Erin Marie Daly - Generation Rx: A Story of Dope, Death, and Americas Opiate Crisis

Copyright 2014 Erin Marie Daly

All rights reserved under International and Pan-American Copyright Conventions. No part of this book may be used or reproduced in any manner whatsoever without written permission from the publisher, except in the case of brief quotations embodied in critical articles and reviews.

Library of Congress Cataloging-in-Publication Data

Daly, Erin Marie.

Generation Rx : a story of dope, death, and Americas opiate crisis / Erin Marie Daly.

Includes bibliographical references.

ISBN 978-1-61902-377-2

1. YouthDrug useUnited States. 2. Drug abuseUnited States. 3. Substance abuseUnited States. I. Title.

HV5825.D354 2014

362.29'30973dc23

2014014412

Cover design by Natalya Balnova

Interior design by Megan Jones Design

COUNTERPOINT

www.counterpointpress.com

Distributed by Publishers Group West

10 9 8 7 6 5 4 3 2 1

FOR ALL WHOSE LIVES HAVE BEEN AFFECTED BY OPIATE ADDICTION

and

FOR PAT

CONTENTS

1898

The Bayer Company releases heroin as a cough suppressant. It is legally sold over the counter in both pill and elixir forms.

Bayer touts the drug as having a low risk of causing addiction, but there is an explosion of heroin-related admissions at hospitals, and cities begin to report a substantial population of recreational users. Some of these users support their habits by collecting and selling scrap metal, hence the term junkie.

1900

The number of morphine addicts in the United States reaches an estimated three hundred thousand, including many Civil War veterans who were exposed to the painkiller for treatment of their war injuries.

1911

Bayer pulls heroin from the market due to widespread concerns about its addictive properties.

1919

The U.S. Supreme Court issues an opinion that interprets the Harrison Act of 1914the nations first drug lawas banning the prescribing of narcotics to those addicted to them. Tens of thousands of doctors are charged with offenses related to the law, leading many medical professionals to become hesitant to prescribe morphine for the treatment of pain, even when it is warranted.

EARLY 1990S

The purity of heroin on U.S. streets dramatically increases. In the 1970s and 1980s, purity levels had been about 3 to 10 percent; by 1991 heroin is about 27 percent pure. By 1994 it is about 40 percent pure. Because heroin is so pure, it can be snorted rather than injected, increasing its popularity.

MID- TO LATE 1990S

Two major groups representing doctors specializing in pain treatment, the American Pain Society and the American Academy of Pain Management, declare that U.S. doctors are not adequately treating pain and are underpre-scribing opioid pain medications due to a misguided fear of causing addiction. The result is a national push to treat pain more aggressively.

The two groups issue a landmark 1996 consensus statement claiming that there is little risk of addiction or overdose among pain patients. They cite a statistic that less than 1 percent of opioid users become addicted, a figure that comes from a single-paragraph report in the New England Journal of Medicine in 1980 describing hospitalized patients briefly given opioids.

The pharmaceutical industry begins to promote opioids as safe for the long-term treatment of chronic pain. Among the most widely used opioids are hydrocodone, which is used in Vicodin, and oxycodone, found in OxyContin and Percocet. Other potent opioids include fentanyl and methadone.

Many small-town family practice and general medicine doctors are relatively inexperienced in the treatment of either pain or addiction, but they begin prescribing large amounts of painkillers due to marketing efforts of pain-management specialists, who are often paid speakers for the companies that produce painkillers.

Chronic pain patients begin getting hooked on medications that were prescribed to them, a situation known as iatrogenic addiction.

19972006

The number of prescriptions for opioid pain pills increases dramatically: prescription sales of hydrocodone go up 244 percent, while oxycodone sales rise 732 percent.

Many parts of the United States, particularly rural areas, begin to see skyrocketing rates of addiction and crime related to the use of painkillers, including pharmacy thefts.

In 2001 a study shows that between 18 and 45 percent of patients who take opioids for more than three months will develop true addiction, not mere physical dependencyfar greater than the 1 percent incidence previously estimated.