The Catastrophic Effects of the Opioid Crisis


The media spreading the word about the monstrous opioid crisis seems to be looking at the problem with tunnel vision. They scream about the deaths, or the costs of treatment.  Yes, these are tragic, but they create a chain reaction that result in even more horrendous devastation on society, families, and the economy. Let’s take a look at them. But first, what are opioids and how does it cause addiction.

Opioids

What if you had back pain and your doctor casually scribbled out a prescription for Oxycontin, or Fentanyl and said nothing about side effects. Trusting, you took the pills, felt amazing, and when you finished the dosage, discovered you craved more, so you got a refill.  I am sorry, but you were done for.  You were addicted. You took it because the good doctor would never have given you something harmful to ease the pain in your back, right? You didn’t do it because you wanted to get high. Now your life has changed and is out of your control. What happened?

​​​​How Does it Cause Addiction? 

Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain.

The drug enters the brain through the bloodstream, creating a flood of artificial endorphins and dopamine — neurotransmitters responsible for feelings of reward, pleasure and satisfaction. This creates a rush of happiness and euphoria. This high is so unlike any naturally-occurring rush of dopamine or endorphins that the only way a person can experience it again is by using the drug again.

After repeated use, however, the brain will stop creating dopamine and endorphins, limiting a person’s ability to experience these feelings again to only when they use opiates. Because of the strong and desirable feelings that flood the brain, and because they cannot feel pleasure naturally any longer, it is easy to crave an opiate high. People choose to abuse opiates in order to lessen their pain and continue experiencing these euphoric feelings on demand. (The Recovery Village, Personalized Addiction Treatment)


Consequences

Drug overdoses killed about 72,000 Americans in 2017, a record number that reflects a rise of around 10 percent, according to new preliminary estimates from the Centers for Disease Control. The death toll is higher than the peak yearly death totals from H.I.V., car crashes or gun deaths.

Analysts pointed to two major reasons for the increase: A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year. From New York Times article by Margot Sanger-Katz,   Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017.

Seventy two thousand!  The size of a decent sized city. That many Americans DEAD from drugs, and the loss of these people who would otherwise be productive members of society, is only the tip of the iceberg when looking at the big picture of the devastation that drugs have on the American culture, health, economy and overall well-being.  So what else?  Here comes the rest, or part of it.

Some Bloody Statistics

“Of the 20.5 million Americans 12 or older that had a substance use disorder in 2015, 2 million had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin. It is estimated that 23% of individuals who use heroin develop opioid addiction. National Opioid Overdose Epidemic Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.” American Society of Addiction Medicine.

4.5 Million Americans on Non Medical Opioids

According to the 2013 National Survey on Drug Use and Health, 4.5 million individuals in the United States were current non medical users of prescription opioids and 289,000 were current users of heroin. The leading causes of death in people using opioids for nonmedical purposes are overdose and trauma. The injection route use (intravenous or even intramuscular) of opioids or other drugs increases the risk of being addicted. And According to the recent NY Times article, it is getting worse. Another source estimates the cost could be up to a trillion in costs in just a few years in medical alone unless contained.

More Provocative Data on Prescription Painkillers

  • The US makes up 5 percent of the world’s population and consumes approximately 80 percent of the world’s prescription opioid drugs
  • Prescription opioid drugs contribute to 40 percent of all US opioid overdose deaths.
  • In 2016, more than 46 people died each day from overdoses involving prescription opioids.
  • Prescription opioid overdose rates are highest among people ages 25 to 54 years.
  • Overdose rates were higher among non-Hispanic whites and American Indians or Alaskan Natives.
  • Men are more likely to die from prescription opioid overdose, but the gap between men and women is decreasing.
  • Because of its cheaper price, heroin has become the drug of choice for many who are addicted to opioid pain relievers. Approximately three out of four new heroin users misused prescription opioids prior to using heroin.
  • More than half (53 percent) of prescription opioid users got their last painkillers from a friend or relative, with 40.4 percent paying nothing for the pills.
  • There are Worst Consequences than Death

    If death isn’t bad enough, what about the costs to the living, to our economy, our productivity, health and our children. Each of these will be taken up in turn. 

    Societal Costs

    Two studies were made to estimate the approximate societal costs incurred by the crisis.  It seems that these carefully studied costs came in six time higher than those previously estimated and given to the president for consideration and action.

    The first is from researchers at the Centers for Disease Control and Prevention (Florence et al. 2016), and the second from the White House Council of Economic Advisers (CEA 2017). The study by Florence and coauthors aggregates nonfatal costs — that is, spending on health care and substance abuse treatment, criminal justice costs, and lost productivity — associated with abuse and misuse of opioids. CEA builds from that estimate and adds the societal burden of fatalities from opioid overdoses, estimating the nonfatal costs of the opioid epidemic in 2015 to be $72.3 billion and the fatal costs to be $431.7 billion for a total cost of $504 billion.Alex Brill@AlexBrill_DC, January 16, 2018 AEIdea

                    $504 billion dollars?  For one the year 2015 alone? 

