2019 fell short of expectations in terms of liability and solutions for opioid addiction, NPR reported. Accountability for “Big Pharma” fell flat with out-of-court settlements despite promising starts to court cases. The opioid crisis causes 130 deaths every day.
According to the NPR article, over 400,000 Americans have died of opioid-related causes since the epidemic began in the 1990s. “Thousands of states, local governments, school districts, and Native American tribes have sued drug companies for aggressively marketing prescription opioid medications while allegedly downplaying the risks of addiction and overdose,” the article said. Family, friends, and loved ones of those who died to opioids had hoped for a major settlement and public acknowledgement of guilt or wrongdoing by pharmaceutical companies, but those hopes were dashed amid quieter settlements. The closest to a victory that families saw was the declaration of bankruptcy by Purdue Pharma in September, which meanwhile offered a $3 billion payment to families of victims. Despite this, a straightforward path to pharmaceutical course correction remains unclear.
How Opioid Addiction Begins
What exactly are opioids and why are they so prevalent in the United States?
“Opioids [are] the class of drugs that includes prescription painkillers like codeine, morphine, Vicodin, Percocet, as well as illegal drugs like heroin,” said Dr. Thad Polk, an Arthur F. Thurnau Professor in the Department of Psychology and the Department of Electrical Engineering and Computer Science at the University of Michigan. “Opioids have been around for thousands of years, and they’ve been the gold standard medical treatment for pain since the Civil War, providing genuine relief to millions of people suffering from severe pain.”
These medicines offer legitimate benefits for those in pain. In the 1990s, they were recommended by pharmaceutical companies that believed the potential for addiction was low, Dr. Polk said. Unfortunately, addiction ran rampant. “In fact, about 25 percent of people who are prescribed an opioid drug end up misusing it, and over two million Americans are now estimated to be addicted to these drugs.”
The ugly side of addiction has been well-documented. Unfortunately, with opioid prescriptions, the cure doesn’t come when refills run out.
“The end result is that once you’re hooked, it’s extremely tough to quit, and as a result many users turn to illegal opioids like heroin once their prescriptions run out,” Dr. Polk said. “About 80 percent of heroin users first misused a prescription painkiller.”
Opioids Wreak Havoc
Even without resorting to seeking concentrated illegal substances like heroin, opioids ruin families and take lives.
“The deadly effects of opioid drugs are caused by their interaction with opioid receptors in the brain stem that affect breathing,” Dr. Polk said. “In particular, activation of these receptors can significantly suppress the breathing reflex; an opioid overdose can suppress breathing so much that the user suffocates and dies from a lack of oxygen.”
So why take the risk of asphyxiation with opioids? Dr. Polk said the benefits often seem more attractive to addicts than the clear drawbacks. “The pain-relieving properties of opioids depend on a different set of opioid receptors on cells in the body’s pain pathways. When these receptors are activated, they block pain signals from reaching the brain; thereby, providing significant pain relief.”
If a user isn’t in any pain to begin with, the activated pain receptors produce a euphoric effect to which many become addicted. Unfortunately, the imbalance it causes in one’s physiology often leads to overdose and death, as is evidenced by the ongoing legal battles between pharmaceutical companies and the families of overdose victims. One can only hope that 2020 provides more answers and closure than 2019 did.
Dr. Thad A. Polk contributed to this article. Dr. Polk is an Arthur F. Thurnau Professor in the Department of Psychology and the Department of Electrical Engineering and Computer Science at the University of Michigan. He received a B.A. in Mathematics from the University of Virginia and an interdisciplinary Ph.D. in Computer Science and Psychology from Carnegie Mellon University.