How we got here
From 1980 to 2000 use and prescribing of opioids changed dramatically. Beginning with an eleven line letter to the editor appearing in the New England Journal of Medicine, providers and pharmaceutical companies began to promote the use of opioid medications as safe and non-addictive for treatment of chronic, non-cancer related pain. The American Pain Society (funded in part by Purdue Pharmaceuticals, manufacturer of Oxycontin) advocated for “pain as the 5th vital sign.” In 2001, also funded, in part, by Purdue pharmaceuticals, The Joint Commission (an independent, not-for-profit group in the United States that administers accreditation programs for hospitals and other healthcare-related organizations) published a document promoting that pain be treated as “the 5th vital sign” stating, “Some clinicians have inaccurate and exaggerated concerns about addiction, tolerance and risk of death. This attitude prevails despite the fact there is no evidence that addiction is a significant issue when persons are given opioids for pain control.” Given this information and encouragement, physicians felt compelled to change their prescribing practice and embrace opioid medications as necessary treatment. Simultaneously, financial incentives towards patient satisfaction were introduced and measured, and provider compensation was tied with positive satisfaction scores. The climate was ripe for the escalation of opioid prescribing – experts telling providers that the risk is minimal, institutions encouraging more aggressive treatment of pain, and providers getting paid more to make patients happy. Following this false marketing of opioids, and physician incentives, a sharp increase in overdose deaths followed. According to the CDC, from 2000 – 2014, “The rate of deaths from drug overdoses increased 137%, including a 200% increase in the rate of overdose deaths involving opioids.”
Structurally, prescription painkillers and street heroin are nearly identical chemical substances. As a result, the misuse of prescription opiate painkillers such as Oxycontin produces a very similar high to heroin. However, acquiring prescription pain pills illegally is costly, and heroin often becomes a cheaper alternative for someone who is misusing opiates. Legally obtained prescription pills can lead to opiate use disorders quickly, and it is nearly impossible to ascertain if one person is more susceptible than another. What is known is that most people who use heroin started by misusing prescription pain pills.
Through community outreach and engagement, we hope that Dying in Vein will bring awareness and understanding to this deadly public health crisis. By breaking down stigmas and misconceptions, and bringing addiction out of the closet, more people will have access to the resources they need to get well.
Talk about addiction. It's a disease.
Links to articles/resources
- CDC, for the most up to date stats and info on opiate and overdose info. https://www.cdc.gov/drugoverdose/index.html
- Alberta Family Wellness Initiative
- National Institute on Drug Abuse
- Utah Naloxone http://www.utahnaloxone.org
- Dear You Film http://www.dearyoufilm.com/aim-1/
- SAMHSA, Substance Abuse and Mental Health Services Administration https://www.samhsa.gov/recovery
- “Dear you” Short film that hopes to “raise awareness about both the current opioid and drug overdose epidemic in the USA and the existence of Naloxone” http://www.dearyoufilm.com