Behind the Epidemic of Opioid Abuse in the US

Last year more Americans died from drug overdoses than ever before.

The most recent numbers from the Centers for Disease Control and Prevention record that more than 52,000 people overdosed and died in 2015.

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Deaths from heroin and synthetic opioids like fentanyl have soared. But it is deaths from prescription painkillers that have taken the biggest toll.

So what's behind this epidemic of opioid abuse and what will it take to bring it under control?

According to Juliet Sorensen, a professor of international law at Northwestern University and the founder of the Northwestern Access to Health Project, it’s a multifaceted problem that will require a multifaceted solution.

“It’s a compelling and complicated problem that is caused by a host of factors and it’s not going to be any one realm of expertise to solve it,” said Sorensen, who recently convened a symposium on opioid abuse at Northwestern.

But the former assistant U.S. attorney says at least some culpability lies with the pharmaceutical industry which for years marketed opioids to doctors while downplaying the risk of addiction.

“In terms of the mission statements of big pharma, they do not say that their sole mission is to maximize shareholder profits. On the contrary, they say they bring health to the world,” said Sorensen. “But it appears from their actions that their mission is not as selfless or philanthropic as all that.”

She says that action from Congress is unlikely and that litigation may ultimately be what forces the industry to change its behavior.

“I don’t know what is going to cause the pharmaceutical industry to change its tune other than fairly drastic action … It may come from the opioids lawsuits that are starting to spring up around the country, not unlike the tobacco litigation of the 20th century. ”

(The Javorac / Flickr)(The Javorac / Flickr)

Dr. Steven Aks has been an emergency room physician at John H. Stroger Jr. Hospital for 25 years and is also a toxicology specialist. He says he has seen all manner of substance abuse cases, involving all age ranges, from teenagers to people in their 60s and 70s.

“They basically come in, they are sedated and they may be unconscious, they may have small pupils in their eyes they may not be breathing – so from a little drowsy to full-blown coma,” he said.

Aks says that early in his career he saw a lot of instances of cocaine use and injection heroin use.

“Then in to the later ‘90s that really seemed to fade out and we saw more inhalation and snorting of heroin on the street,” said Aks. “Then into the 2000s we started seeing a much wider availability of pills and people abuse prescription opioids. And then unfortunately after that, we saw people swing back to heroin.”

Aks also believes the pharmaceutical industry, along with some physicians, bear a significant share of the blame where prescription abuse is concerned.

“Opioids are incredibly addictive and I think they were marketed as being not addictive and as a medical community we’ve been somewhat sloppy in not looking critically at this,” said Aks. “I think we as a community have been part of creating some addiction cycles.”

But Aks said he believes that progress has been made, especially in terms of our understanding of addiction.

“By de-stigmatizing and realizing that this is a disease, and that this is a public health problem and not a law enforcement problem, I think that is a great stride forward.”

Aks and Sorensen join host Phil Ponce in discussion. Also joining us are: 

June Oliver, an advanced nurse practitioner at Swedish Covenant Hospital and a specialist in pain management who has helped train other medical professionals to detect signs of opioid abuse.

Kathleen Kane-Willis, who recently became the director of policy and advocacy at the Chicago Urban League. Prior to that she was for 11 years the director of the Illinois Consortium on Drug Policy at Roosevelt University.

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