How the opioid epidemic began and why our society is to blame

Recently, President Donald Trump made a series of bold new statements about the government’s latest response to the deadly opioid epidemic sweeping the nation. While his impassioned speech promised that this “can be the generation that ends the opioid epidemic,” his limited 90-day public health emergency does little to address the crisis that claimed the lives of 64,000 Americans in 2016 alone.

The announcement came months after his August 11th statement that promised the federal government was going to “use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.” While his newest declaration will take some small steps to combat the growing crisis, including granting rural patients access to addiction medication via tele-medicine and allowing certain federal agencies to redirect existing grant money to patients battling addiction, it does not ask Congress for expanded funding for treatment. It does not ask for increased insurance coverage for struggling addicts. 

For many, this limited order is little more than a bandaid over the bullet hole that is the opioid epidemic.

People around the country are still left wondering: how did this crisis begin and who is to blame for its utter destruction?

Trump's essentially got a five step program to stop the opioid crisis. Step four? Build a wall. pic.twitter.com/EjxBT0Al2o

— VICE News (@VICENews) October 27, 2017

“The opioid addiction disaster is the product of a well-coordinated institutionalized effort on the part of a dozen Fortune 500 pharmaceutical manufacturers and distributors, explains Mike Papantonio, author, lawyer, and host of Ring of Fire radio show with Robert F. Kennedy Jr. and Sam Seder.

Papantonio continues, “None of this took place by mistake. At the very time that the corporate drug pushing infrastructure recognized that opioids were being dramatically abused, those same corporations began to build that drug abuse into their business plan.  There is no argument here that none of this was foreseeable as we often hear from the corporate drug pushers.  After the first two years of the American opioid flood, the industry saw their profits increase to multi-billion dollar levels simply by creating the myth that opioids could be used not only for acute short-term pain, but for chronic limitless long-term use.  Once that industry began to calculate profits, there was no turning back even while they saw the addiction crisis become worse year after year.”

It’s no secret that big pharma has played a huge role in the growing crisis, but according to Papantonio, “The opioid catastrophe, along with being laid at the feet of the pharmaceutical industry, should also be laid at the feet of regulators and politicians more interested in protecting the rights of big business rather than the rights of consumers.”

Many in the media are quick to blame doctors and medical professionals for the growing epidemic, but Papantonio argues that doctors were also victims of the aggressive misinformation campaign produced by big pharma — or as he calls it, the corporate drug cartel.

“Because there was so little discussion about the epidemic, the opioid drug industry was able to hire science biostitutes in some of America’s most prestigious universities who were willing to create [phony] scientific literature that clearly declared that long-term use of addictive opioids was not real,” he explains.

Nancy Pelosi questions the value of Pres. Trump's opioid declaration: "Show me the money." https://t.co/jiMxWceLkJ pic.twitter.com/q4vrZhnwi8

— ABC News (@ABC) October 29, 2017

As the opioid crisis has become more and more obvious over the last decade, several regulatory agencies — including the DEA, FDA, SEC, and EPA — have attempted to take some control of the epidemic. But Papantonio argues they have all been seized by the industry:

“As a public policy, we should be comfortable believing that regulatory entities have control over industry, however, that is far from a reality in a 2017 America. Unfortunately, no significant cultural change will take place in how the pharmaceutical industry operates in the U.S. and around the world until we find ourselves as willing to incarcerate a Wall Streeter in an Armani suit as we are a teenager in a hoodie.”

The Trump administration may have declared the opioid crisis a public health emergency, but the newest order does very little to address the legal obstacles and policy practices protecting the big businesses who helped ignite this growing problem.

It seems to do even less to assist addiction specialists, medical professionals, and the pain patients that they’re treating.

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According to the co-founder and Chief Medical Director of the Laser Spine Institute, Dr. Michael Perry, the opioid addiction problem begins with how the United States looks at and responds to pain and injury. He believes we need to “stop treating the symptom, and work harder to find the source: Physicians have too frequently treated pain symptoms with the simple stroke of a pen, signing a prescription for opioids. All too often in our busy practices, we become shortsighted, treating the symptom and neglecting the big picture…[T]his method is not a cure-all. Medicine needs to focus its energy and resources on further research into the mechanisms of pain, finding better ways to treat and combat a condition that at one point affects every one of us.”

Mariel Hufnagel, Executive Director of the Ammon Foundation, a philanthropic organization that supports patients in addiction recovery pursuing education, says:

"America consumes 80% of the world's opioids but comprises only 10% of the world's population. Providers are quick to prescribe a pill instead of addressing the causes of discomfort and prescribing therapies to ameliorate the root of the problem."

