What are Opioids?
Opioids are highly addictive pain relieving medications that act on the nervous system. When used in a medical capacity, opioids are primarily used for pain relief, including anesthesia. Opioids include the illegal drug heroin, synthetic opioids such as fentanyl, and legal pain relievers such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.
What’s the Problem?
Since 1999, the number of prescription opioids drugs sold in the U.S. has nearly quadrupled. During this same period, deaths from prescription opioids have also more than quadrupled.
Lawsuits are piling up in courts across the country filed by family members and other loved ones who claim that doctors, pharmaceutical companies, and “pill mills” took advantage of patients, got them addicted to opiates, and cost U.S. taxpayers millions of dollars.
Which Medications are Opioids?
- Codeine (generic form only)
- Fentanyl (Actiq, Duragesic, Fentora, Abstral, Onsolis)
- Hydrocodone (Hysingla ER, Zohydro ER)
- Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
- Hydromorphone (Dilaudid, Exalgo)
- Meperidine (Demerol)
- Methadone (Dolophine, Methadose)
- Morphine (Kadian, MS Contin, Morphabond)
- Oxycodone (OxyContin, Oxaydo)
- Oxycodone and acetaminophen (Percocet, Roxicet)
- Oxycodone and naloxone
One of the major problems with opioid medications is their easy availability. In 2010 alone, an estimated 210 million prescriptions for opiates were dispensed. Prescription opiate abusers are now far more likely to eventually develop a heroin addiction than a non-opiate abuser, as heroin offers a similar high at a cheaper price.
Signs and Symptoms
Physical signs that a person may be abusing opioids include:
- Noticeable elation/euphoria
- Marked sedation/drowsiness
- Constricted pupils
- Slowed breathing
- Intermittent loss of consciousness
Other signs of possible opiate addiction may include “doctor shopping” (getting multiple prescriptions of the same drug from different doctors), shifting moods dramatically, extra pill bottles laying around the house / in the trash, social withdrawal / isolation, and sudden financial problems.
- Nausea and vomiting
- Inability to sleep
Opioid Epidemic Worsening: CDC Video
Opioid Overdose Symptoms
- Confusion / delirium
- Beady eyes
- Extreme sleepiness / inability to “wake up”
- Loss of consciousness
- Breathing problems (slowed or irregular breathing)
- Respiratory arrest (absence of breathing)
- Cold, clammy skin, or bluish skin around the lips or under the fingernails (jaundice)
Opiate Epidemic Statistics
- Over the next decade, it is estimated that more people in the U.S. will die from opioid overdoses than the total number of American soldiers killed in World War II.
- In 2015, there were 91 opioid overdose deaths per day.
- In 2016, 66% of drug overdose deaths involved an opioid.
- U.S. sales of prescription opioids quadrupled from 1999 to 2014.
- Drug overdoses are the leading cause of death for Americans under 50.
- The number of overdose deaths on fentanyl and synthetic opiates more than doubled, from 9,580 in 2015 to 19,413 in 2016.
Opioid Lawsuits Allegations
- Unjust Enrichment – A lawsuit filed by McDowell County, West Virginia, aims to hold 3 drug wholesalers accountable for their part in the opioid epidemic: McKesson Corp., Cardinal Health, and AmerisourceBergen Drug Co. The complaint alleges negligence, state code violations, and unjust enrichment on the part of defendants. It claims that, in addition to spreading “addiction and destruction,” these companies have caused and will continue to cost the surrounding counties substantially in dealing with the consequences of the opioid epidemic that was fueled by defendants’ illegal, reckless and malicious actions.
- Physicians and Pharmacies Caused Addiction – Dozens of lawsuits filed in courts across the U.S. allege that “a veritable rogue’s gallery of pill-pushing doctors and pharmacies” caused or significantly contributed to the plaintiffs’ addictions to controlled substances. The suits claim that by prescribing these powerfully addictive drugs, defendants caused the plaintiffs to abuse the opioids and even engage in criminal activity to obtain them. In many cases, plaintiffs lost jobs or wages as a result of their addictions.
Government Crackdown on Opioid Abuse
President Trump recently went on record stating that he supports pursuing a federal lawsuit against opioid drug makers, along with stricter laws for illegal opioid drug trafficking. Meanwhile, the U.S. Department of Justice (DOJ) is helping local and state governments by providing data about prescription painkiller sales to support opioid lawsuits at the local level.
1861-1865 – Morphine commonly used
1861-1865 – Morphine was commonly used as a battlefield anesthetic in the Civil War. Many soldiers developed morphine dependency as a result.
1898 – Heroin first produced commercially
1898 – Heroin first produced commercially by the Bayer Company. At the time, heroin was seen as less habit forming than morphine, and was actually prescribed to people with morphine addiction as a way to wean off opioids.
1914 – Congress passes Harrison Narcotics Act
1914 – Congress passes the Harrison Narcotics Act, which requires a written prescription for any narcotic. Importers, manufacturers and distributors of narcotics must register with the Treasury Department and pay applicable taxes.
1924 – Heroin banned in the U.S.
1924 – The Anti-Heroin Act bans the production and sale of heroin in the U.S.
1970 – Congress passes the Controlled Substances Act
1970 – Congress passes the Controlled Substances Act, which creates a schedule of illicit substances based on their potential for abuse. Heroin is classified as a schedule I drug while other opiates including morphine, fentanyl, oxycodone and methadone are schedule II.
1980 – Letter published in the New England Journal of Medicine
1980 – A letter entitled “Addiction Rare in Patients treated with Narcotics” is published in the New England Journal of Medicine (NEJM). This was not a study, but rather an exploratory article that examined incidences of addiction among a very specific subset of hospitalized patients. This article would become widely cited as proof that opioids were a safe treatment for chronic pain.
1995 – OxyContin marketed as safe
1995 – OxyContin, a more powerful and longer acting form of oxycodone, is introduced and aggressively marketed as safe by Purdue Pharma.
2007 – U.S. government files criminal charges against Purdue Pharma
2007 – The U.S. government files criminal charges against Purdue Pharma for marketing OcyContin as a safer and less addictive alternative to other opioids. The company and a handful of executives plead guilty, and agree to pay $634.5 million in fines.
2010 – New form of OxyContin approved
2010 – FDA approves a new form of OxyContin that is supposedly non-habit forming. It isn’t.
2015 – U.S. Drug Enforcement Administration makes arrests
2015 – The U.S. Drug Enforcement Administration (DEA) announces that it has arrested 280 people, including 22 doctors and pharmacists, after a 15 month sting operation that focused on healthcare providers who dispensed large amounts of opioids.
2016 – Centers for Disease Control and Prevention (CDC) publishes guidelines
2016 – The Centers for Disease Control and Prevention (CDC) publishes guidelines for prescribing opioids to patients with chronic pain. Recommendations include prescribing over the counter pain relievers like acetaminophen. Individuals who had previously managed their pain through an opioid prescription were now forced to find alternative methods of treatment, as many doctors would no longer prescribe them.
2017 – President Trump declares national public health emergency
2017 – President Trump declares a national public health emergency to combat the opioid crisis, but fails to specify exactly how he plans to deal with the situation.
- Opioids may kill more Americans than World War II. IndyStar. January 25, 2018.
- Timeline of the Opioid Crisis. ColumnHealth.
- “Addiction Rare in Patients Treated with Narcotics”. New England Journal of Medicine (NEJM). 1980.