Opioids, or drugs that mimic the ingredients of the opium poppy plant have been around for a few decades now. Their chemistry was discovered and isolated back in the 19th century. At the time of their commercial production, they were to be used as painkillers.
According to the Congressional Research Service (CRS), opioids act upon brain receptors that regulate pain and emotions. Natural variants have been used for hundreds of years, an example of which would be morphine.
Today, semi-synthetic and synthetic opioids are being heavily used by Americans, even if these may be illicit. This has inevitably led to a full-blown public health crisis of opioid use disorder (OUD).
In this article, we will delve deeper to understand the complexity of the situation. This may answer why the US continues to struggle despite strict measures in place.
A Public Health Crisis of No Mean Proportions
A precipitous rise in opioid use happened during the 1990s. Pain advocacy campaigns and the hope of greater pain management led people to these drugs. Between 1999 and 2010, the demand for opioids and their use nearly quadrupled across the country.
This is the same period during which an increasing number of opioid-related overdose deaths were reported. It is often referred to as the first wave of the opioid crisis. US officials were alarmed, and that’s when concrete steps were taken to regulate opioid production, including that of fentanyl, heroin, etc.
The current situation is not any better. It continues to float on the crisis levels, demanding immediate attention on national, state, and institutional fronts. Over 107,000 lives were claimed in 2023 due to drug overdose. Given how preventable this scenario is, even one overdose death is one too many.
Equally Questionable Solutions
The World Health Organization (WHO) states that there are different treatment options available for opioid use disorder. Sadly, not even 10% of those needing such treatments can get the benefit. In some developing countries, the main reason could be a lack of accessibility due to treatment costs.
In the US, the problem predominantly lies with the stigma attached to opioid addiction. According to Johns Hopkins Medicine, the belittling and judgmental terms used to refer to people with substance abuse disorder are a major roadblock. It further dismantles the reason why such a stigma exists in the first place.
Society continues to run on the deep-seated belief that addiction is the result of poor willpower and moral failure. People fail to realize that addicts often have the will to recover but not the strength. Besides this challenge, the medications available may pose another problem. Such is the case with a popular drug used to treat OUD – Suboxone.
It has been over two decades since this medicine received Food and Drug Administration (FDA) approval. Even so, its side effects are quite discouraging in the face of existing issues. According to TruLaw, patients have sustained severe dental injuries like decay, infection, and tooth loss.
In most cases, they were completely oblivious to the aforementioned complications. As a result, costly corrective procedures have had to be performed. This made it imperative to start the Suboxone lawsuit, now filed by over 10,000 individuals. The manufacturer, Indivior, has been criticized for keeping profits over public welfare.
Where Are the Drugs Coming From?
By drugs here, we are not referring to Suboxone and other medications used to treat OUD, but the opioids. Since the problem and its ‘alleged’ solution nullify the outcome, the US must rely on restricting opioid entry and circulation.
As per the officials, most of the fentanyl brought inside the US is smuggled via the Mexican border. Small quantities are smuggled through pedestrians or vehicles so the drugs can be easily concealed. The mean weight seized to date has been a meager 2.6 pounds. However, the same may contain nearly 50,000 lethal doses.
By the end of 2023, over 27,000 pounds were caught being smuggled via the southern US border. Earlier, China had been the dominant source of fentanyl within the US. That came to a stop when production was banned in 2019. Even now, the narcotics smuggled via Mexico are made using chemicals produced in China.
What’s even more alarming is the fact that a significant percentage of opioid traffickers are American citizens. One of the two major narcotic-producing cartels, Sinaloa Cartel, announced that it would be moving away from fentanyl trafficking in October 2023. Is there any genuine basis to believe such a transition? This is the question troubling US officials.
US Struggles to Close the Floodgates on Opioids
America’s struggle to put a complete ban on narcotics has been ongoing for decades. Since most of the smuggling is done through Mexico, the US even offered $3.5 billion as counternarcotics aid between 2008 and 2021.
Despite it all, deaths related to heavy opioid use continue to rise within the country. Policymakers are compelled to make a drastic shift in drug policy. In late 2021, President Joe Biden declared opioid trafficking to be a national emergency. By late 2023, 25 different China-based companies were sanctioned as producers of precursor chemicals for fentanyl.
Moreover, Mexico is under pressure from the US to crack down on narcotic-producing labs. In November 2023, separate agreements were made with the Mexican and Chinese Presidents to prevent the production and distribution of illicit fentanyl.
The FDA even approved the naloxone nasal spray in March 2023 for overdose cases. This may seem like a significant step but accessibility and cost challenges ruled it out from being a panacea.
Researchers are still looking for alternative approaches such as intensified border inspections, tighter regulations, supervised consumption sites, etc. As of now, the floodgates on fentanyl and other illicit narcotics are still open.
As we just discussed, the US is stuck between a hammer and an anvil. It is desperately making efforts to curb the opioid health crisis. However, drug circulation is still not under control. On the other hand, the treatment options are far from satisfactory.
Amid such tension from both ends, the Centers for Disease Control and Prevention (CDC) shared some stats that may offer a glimmer of hope. Its data revealed that the number of synthetic opioid overdose deaths dropped in 2023 compared to the previous year.
The same remains high for cocaine and psychostimulants. In a nutshell, it signifies that the US has come a long way, but still has much distance to cover.