Andrew Hauput, Ammon’s Head of Product and Marketing, goes even further: “The medical community also needs to take responsibility here. Patients in pain see their medical provider as a figure of authority and will loyally follow doctor’s orders…American doctors are overprescribing opioids, but limiting this is an obvious step […] It has to be all hands on deck – politicians, hospitals, educators, doctors, and treatment centers – in order to stop the cycle of abuse and addiction.”

Another culprit responsible for the opioid epidemic is the way Americans, particularly those in the media, see and talk about addiction and addicts.

Too often, addiction is discussed in terms of will power or control, rather than in medical terms of disease. Our society — including the media and the medical field as a whole — places the responsibility of recovery almost entirely on the patient. This ideology ignores the fact that, like a cancer or diabetes patient, they have no control over their illness.

“It’s a shared responsibility on the medical industry as a whole," Dr. Perry adds. "That’s probably one of the most difficult things for my peers to admit — but is an urgently needed first step in confronting this modern-day epidemic.

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For many addicts, recovery on their own is not an option, and despite popular public opinion, drug use is not a choice. Addiction is a disease, and one that requires medical attention and continued treatment. That treatment, however, is often limited to those who can afford it privately, without the help of their insurance companies or federal funding.

Without access to this kind of treatment, opioid users across socioeconomic lines nationwide continue to stay addicted to medication that was originally intended to help them heal.

“The media tends to focus on the poorest communities,” explains Mindi Levins-Pfeifer, LCSW and Liz Gomez, MSW, of Sober College. “[T]he opioid epidemic is perceived as a person shooting heroin when in reality it could simply have started with pain medication for medical necessity. This could include star athletes…forced to push through pain to get the win…There are those who suffered from an accident; [there are] post-surgery patients. It doesn’t always start off as an addiction.”

Whether one’s opioid dependency begins through prescribed pain killers or street drug use, addiction is a chronic illness that requires long-term care. “There is not a quick fix,” says Levins-Pheiger and Gomez. “Long-term care costs money and takes time.”

Unfortunately, accessing that care is only getting more and more difficult for patients across the country, and the lack of access only makes the crisis bigger and harder to control. There are not enough beds available to addicts in need, and only 1 in 10 patients receive the medical attention their disease requires

the headline nobody has guts to run today: "Trump vows not to spend one additional dollar on opioid epidemic"

— Eric Boehlert (@EricBoehlert) October 27, 2017

As  Michael Castanon, the CEO and founder of Luminance Recovery Center, explains, “It is critical that someone detox in a medically supervised environment. Aside from helping the client ease their discomfort during withdrawal, depending on the severity and length of drug use, detox can be deadly…Many of our clients have turned to drugs because of a trauma, and to overcome this trauma long-term, it really does require help from a variety of trained and specialized professionals.”

But according to Castanon, the biggest challenge facing treatment facilities is trying to set up recovery treatment with interested patients whose insurance coverage falls short of their needs.

What’s more, there are not enough legitimate, affordable, or accessible treatment centers. Castanon goes on to explain that the reasons for the lack of accessible clinics is both political and cultural. “So many cities do not want treatment centers in their town. Neighborhoods do not want sober living or rehabs in their neighborhoods,” Castanon says. “Until city leaders come together and address this most basic issue, many people will continue to not have access to the treatment they need to save their life…While the news media has focused on the epidemic, what has received very little press is: How is society going to solve the problem? Starting with how people view addicts is a very important place to begin.”

It is easy to look at addiction in the limited terms of the addict themselves, but for medical professionals who specialize in addiction treatment — and for the millions of Americans who have watched their loved ones fall victim to the vicious disease — the opioid crisis is not that simple.

It isn’t a matter of choice, but rather a lifelong medical condition whose root cause lies at the feet of pharmaceutical companies who put profit over people, medical professionals who chose treating pain symptoms with pills rather than uncovering the source of the problem, politicians who allow themselves to be controlled by the corporations that fund their campaigns, and a society that refuses to accept addiction as a disease.

As Castanon bluntly puts it, “The truth is that addiction is…a lifelong condition which has to be managed and cared for. This takes time and commitment […] If we wait for the regular political process to follow, many more people will die when we could have saved them.”

Looking back, it’s easy to see the perfect storm that started the opioid crisis, and it’s even easier to point fingers at the parties we think are responsible for it. But, as the idiom goes, every time you point a finger, there are three pointing back at you. Unless we all begin to change the way we talk about, think about, and respond to opioid addiction, we will all be to blame for the epidemic’s endless reign.