The roots of the North American opioid crisis, and 3 key strategies for stopping it

The Netflix series Painkiller recently depicted how the over-prescribing of the medicine OxyContin wreaked havoc on American society.

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The ConversationThe Conversation
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https://theconversation.com/the-roots-of-the-north-american-opioid-crisis-and-3-key-strategies-for-stopping-it-213716https://theconversation.com/the-roots-of-the-north-american-opioid-crisis-and-3-key-strategies-for-stopping-it-213716
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Tuesday, October 17, 2023
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Tags: 
Pain, Purdue University, Heroin, Oxycodone, Industry, Cocaine, Opioid use disorder, Research, Public, Morphine, Government, United Kingdom, Benzodiazepine, Fentanyl, Social support, Methadone, Office of National Drug Control Policy, Employment, Death, Psychotherapy, Medicine, FDA, Netflix, Education, Purdue Pharma, Prescription, Marketing, Awareness, United States drug overdose death rates and totals over time, Patient, Quality of life, Prison, Fatality, Video game, Pharmaceutical industry, Drug, Nursing, Analgesic
Geotags: 
NORTH AMERICA, UNITED STATES, CANADA
Summary
Key Points: 
  • The Netflix series Painkiller recently depicted how the over-prescribing of the medicine OxyContin wreaked havoc on American society.
  • Today the grim reality is that opioid-related deaths in North America reached a record level in 2022, with more than 109,000 fatalities in the United States.
  • The opioid overdose crisis has been ongoing for over two decades in Canada and the U.S.

The roots of the crisis

    • After introduction of the opioid painkiller OxyContin in 1996, Purdue Pharma marketed the drug aggressively, underplaying its potential for addiction.
    • To address addiction, prescription monitoring programs aimed to limit supply but many patients then sought illicit opioids, leading to large heroin markets in the 2010s.
    • Fentanyl is extremely toxic — up to 100 times stronger than heroin — and is largely responsible for the increase in overdose deaths.

1. Treat substance use disorders as a public health problem

    • In reality the data shows that illegal drug prices have fallen whilst purity and deaths have increased.
    • Overdose deaths have also increased in prisons showing that places with even the highest level of security are vulnerable to drug smuggling.
    • Focusing on the opioid crisis through a public-health approach includes massively increasing access to care and treatment for patients experiencing substance use disorder.

2. Find better treatments through research

    • Although these are effective when used, there are barriers to access and long-term engagement with these treatments.
    • We need more innovation to rapidly increase access to care and to find better therapies that suit the needs of different patients.
    • These research initiatives aim to increase the number of evidence-based treatments that can be used to enhance patient recovery and quality of life.

3. Stop the international spread of the epidemic

    • Currently the epidemic is contained within North America but there is the real concern of the crisis spreading to other countries.
    • Clinicians must remain actively vigilant on how they prescribe these drugs.
    • There should be greater international regulation in the marketing and operational strategies of pharmaceuticals, and oversight of the “revolving door” between industry and regulator employment.
    • There is a potential conflict of interest when pharma companies hire the government employees who oversee their applications.
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