The experiences of a young adult taking the drug Vicodin after a wisdom tooth operation and of another person injecting heroin into their blood stream may appear like drastically different scenarios.
But while both drugs are opiates — drugs with morphine-like effects derived from opium — and have similar effects and processes in the brain and body, one is the symbol of the nationwide opioid epidemic and the other is a commonly prescribed pain medication.
Although there is little evidence to suggest that heroin use across the country is skyrocketing, the widespread prescription of over-the-counter opiates like Vicodin or Morphine is the main driving force of what has been dubbed America’s “opiate epidemic.” As with heroin, prescription opiates activate receptors in the brain, and it is this surge of dopamine that places people at risk for repeat use.
“Synthetic opioids, like heroine, work exactly the same in the body as their natural counterparts, opiates, except they last slightly longer in the body,” Italo Mocchetti, Vice Chair of Georgetown’s Department of Neuroscience explained in an interview with The Hoya.
Around 80 percent of heroin users began by misusing prescription drugs. According to Nour Al-muhtasib, a Doctor of Philosophy candidate at Georgetown’s Department of Pharmacology, 21 to 29 percent of those prescribed Vicodin or Percocet become addicted, and 4 to 6 percent of those who abuse these prescriptions will eventually transition to heroin.
This percentage is a small proportion, but when multiplied by the millions of people being prescribed opioid painkillers, these numbers are devastating and ultimately lead to the decrease in the average American life span. A report by the Drug Enforcement Administration cited that, in 2015, there were 2 million people in the United States suffering from opioid-related substance abuse disorders, 591,000 suffering from heroin abuse disorder and 33,000 deaths because of opioid overdose.
Heroine did not just appear on the streets in the last 10 years. Opium-based products have been a part of society for hundreds of years. Both Mocchetti and Al-muhtasib attribute the spike in opiate-related deaths to the over-prescription of painkillers.
“In the 70s and 80s,” Al-muhtasib said in an interview with The Hoya, “doctors were hesitant to prescribe opioids out of fear they were addictive. Pharmaceutical companies really pushed that they aren’t addictive so prescribing went up.”
The problem does not extend only to receiver of the prescription. With over-prescription, many people do not use the entire quantity prescribed. Half-full pill bottles stocking bathroom cabinets extend risk of abusing the drugs to the patients’ immediate family.
To add to the crisis even more, the problem of over-prescription has been accompanied by the increased popularity of an even more potent narcotic, fentanyl. One of the most widely used pain medications in hospitals, fentanyl first infiltrated recreational circles, laced in other drugs like heroine and cocaine and then on its own. “You don’t need to inject it and it lasts longer, so it’s more appealing to many,” Mocchetti said in regards to the drug’s increased popularity.
The added danger of fentanyl is its potency. “Fentanyl is similar to Morphine, but at least 75 times stronger,” Al-muhtasib said. “First, that makes it easier to overdose because you are more likely to accidentally take more. Second, this made it easy to enter the drug trafficking world.” A picture circled the internet in 2017 of a penny next to a lethal dose of fentanyl, with the drug covering not even 5 percent of the coin’s surface.
The strength and the speed of the opioid crisis has encouraged politicians and law enforcement to look toward unconventional tactics for drug and crime control. Needle exchanges are becoming popular in cities to encourage habitual drug users to use clean needles to avoid the spread of HIV/AIDS. Although controversial, methadone clinics distribute rationed amounts of methadone, an opioid analgesic, to make withdrawal less life-threatening and smoothly ease addicts into a life of recovery.
In 2016, Canada legalized doctor-prescribed heroine, also in an effort to wean addicts off the drug in a safe and controlled manner. Although seemingly extreme, these tactics are being employed in response to the high risk of overdose that accompanies opioid use. Opioids depress the region of the brain that controls breathing, leaving its victims to die by suffocation.
Although little research has been done on the specific effects opiates may have on the college population, every Hoya should be aware of the dangers of pain killers before filling a prescription for an opiate. They can be the most effective drugs for pain, but the danger comes in with the length of use.
“There is no reason for a student to take medications with opiates in them for more than one to two days,” Mocchetti said. “The longer you take the pills, the more likely it is to get addicted.”