dangerous light. Big Pharma and the media made billions of dollars together over the years. And it’s just business.
While Big Pharma and the media are convenient scapegoats, they couldn’t have profited so much without the users who have created such a vast demand for opiates. While users believe opiates are safe when prescribed and monitored by a doctor, they mistakenly think there is no chance they will be one of those morally weak few who become addicted. They don’t realize they already have a dependency since they are still seeking opiates to “cure” their pain when the drug clearly doesn’t do that. If it did, there would be no need for long-term use or stronger prescriptions. The pain would be gone. By the time people acknowledge there is a true problem, it is already too late. They are addicted, and likely behaving the same way as the addicts with whom they thought they had nothing in common. They are in trouble with the law. They’ve lost their jobs or their families. Or maybe it is too late and they are dead, and they never even realized they had a problem at all.
The opioid crisis is not brand new. But every attempt to solve it so far has failed. This is likely because everyone is hindering everyone else’s efforts. Law enforcement is hindered by the FDA’s lack of enacting effective laws to stem the problem. The FDA can’t change anything without battling against the financial might of the Big Pharma lobby. Big Pharma controls the media and convinces doctors and everyone else that opioids are safe and the risk of addiction is negligible. Users are hesitant to change anything that would stop the flow of opiates they now depend on to work and live. It’s everyone else that has a problem. But it doesn’t have to be. Everyone has an opportunity here to change something harmful they are doing for the better. They can do the right thing, solve the opioid crisis, and make the world a better place. But it will be hard. It’s already been proven that there is no easy way. The first step is to eliminate the manufacture, sale, and use of all opiates.
Next, Big Pharma can step in and manufacture new medicines that truly block pain without the risk of dependence. This is a real possibility as they have already invented Naloxone which cancels the effects of opiates and averts overdoses if administered in time. It would take just one more small discovery to create new medications that overcome dependence and addiction. If Big Pharma could use its awesome power for good by making non-addictive medicines that actually cure pain, they would be the biggest savior in the opioid crisis. It’s been said that there is no money in a cure. Big Pharma’s profits will take a hit but that could happen anyway due to the lawsuits, just like it did with Big Tobacco. They could learn from Big Tobacco’s destruction and get in front of this problem. It would be better in the long run for Big Pharma to be the hero.
But if Big Pharma does go down, the media outlets should go with them. An example should be made to create a deterrent to the media acting against a clear-cut conflict of interest. Laws should be enacted to prohibit companies from owning controlling interest in the media, almost like the separation between church and state. The best thing the media can do at this point is report truthfully and impartially on opiates. The need to stop stigmatizing the addicted, playing down this crisis, and start showing those affected in a more relatable light. They’ve already started to some degree by showing families in their home when discussing opiate addiction instead of just junkies living on the street (Shaw). The media could truly help solve the problem of opiates by showing the crisis in a more honest way and educate the public about the true nature of opioids. This will allow people to come to the conclusion, on their own, that they do, in fact, have a problem, before they find out the hard way.
Doctors are going to have to step up their game as well. The hardest part initially will be denying access to opiates for their patients. Doctors will be on the first line when it comes to withdrawal. They will have to provide referrals to effective rehabilitation centers. Then they will actually have to fix the cause of their patient’s pain with alternative treatments, or successful surgery, following up with physical and behavioral therapy for recovery. Doctors will be able to put their knowledge and skills to good use in the absence of opioids which, for years, have been the equivalent of a band aid. Doctors will be the face of true healing to their patients…no longer being sought out as just some alternative form of drug dealer.
The users will have the most difficult challenge of all. First of all, they will have to overcome their deep and long held belief that they need and must have opiates in order to function. If users can admit that opioids are truly ineffective for pain relief, they might open up to the idea of alternatives. Looking at opioids logically, a person would see that they don’t really stop pain. If they did, there would be no reason for people to continue to use them as if they were a long-term solution. If opiates truly worked, there wouldn’t be a constant need to seek out stronger medications. Opiates create a feeling of pleasure which competes with the feeling of pain, giving users something else to focus on, but the pain itself is still present. New studies show that opiates are no more effective for pain relief that Tylenol (CBS/AP).
When users come to the conclusion that they want to change how they deal with pain, they will have to go through withdrawal. People don’t die from opiate withdrawal but they will feel like it. The withdrawal will be terrible. But it will be no worse than living with addiction or dying. And it will pass. Then they will open their mind to new treatments, many of which may take some time, but eventually they will heal and no longer have pain. They may have to change their lifestyle for awhile, take an easier job, cancel extra commitments like school or taking care of others until they recover. They will see that opiates were never going to be a legitimate long-term solution. They will not blame doctors for their misfortune. Or Big Pharma. Or the media. Or even God. They will see that it doesn’t even matter who is to blame. The users will see that blame doesn’t have any effect on improving their situation at all.
At this point, users will take their treatment into their own hands and move forward to find an actual cure for their pain, instead of relying on the crutch of opioids, instead of making excuses, instead of being profited off of by those who think there is no money in a cure. They may even come to realize that the pain might have been the best thing that ever happened to them, because now it has transformed them from opiate users into strong positive people that affect change and are able to take responsibility for their own lives.
Opioid medications can and must be eradicated. They don’t fulfill their intended purpose and only cause more problems for everyone who takes them. No person is immune. Dependence and addiction can happen to anyone. Big Pharma, the law, doctors, and users all share responsibility for this problem. But alone, none of these groups have the power to stop the opioid crisis. It will take everyone working together to remove opiates from play. It will take a lot of time. There is no quick fix. The opioid crisis didn’t happen overnight so it shouldn’t be expected to be corrected that quick. It took years to become what it is today. And as much as it sounds impossible to eradicate opiates, it’s the only way to stop this crisis. A decision must be made about which matters more, making money or saving people’s lives.
Ahlberg, Amy. “8 Surprising (and Natural) Ways to Beat Pain.” 27 February 2015. www.prevention.com/mind-body/natural-remedies/pain-management-natural-remedies-ease-aches. Website. 12 May 2018.
Bentley, Gary. “Big Pharma Owns the Corporate Media, But Americans are Waking Up and Fighting Back.” 11 April 2017. https://trofire.com/2017/04/11/big-pharma-owns-corporate-media-americans-waking-fighting-back/. Website. 12 May 2018.
CBS/AP. “Opioids No Better than Tylenol for Chronic Pain, Study Finds.” 6 March 2018. www.cbsnews.com/news/opioids-no-better-than-tylenol-for-chronic-pain-study-finds/. Website. 12 May 2018.
“FDA Opioids Action Plan.” 26 April 2018. www.fda.gov/drugs/drugsafety/informationbydrugclass/ucm484714.htm. Website. 12 May 2018.
Graedon, Joe. “What Will People in Severe Pain Do Now?” 24 March 2016. www.peoplespharmacy.com/2016/03/17/what-will-people-in-severe-pain-do-now/. Website. 7 May 2018.
Perin, Michelle. “Law Enforcement’s Role in the Opioid Epidemic.” 20 April 2018. www.officer.com/investigations/drug-alcohol-enforcement/article/20996096/law-enforcements-role-in-the-opioid-epidemic. Website. 12 May 2018.
Purdue Pharma L.P. www.purduepharma.com/corporate-social-responsibilities/ongoing-efforts-to-help-address-the-opioid-crisis/open-letter/. n.d. Website. April 2018.
Shaw, Michael. “Photos Reveal Media’s Softer Tone on Opioid Crisis.” 27 July 2017. www.cjr.org/criticism/opioid-crisis-photos.php. Website. 12 May 2018.
Karla Mae Cochran