50 Years Post Controlled Substances Act: The War on Drugs Rages on with Opioids at the Forefront

Abstract

The words “Opioid Epidemic” are not hyperbole or a misguided use of words in describing the scope of this tragedy in the United States and resultant impact on society. Nearly 200 people die each day from a drug overdose, with nearly 70% of those dying from an opioid-related overdose. Roughly two million Americans have a substance use disorder (SUD) related to prescription opioid pain medication. An estimated eight million children live with at least one parent with a substance use disorder. Thirty-five percent of children who entered the foster care system in 2016 were removed from their parents due to parental substance abuse. Between 1999 and 2016, nearly 9,000 children died as a result of opioid poisoning; 88% of those were classified as “unintentional deaths,” five percent were the result of suicide, and two percent due to homicide. When broken down further by age group, nearly one quarter of all children under the age of five who died of opioid poisoning, died as a result of homicide. Undoubtedly, there is a crisis and undoubtedly there is no quick fix.

When a person dies from an overdose, practitioners do not use universal classifications or definitions to determine and record the cause of death; however, according to the Centers for Disease Control (CDC), nearly 40% of all opioid overdose deaths in the United States in 2017 involved a prescription opioid, and roughly one third were due to heroin overdose. Over 47,000 of the roughly 70,000 overdose deaths in 2017 were related to opioids. As a point of reference, opioid related deaths exceeded the number of individuals killed in car accidents for the first time in 2017. Opioids have been touted as a gateway drug and by way of illustration, among those who initially started using heroin between 2000 and 2013, nearly 75% reported having misused prescription opioids prior to starting heroin, compared to the 1960’s where 80% of heroin users in treatment reported starting heroin prior to using any prescription opioids. As a result of the staggering statistics linking prescription opioids directly to overdose deaths and heroin addiction, this article focuses on how prescription opioids created the quagmire our nation is mired in today.

Today, in the United States, opioids include both prescription medications designed to treat pain, such as hydrocodone, oxycodone, and fentanyl, medications designed to treat opioid addiction, such as methadone and Suboxone as well as heroin and illicitly manufactured fentanyl. The opioid epidemic as it is known today, is complex and there is no simple “quick fix” solution.

Keywords: opioid epidemic, opioids, drug abuse, drug policy, drug law, pharmaceutical industry

JEL Classification: K3, I18