A month ago, my father texted me and asked “what is an opioid?”  I don’t usually pick up the phone when he texts me, but this time I did.  He said that he was watching a documentary on the opioid epidemic, and the documentary never defined what an opioid is.

You probably know this, but just in case- “opioid” and “opiate” are used interchangeably, and describe a class of drugs that were originally derived from opium, which is extracted from the poppy plant.  Examples of drugs in this class include opium, morphine, codeine, heroin, fentanyl, carfentanil, hydrocodone and oxycodone.

Opioids are very potent pain relievers.  Unfortunately, they are highly addictive, because they can also be enormously pleasurable when first taken.


The New York Times published an article this week on drug overdose deaths.  Check it out at this link:  https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html?_r=0

 

The New York Times estimated that 59,000-65,000 Americans died of overdose deaths in 2016.  In one chart, they compare that rate to the peak fatality rates for car accidents, shootings and deaths from HIV.  All of those rates are lower than the current rate of overdose deaths.

If an airliner with 180 people crashed today, killing everyone on board, within an hour every network would have special programming about it.  You would know the name of the airline, the flight number, and details about all of the passengers.

An airliner full of Americans dies every day from drug overdoses, and no network is breaking into their regular programming about it.

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There are a many reasons for the increase in overdose deaths in America.  One is that prescription pain medication has become much more potent, and much more available.  Several years ago, a new oral agent (oxycodone, marketed as Oxycontin), was approved for marketing.  This drug has become widely available not only for prescription use, but also for abuse.

At the same time, the supply of heroin has increased and the cost has decreased. Heroin is now much more available, much more widely used, and less expensive than when I was growing up.  Supposedly, the cost of a dose of heroin is now less than the cost of a bottle of beer.  When I was in high school, the “gateway drugs” were marijuana and alcohol.  Not now.

One other reason is that other very potent drugs (fentanyl and carfentanil) are being sold as heroin.  Fentanyl is more potent than heroin, and carfentanil is said to be 1000-5000 times more potent than heroin.

If someone thinks that they are injecting heroin, but receives either fentanyl or carfentanil, they are going to die.

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The opioid epidemic is not some far-away problem that only happens in a newspaper.  It is a local problem that is killing people who live near me.  Drug overdoses now look like this in my area:

Last week, two men died of heroin overdoses not too far from where I live.  What made their overdoses even more remarkable was that they were house managers in a local halfway house.  They were the ones in charge of oversight at their facility.

The same week, 8 addicts died of overdoses in another small town not too far from where I live.

A recent local high school graduate died of an opiate overdose a few weeks ago.

A Philadelphia Inquirer article noted that Philadelphia had 900 fatal overdoses in 2016.  Bucks County had 185.  The same article included an old estimate of 10 fatal overdoses a day in Pennsylvania- and then noted that that estimate might be low now.

10 people lose their lives every day in my state from a preventable problem.  And either we have become used to it, or we don’t know about it.

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This is a complicated problem with no easy answers.  It would be intellectually lazy to say “just cut off the supply”.  The supply is not just illegal drugs like heroin.  It also includes prescription drugs that are diverted.  The problem is not just at our borders-it is also in our doctor’s offices and our pharmacies and our own medicine cabinets.

I read that the United States consumes 80% of the world supply of opiates.  We have 4% of the world population.  There is something wrong with that.

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Fortunately there is hope.  Treatment exists.  I know two young men who recently were in treatment for opioid addiction, and both are now in recovery.   But every day that they remain in recovery, almost 200 Americans are going to die from drug overdoses.

And I don’t know what to do about that.

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