History of the opioid epidemic

The history of the United State’srelationship with Opioids and Substance Use Disorder is important to understanding how the current public health concern came to be.

Early History

1700s

  • 1775 - Opium becomes available in the United States

1800s

 

  • 1860 - Because of the powerful pain-management properties of Opium, it is implemented as a means to reduces battlefield injuries during the Civil War in the form or Morphine

  • As Morphine moved into the ranks of mainstream medicine, there was a sharp increase in addiction. This was contributed to by the over-the-counter availability and the development of the hypodermic syringe in the mid-1800s.

  • Common over-the-counter products included Heroin, developed by the Bayer company for cough relief and touted as a cure for morphine addiction.

Turn of the Century

1900s

  • Morphine emerges as a primary tool for pain management.

  • 1914 - The Harrison Narcotics Act is passed in response to the increasing number of addicted patients. The use of opium-related products such as heroin, morphine, and laudanum were reaching record numbers. 

 

1920s

 

  • In an attempt to decrease addiction rates, opioids only become legally available to those dying and to treat acute pain.

1950’s to Now

Post World War II, Korean War, and Vietnam veterans experienced higher rates of addiction while being treated for physical and psychological trauma. ​

1980s

  • A short letter to the editor in the New England Journal of Medicine claims that opioids are not addictive to the majority of patients, suggesting that opioids were only addictive if used recreationally and not if used for pain management. This one-paragraph letter was inaccurately cited by many as a definitive study.

1990s

  • Purdue Pharma pushes out a multi-million dollar marketing campaign encouraging the use of opioids as a primary form of pain management, making claims that medications, such as Oxycontin, were safe and non-addictive. 

  • Pain is defined as the “fifth vital sign” by the American Pain Society, a concept later adopted by the VA and the Joint Commission.

2000s

  • Dramatic increases in addiction to opioid substances emerge. 

  • Affected populations include teenagers who are accessing opioids via leftover medications found at home.

2010s

  • Opioid prescribing surpasses rates of the 1990s by nearly 4x

  • 2016 - Opioid overdose deaths reach a record-breaking high. 

  • 2017 - The Opioid Epidemic is identified as a national public health emergency. 

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