Facts about the opioid abuse crisis

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Here are some facts about the opioid crisis: 

A BRIEF HISTORY OF OPIATE LAWS IN THE U.S. 

(Source: https://www.naabt.org/laws.cfm)

• 1909   – Smoking Opium Exclusion Act- Banned the importation, possession and use of "smoking opium". Did not regulate opium-based "medications". First Federal law banning the non-medical use of a substance.
• 1924 – Heroin Act- Prohibited manufacture, importation and possession of heroin illegal – even for medicinal use.
• Various other drug laws were passed until;
• 1970, when the comprehensive Controlled Substance Act/Controlled Substances Import and Export Act were passed. These laws set up the drug scheduling system we still employ.
“These laws are a consolidation of numerous laws regulating the manufacture and distribution of narcotics, stimulants, depressants, hallucinogens, anabolic steroids, and chemicals used in the illicit production of controlled substances. The CSA places all substances that are regulated under existing federal law into one of five schedules. This placement is based upon the substance's medicinal value, harmfulness, and potential for abuse or addiction. Schedule I is reserved for the most dangerous drugs that have no recognized medical use, while Schedule V is the classification used for the least dangerous drugs. The act also provides a mechanism for substances to be controlled, added to a schedule, decontrolled, removed from control, rescheduled, or transferred from one schedule to another.”
• 1973- The DEA was formed by executive order. It replaced the Bureau of Narcotics and Dangerous Drugs.

 

ROOTS OF THE CRISIS

Source: American Journal of Medicine 

• The first decade of the new millennium saw a significant increase in the availability, use, and abuse of prescription opioid medications and the development of an unprecedented drug overdose epidemic.
• This phenomenon is complex and multifactorial in etiology,
o owing in part to increased emphasis on treating pain,
o a push toward the philosophy that opioid pain medications are “safe,”
o insufficient or ineffective oversight,
o and a marked growth in nationwide consumption and demand in the United States.
o As general medical use became more commonplace, so too did nonmedical use.

This parallel relationship led to an estimated 25 million Americans engaging in the nonmedical use of prescription opioids from 2002 to 2011.
• 2010 was the eleventh consecutive year that saw an increase in the number of prescription opioid-related deaths with 16,651 fatalities.
• Put into perspective, in that year, opioid analgesics contributed to more than twice as many deaths as heroin and cocaine combined.
• In 2009, deaths attributed to drug overdose surpassed mortality from motor vehicle collisions for the very first time.
• More than three-quarters of these drug overdose deaths are unintentional.
• Although medication overdoses frequently involve multiple classes of drugs, 4903 of 16,651 opioid deaths (29.4%) in 2010 involved solely the ingestion of opioids, a proportion nearly 3 times higher than fatal single-class ingestions of any other psychotropic or central nervous system medicine.
• From 2002 to 2015 there was a 2.8-fold increase in the total number of deaths.


 

FLORIDA'S NEW CONTROLLED SUBSTANCES LAW:

Bill CS/HB 477

WHAT THE BILL DOES: It’s about more than opiates. Creates harsher punishments for those possessing and/or trafficking opiates and other popular street drugs, as well as making it a murder charge on the dealer if a person dies from the drugs that they bought. The law also makes it a first degree felony to possess 10 or more grams of some schedule 2 drugs, which include Adderall, Roxicodone, hydrocodone, Lortab, Oxycontin, Percocet, Vicodin, and other medically prescribed yet often abused substances. But more specifically, this law:

• Makes it a felony murder charge if a person over 18 is convicted of illegally distributing  ANY controlled substance, including a specified fentanyl-related substance, and that substance is proven to be the cause of death.
• Broadens the scope of Schedule 1 drugs, by including a class of “fentanyl derivatives and five substances that were originally developed for legitimate research but that have now emerged in the illicit drug market.”
• Makes it a first degree felony to unlawfully possess 10 grams or more of certain Schedule 2 substances in including some fentanyl-related substances. 
• Adds codeine, an isomer of hydrocodone, to a current provision punishing trafficking in hydrocodone, and adds additional phenethylamines (PCP) and phencyclidines (Amphetamine, methamphetamine and MDMA, aka ecstasy, aka molly) to current provisions punishing trafficking in phencyclidine and phenethylamine.
• Punishes trafficking in fentanyl, synthetic cannabinoids, and n-benzyl phenethylamines, including mandatory minimum terms of imprisonment and mandatory fines;
• Ranks new trafficking offenses (first degree felonies) in the offense severity ranking chart of the Criminal Punishment Code
• Authorizes certain crime laboratory personnel to possess, store, and administer emergency opioid antagonists used to treat opioid overdoses.
• Provides that cross-references throughout the Florida Statutes to the Florida Comprehensive Drug Abuse Prevention and Control Act (ch. 893, F.S.), or any portion thereof, include all subsequent amendments to the act.

 

OPIATE USE AND UNEMPLOYMENT

(Source: The Atlantic)

• A recent study suggests that unemployment might be one of the factors behind that dramatic rise. The paper, published by NBER , finds that as the unemployment rate increases by one percentage point in a given county, the opioid-death-rate rises by 3.6 percent, and emergency-room visits rise by 7 percent.

• Rather than more people getting injured when jobs are scarce, the authors suspect that the increased use of painkillers is a “physical manifestation of mental-health problems that have long been known to rise during periods of economic decline.” Depression and pain are twin agonies, in other words: Not only does depression make people more sensitive to pain, they note, opioids have been shown to help relieve depressive symptoms.

 

 

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