Opioid Crisis in America

Table of Contents

Introduction to Opioid Crisis in America
Sociological Profile of Opioid Crisis in America
Beneficiaries of Opioid Crisis in America
Government Actions on Opioid Crisis in America
References on Opioid Crisis in America

Introduction to Opioid Crisis in America #

The opioid crisis in America is a major public health problem in the United States. On average, 130 Americans die each day from an opioid-related overdose, which has become the leading cause of preventable death before the age of fifty, far ahead of traffic accidents and gun deaths. Since 2000, the consumption of opioids, in different forms (drugs legally prescribed, used in a backdoor or bought on the black market), has caused more than 300,000 deaths by overdose: it is an unprecedented health crisis.

The current epidemic is characterized first and foremost by the rapid increase in opioid overdose mortality, which each year reaches a new record. In response to the panic triggered by the spread of this epidemic, President Trump declared the state of Awareness of the problem and the public responses put in place are therefore relatively recent, while the origins of the epidemic date back to the 1990s. We can indeed identify several expansion phases of the opioid epidemic.

The Essay on opioid crisis in america first corresponds to the broadening of the prescription of opioid-based painkillers to all types of chronic pain: products long reserved for the treatment of cancers have thus been prescribed more widely, in particular oxycodone, which has been put on the market. from 1996, which was the subject of a real commercial campaign with a lot of marketing and influence strategies to encourage physicians to prescribe and patients to consume more and more strong opioids.

The second phase of the epidemic resulted in an extension of the consumption of these opioids outside the medical framework: some patients, who became dependent on opioids, increased and diversified their consumption of opioids, by turning to products that are increasingly strong and dangerous because they are out of control, in particular heroin (available on the black market) and certain synthetic opioids (in particular fentanyl, an opioid a hundred times more powerful than morphine , consumed as a medicine but also sold on the internet as counterfeit products made in China).

This crisis is therefore explained both by the increase in requests for pain management but also by a commercial strategy to increase the supply in the specific American context where the drug monitoring system is relatively unconstrained. and where advertising for medicinal products is authorized (whereas it is prohibited in other countries, in particular in France), as well as promotional operations (reduction coupons for the purchase of boxes of medicines, for example). We can therefore speak of an epidemic that was created by an abuse of prescriptions on the one hand and drug promotion practices on the other: this is what makes this phenomenon quite unique.

Sociological Profile of Opioid Crisis in America #

Unlike previous drug epidemics in the United States, which mostly affected precarious and racialized urban populations (like crack cocaine in the 1990s), the opioid epidemic first hit rural whites. Today, an opioid dependent child is born every 19 minutes (these babies with neonatal abstinence syndrome are called “heroin babies”).

It also has the particularity of reaching more women, in particular from the middle classes. In general, the opioid crisis is distinguished by the fact that it affects a certain number of “unusual” audiences, for example working mothers or new-borns who are victims of a withdrawal syndrome at birth due to the fact. mother’s drug addiction during pregnancy: today, an opioid dependent child is born every 19 minutes (these babies with neonatal abstinence syndrome are called “heroin babies”).

Even if the profile of the victims of the crisis has diversified over the past twenty years and now affects all categories of the population, the opioid crisis appears to be a social phenomenon that primarily affects adults (aged 25 to 50), whites, from the impoverished middle classes (working poor or unemployed) and the white working class of rural areas, who represent part of the electoral base of D. Trump, especially in the Midwest. The health crisis has also been a campaign theme of the 2016 presidential and Trump got very good scores in most areas bereaved by the wave of “despair of the dead” (death of despair ) related opioids – to use the concept created by Anne Case and Nobel Laureate in Economics Angus Deaton.

Beneficiaries of Opioid Crisis in America #

In terms of turnover, the main beneficiaries of this epidemic have been the pharmaceutical companies producing strong opioid drugs which, to optimize their commercial profits, have relied on an all-out development strategy (targeting both prescribing doctors and on patients). But this success was accompanied by a legal backlash because these companies were ordered to pay heavy fines for false advertising. On the other hand, the Mexican drug cartels were undoubtedly the big winners of this epidemic, which they took advantage of to revive and take over the street heroin market. The Mexican drug cartels have undoubtedly been the big winners of this epidemic, which they have used to revive and take over the street heroin market.

Finally, Chinese clandestine laboratories producing synthetic opioids (such as fentanyl and its derivatives) have also taken advantage of this epidemic. President Trump has urged Chinese President Xi Jinping to better control fentanyloid exports to the United States and to punish manufacturers with the death penalty. These observations underline the need for a reflection on effective and coordinated regulatory policies at the international level, to control the trafficking of narcotics but also of diverted drugs or synthetic drugs (which are not classified as narcotics but which mimic the effects of known substances).

Government Actions on Opioid Crisis in America #

The opioid epidemic has forced the United States federal government to think about a better adapted public health policy, taking into account the needs of pain management, planning to develop risk reduction to slow the rate of progression epidemic and improving monitoring of pain medication. Faced with “the worst drug-related crisis in the history of the United States”, President Trump declared a state of health emergency in October 2017 but without budgeting for the budgetary means to meet the challenges of access to healthcare. care of the population (in particular those who do not benefit from sufficient medical coverage). A number of emergency measures have nevertheless been taken,

However, the level of engagement in the management of this crisis depends largely on local initiatives, that is to say on the will and finances of each State. Which means that the answers are disparate across the country. Thus, only 32 states out of 50 have introduced the “good samaritan” rule which guarantees people who come to testify about a patient overdose that they will not be prosecuted. Likewise, several states – but not all – have limited the number of pills a doctor can prescribe. Other states have created a database of prescriptions so that a patient cannot go and collect prescriptions from several doctors (medical nomadism, called doctor shopping). Even today, the consumption of heroin and crack is confined to vulnerable populations, despite a certain increase in the festive uses of heroin. Responses therefore remain localized and limited in certain states, in the absence of a national emergency plan.