The Opioid Crisis: How Did We Get Here?
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For the last few years, opioids have made headlines, and not in a good way. The phrase “opioid epidemic” is uttered with increasing frequency, which makes sense considering how many individuals rely on opioids to manage chronic pain. While numbers vary, it is estimated that one in three Americans are prescribed an opioid, and about 40 percent of that number will become addicted.
Thus, the so-called “epidemic,” which has claimed more than 300,000 lives to overdoses since 2000, has less to do with pain management and everything to do with the addictive properties of opioids. Some experts believe that the healthcare system itself, which they say over-prescribes opioids, is primarily to blame for the crisis.
“The opiate crisis is in large part the result of legal drugs being prescribed by doctors,” says writer and botanist Michael Pollan, whose 2018 book, “How to Change Your Mind,” proposes the use of non-addictive psychedelics in place of opiates for some patients.
Opioid Versus Opiate: What’s in a Name?
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At their core, opioids come from nature. An opioid analgesic is a derivative of the opium poppy, and it has been used as pain management tool for millennia. Evidence shows that opium poppies were cultivated by the Sumerians as early as 3400 B.C.
The term “opioid” is sometimes used interchangeably with “opiate,” although that’s not quite correct. An opiate is an opioid subset, typically naturally occurring rather than synthesized. Morphine and codeine are opiates, while Percocet, oxycodone, hydrocodone, and fentanyl are examples of synthetic or semi-synthetic opioids.
The Science Behind Opioids
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The Sumerians may not have understood exactly how the opium poppy eased their pain, but modern healthcare providers have some idea. It is believed that opioids bind certain pain receptors in the brain and spinal cord, effectively “blocking” pain. However, opioids can also cause feelings of euphoria, which may ultimately lead to addiction.
But pain blockage itself, and the body’s ability to adapt to regularly ingested substances, is another reason behind today’s high rates of opioid dependency.
Proposed Alternatives to Opioids
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While the analgesic properties of opioids can’t be denied, plenty of alternatives exist that are just as viable when used for pain management. As previously mentioned, psychedelics have shown promise in treating chronic pain, but the biggest name in alternative pain relief is cannabis. Specifically, it’s the compound cannabidiol (CBD), which is present in cannabis in varying amounts depending on the strain.
Unlike THC, which gives users a “high,” CBD is the non-psychoactive compound found in marijuana. It interacts with the body’s serotonin receptors to stimulate the neurotransmitter oxytocin, which regulates feelings of happiness and euphoria, and promotes pain relief.
Along with controlling anxiety, high blood pressure, and nausea, CBD has shown promise in treating aggressive forms of cancer, including mesothelioma and melanoma.
Unforeseen Complications of the Opioid Epidemic
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Along with the elevated fatality rate, opioid use has additional, unexpected downfalls. The estimated direct cost of the opioid crisis since 2001 is more than $1 trillion, and there are plenty of hidden costs as well.
A recent report from CBS News cites numerous issues that accompany addiction, one of the most surprising of which is an impact on the U.S. labor force.
“Except for people 55 and over, Americans of all age groups are less active in the labor force than they were in 2001,” the report claims. And CBS postulates that the discrepancy is due to the number of “prime-age workers” who spend time managing their opioid addiction rather than looking for jobs in today’s healthy job market.
Further, some patients who rely on opioids to manage their pain have reported that it is increasingly difficult to acquire prescriptions due to the high rates of opioid addiction. While doctors shouldn’t be indiscriminate when prescribing opioids, patients who rely on the drugs to manage their pain also shouldn’t be treated like criminals or junkies looking for a fix.
Final Thoughts
Medical marijuana and psychedelics may be key to solving the opioid epidemic, but we have a long way to go. Medical cannabis remains illegal at the federal level, despite the 31 states (and Washington, D.C.) that allow it. Many medical facilities are calling for wider availability of cannabis products in hospitals, and CBD use for pain management is becoming increasingly widespread. Whether CBD is truly a solution to the opioid epidemic remains to be seen.
