Once seen as a wonder drug, opioids were first introduced to the public under Purdue Pharma’s brand name OxyContin. It was a go-to painkiller for acute to chronic pain management. In 1997, 670,000 OxyContin pills were produced; by 2002, 6.1 billion pills were available on the market. The explosive increase in demand for OxyContin brought tremendous profits to Purdue Pharma, increasing their sales from 48 million dollars in 1996 to 1.1 billion dollars in 2000.
Pharmaceutical companies’ profit caused the opioid epidemic that cost millions of lives in the United States. The highly addictive nature of opioids was masked by the false advertisement and heavy lobbying of pharmaceutical companies when the drugs were first introduced, which resulted in the sharp rise of prescription overdose deaths in the early 2000s. The uncontrolled prescription pattern and the lack of regulation on opioid production resulted in enough opioids on the market to “supply every adult American with 5mg of hydrocodone every 6 hours for 45 days” in 2010 alone. By the time the Food and Drug Administration took action against opioid manufacturers in 2010, more than 100,000 lives had already been lost to fatal overdoses on prescription opioids (this figure does not include illicit opioids like heroin). While the population with the highest rate of opioid overdoses has been non-Hispanic whites, the rate of opioid overdose in the Black and Hispanic populations, respectively, has also been sharply increasing, reflecting its pervasiveness regardless of ethnicity.
In 2007, Kentucky filed a total of 12 claims against Purdue Pharma, including false advertisement and unjust enrichment; Purdue Pharma pleaded guilty and paid 600 million dollars in fines for misrepresenting OxyContin as a non-addictive painkiller. By 2018, a total of 27 state governments had filed lawsuits against Purdue Pharma for contributing to the opioid epidemic through misbranding and false advertisement. While Purdue Pharma is possibly facing billions of dollars in fines, it is simply not enough to holistically address the core problem of opioid epidemic by treating those who are suffering from the opioid use.
While there have been nearly 14,000 treatment facilities in all states of the United States since the peak of opioid epidemic, only 50% of the self-reported people suffering from heroin use utilized the treatment facilities in 2014-2015. The rising number of opioid overdose deaths and underlying number of unreported opioid users represent the issue with current treatment facilities. While the World Health Organization identified medication-assisted treatment (MAT) as the most effective treatment for those suffering from opioid use disorder, only 36% of all treatment facilities in the United States offer one form of MAT and 6% of them offer all three qualified MATs (2% of all treatment facilities). Due to opioids’ strong, addictive chemistry, medication-assisted treatment plans are imperative to prevent relapses in opioid addiction. Creating federal guidelines and increasing the MAT facilities across the nation will be a crucial cornerstone in recovering from the opioid epidemic.
Rhode Island’s approach to treating opioid addiction serves as an exemplary model of fighting the opioid crisis. Rhode Island state government acknowledges that drug trafficking offenders are “a population of the most severely impacted, the most advanced stages of opioid use disorder — the people who have taken the greatest risks and gotten caught up in the system” and provides all three medication-assisted treatment along with the drug counseling services to such individuals. Furthermore, the state provides discharge planners who coordinate further appointments with treatment facilities outside of prison so that people could continue to receive care even after their release. The implementation of this method has already shown to dramatically decrease the overdose deaths among those who have been imprisoned recently.
The opioid epidemic has opened the new era of framing drug crisis as a public health concern. However, there is an absolute lack of means to appropriately treat those who are suffering from the opioid use due to insufficient funding and a uniform guideline in treatment plans. Our efforts to treat those suffering from the drug use has to be taken now to consolidate and expand further on the public health framing of drug crisis. Only then, we can resolve the core problem of the opioid crisis and create better frame for addressing drug crisis.