What is an Opioid and why is there an epidemic?

By Diane L. Marolla, LICSW

“Most people who become addicted [to opioids] like me do so after a prescription for a painkiller following a medical procedure. Once the phenomenon of craving sets in, it is often too late,” Jaime Lee Curtis

Undeniably, the opioid epidemic and how to address it has been a topic of concern that has been in the forefront of our local, state, and national elected officials. It is an issue that has affected our families, our friends, our school systems, our healthcare system, our police departments and our economy. The epidemic has everyone scrambling to try and stop the addiction, the overdoses, and the deaths that are occurring on a daily basis. All of us, in some way have been affected by this epidemic. Given that it is has been an important news story, and an issue that has affected so many people personally, I thought I would dedicate May’s article to break the topic down as there are so many myths and misconceptions about the root cause of the problem, and why so many individuals are dying on a daily basis.

What is an opioid?

Simply stated, an opioid is a narcotic. Opioids can either be a legally prescribed drug or an illegal drug. Examples of legally prescribed opioids are Oxycontin, Hydrocodone (Vicodin) and Morphine. Legally prescribed opioids are prescribed for pain and are meant to be a short-term solution to alleviate pain. They have and can also be used for individuals who are at the end of their life to alleviate pain and suffering. Fentanyl is an opioid that we hear about in the news daily. Fentanyl is a “synthetic” opioid that is more potent than Morphine. Fentanyl is a legal drug; however, it is now hitting the “streets” and coming into our country from other countries illegally. Fentanyl is a potent and deadly drug if misused or combined with other drugs. Heroin is an example of an illegal opioid. Statistics are showing that new users of heroin started out taking legally prescribed prescription drugs.

Can I get addicted to an opioid that has been legally prescribed by my doctor?

The simple answer to this question, unfortunately is yes, if you misuse or overtake the medication other than for short term use. Many individuals who have become addicted to opioids were prescribed the medication to alleviate pain after a medical or dental procedure. They are unaware of the potency or the addictive qualities of the drug they were taking. They thought it was something that was safe to take as it is prescribed by a doctor. Unfortunately, I have heard many stories from individuals who became addicts simply because they had a procedure and were given a 30-day supply of the opioid. I recall being prescribed a 30-day supply of Hydrocodone when I tore my rotator cuff. Although I did not want to take the medication, the pain was excruciating, particularly at night, so I did take it. I didn’t get addicted thankfully but did seek an effective alternative therapy (acupuncture) to alleviate the ongoing pain.

Opioids in essence trick the brain and body in not feeling pain. Opioids attach to the receptors in our brain and body. They slow breathing and have a calming effect. People initially take them, so they feel good, but as the addiction takes hold of them, they become dependent on them, and ultimately become addicted where they cannot get through the day without the drug.

Why is this such a big problem now?

In the research that I have done, the epidemic was started by the pharmaceutical company who makes Oxycontin. This drug was marketed as a safe way to treat pain. Other drugs like Vicodin and Percocet were also aggressively marketed to treat pain. Whereas the pharmaceutical companies knew how dangerous and addictive these drugs could be, they did not disclose this information to the physicians who would be prescribing them. The pharmaceutical companies made millions of dollars in profits marketing these drugs. This is why they are now the target of states suing them for the opioid epidemic. Rhode Island is one of the states who has joined other states in suing the pharmaceutical industry.

I hear so much about this, but what are the facts?

According to the National Institute on Drug Abuse, 115 Americans die every day after overdosing on an opioid.
The American Society of Addiction Medicine (ASAM) reports that the leading cause of accidental deaths in the United States is due to drug overdoses. ASAM also reports that prescribing rates of opioids among adolescents doubled from 1994-2007.
HHS.gov (The Department of Health and Human Services) reports that the economic cost of the opioid epidemic is $504 billion.

Where can I get help for myself or a family member who is addicted to opioids ?

Locally and nationally we have a wealth of information to help us help someone else. If you or a loved one is addicted to opioids here in RI, we have a local telephone number (1-401-942-STOP) that is staffed 24/7 to help. Additionally, the Department of Health (www.health.state.ri.us), The Department of Behavioral Health and Development Disabilities (www.bhddh.ri.gov ) and the Substance Use and Mental Health Leadership Council (www.sumhlc.org) all contain resources to help individuals with addictions.