How did Prescription Opioid Addiction Become an Epidemic?
Whether or not you know it, there has been a growing epidemic in the United States. Over the past few decades there has been an explosion of narcotic abuse, and a large portion of people have become addicted to prescription opioids. At least 1.9 million Americans over the age of twelve years old are addicted to these pain relievers.1
In 2015, there were 18,893 overdose deaths related to prescription pain relievers.2 These numbers show no signs of slowing, which begs the questions: How do we stop this deadly trend?
The first step towards reversing this cycle of drug abuse is to understand the root of the problem.
What are opioids?
The word Opioid was originally coined in the 1950's to describe a class of substances that were "opium-like."3 Opium is derived from the flowering opium poppy and it is one of the oldest man-made products in the world. It is often used to produce drugs like heroin and can be extremely addictive.
Prescription opioids are made from natural or synthetic substances that bind with opioid receptors in the brain. These drugs have a host of effects, most notably they are able to relieve pain and induce euphoria.
Why are they prescribed?
Opioids like hydrocodone, oxycodone, morphine, and codeine are often prescribed by medical professionals for a variety of pain or injury related conditions. In the last twenty-five years there has been an upsurge of these prescriptions. In 1991 there were around 76 million opioid prescriptions written, and in 2013 that number hit 207 million.4 What is especially concerning is that the United States accounts for nearly 100% of the world total use of hydrocodone and 81% for oxycodone.5
How can their use be a problem?
According to the American Society of Addiction Medicine, addiction is a primary, chronic and relapsing brain disease characterized by an individual pathologically pursing reward and/or relief by substance use or other behaviors. Opioids are very potent and extremely addictive.
Many people that are given prescription painkillers for temporary conditions end up with a physical need for the substance. Unlike heroin or crack, these drugs don’t need to be injected, smoked, or prepared. This makes prescription opioids easier to ingest and their abuse easier to hide.
How do we know that there is a problem?
By the year 2002, prescription opioid abuse had become so prevalent that it was listed as a more common cause of death than heroin or cocaine.6 What is just as frightening is the rate at which abuse of these substances is growing. In 2014, there was a 14% increase in opioid overdose deaths year over year.7
This graph depicts the alarming rise in abuse of opioids.
Courtesy of the CDC8
What do the next steps look like?
In 2016, president Obama announced a plan to tackle opioid abuse in the United States. “We live in a society where we medicate a lot problems and we self-medicate a lot of problems...”9
A large part of curbing the rise of prescription opioid addiction will be changing the way that we treat injuries. Early intervention strategies that focus on functional improvements soon after an injury will become more prevalent as doctors rethink prescribing courses of bed rest and pain medication.
 Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.
 Center for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File. (2015). Number and Age-Adjusted Rates of Drug-poisoning Deaths Involving Opioid Analgesics and Heroin: United States, 2000–2014. Atlanta, GA: Center for Disease Control and Prevention.
 Paulozzi et al. Increasing deaths from opioid analgesics in the United States Pharmacoepidemiol. Drug Saf., 15 (2006), pp. 618–627