                His analysis shows that the nonfatal per-capita economic burden of the opioid crisis is highest in the District of Columbia ($352 per resident) and lowest in South Dakota ($162 per resident). Adding fatalities, as CEA did, gives West Virginia the highest per-capita burden ($4,793 per resident) and Nebraska the lowest ($465 per resident). A table that provides a state-by-state breakdown of total costs, per-capita costs, and costs as a share of state GDP is made a part of this study and attached.

    And the Top Five Winners (Losers) Are:

    West Virginia, New Hampshire, Ohio, Maryland and Washington DC, ranked, according to most deaths per 100,000 and prescriptions per 100,000 persons.

    State

    Opioid-Related Overdose Deaths/100,0001(2016)

    Opioid Prescriptions/100,000 persons2 (2015)

    West Virginia

    43.40

    110.00

    New Hampshire

    35.80

    66.60

    Ohio

    32.90

    85.80

    Maryland

    30.00

    65.60

    Washington D.C.

    30.00

    70.00

    State Opioid-Related Overdose Death Rates and Opioid Prescribing Levels

    National Institute of Drug Abuse

    Other, Perhaps More Serious Effects

    No study has really taken into account the way opioid dependency is impacting the economy by its effect on labor force participation. What about absentee workers, the loss of hours at work and resulting decline in real output.  One study found:

    In 2015, 919,400 prime-age individuals were not in the labor force due to opioids.  Between 1999 and 2015, the decline in labor force participation cumulatively cost the economy 12.1 billion work hours; and. during that period, the reduction in work hours slowed the real annual economic growth rate by 0.2 percentage points, cumulatively costing $702.1 billion in real output. Ben Gitis, Director of Labor Market Policy, American Action Forum. 
    https://www.americanactionforum.org/research/labor-force-output-consequences-opioid-crisis/#ixzz5RO4oCQcx

    Actual Productivity

    When a worker on drugs actually shows up for work, how much is he, or she, worth?  How does the fogginess and “out to lunchness” from the drugs affect the quality of the work and thus its productivity and real value.  How many mistakes do they make?  How much machinery or supplies and equipment gets destroyed or damaged because of inattentiveness?  What about work that is actually done or turned in that is defective or just plain bad result? How much waste occurs?  These issues are not factored in for they cannot be reasonably quantified or qualified in terms of hours or dollars but we all know what it is like working with someone who is a potential trouble source whose mistakes cost you in many ways. They are literally sick people, not hitting on all cylinders and are dangerous to be around and work with.

    Quality of Life

    Let’s take a look inside the addict’s home.  It is probably beyond comprehension as to what the spouse and children have to experience every day of their lives.  The addict is stupid, usually volatile and crazed for drugs if they aren’t available, and if available not contributory around the house to fix things, prepare meals, take care of the children (especially babies and toddlers), causing repercussions in those children’s lives that will last them a lifetime of mental scars and bruises that live like baggage affecting their decisions and happiness -  all because one of the parents, or children, are addicted.

    Here Are Some Big Ones:  A DEVASTATING TOLL ON CHILDREN

    8.7 million children nationwide have a parent who suffers from a substance use disorder! Of these, 85.4% of people suffering from drug dependence or abuse to untreated. These parents often neglect the child or children and welfare has to step in and remove the endangered or neglected child to a foster home. How many do you think are removed from your state a year?  In this article I provide a table that gives you these facts for your state and all fifty of them. This table shows the amount spent per state on drugs per death, cost if no death but addiction, cost to the economy, number of children reassigned to foster homes and the number of children affected by HIV and other diseases.

    270,000 Children in Foster Homes in 2016 Because of Drugs

    According to a bulletin from the American Academy of Pediatrics, 270,000 children in the US were placed in foster care in 2016. Nearly 1 in 5 were infants. In more than 1/3 of these placements, parental substance use was a factor - second only to neglect.  This has a lifelong impact on these children. Children dealing with traumatic experiences can face social, emotional, physical and mental health challenges that last into adulthood. Without help, this serious adversity can lead to school failure, alcohol and drug use, and increased health conditions like obesity and heart disease.

    Addicted at Birth

    Every 25 minutes a baby is born suffering from opioid withdrawal which can mean lower birth weights, respiratory conditions, feeding difficulties, seizures, generalized susceptibility to disease, longer hospital stay and a life of misery and unthinkable problems inflicted on these innocent babies.

    Now Heap Another Load on These Little Ones

    A baby can become infected with HIV in the womb, during delivery or while breastfeeding. If the mother does not receive treatment, 25 percent of babies born to women with HIV will be infected by the virus. With treatment that percentage can be reduced to less than 2 percent, according to the March of Dimes. But when the mother is an addict, or under the influence of drugs like opioids, she can be careless and not use a condom, or not  attach it properly, or has a variety of lovers, or cannot manage her business while under the influence, so is a candidate for HIV and AIDS if she is an addict. Thus if she is or she becomes pregnant, one out of four will pass her disease on to her baby.

                What worse punishment can an irresponsible parent inflict on a newborn child?

                As you can see, there are many devastating repercussions from being an opioid or just plain drug addict, whether it is opioids or not.  But with the proliferation now, the odds are the addict is on one of the forms of the opioids, and it is getting worse every day.