Who Is Fueling The American Opioid Epidemic?

Prince's death by opioid overdose last year was just one in tens of thousands across the United States. Prince died of an opioid overdose just about a year ago today. CNN reports recently unsealed records report numerous bottles of fentanyl were found around his mansion, Paisley Park. They were legal prescriptions given to the singer by his personal physician, Dr. Michael Todd Schulenberg. The prescriptions were written in the name of Prince's manager, Kirk Johnson, to protect Prince's privacy.

Prince's official cause of death is listed as an accidental overdose of an opioid. Opioid abuse is fueling an epidemic of deaths across the United States. According to the Centers For Disease Control, there were 33,091 opioid-related drug deaths in 2015. According to a CNBC report, there were over 300 million prescriptions written for pain prescriptions in 2015, about $24 billion worth of business to pharmaceutical companies.

opioid fentanyl, same drug found in Prince's home
Fentanyl [Image by Tommy Farmer/AP Images]

Everything isn't bleak though. Since 2013, the number of written prescriptions for painkillers has been slowly decreasing. However, that only covers the legal prescriptions for opioids, it does not include the opioids smuggled into the United States from other countries. Unfortunately, that decrease did not translate into lower opioid deaths. So, where are the opioids coming from if doctors are writing fewer prescriptions?

When people hear about opioids, they usually think of heroin, the street drug that has been around for decades. However, today heroin would be considered a kid's toy compared to the legal opioids available on the street and in pharmacies. Most of the opioids made today are manufactured in pill form and sold legally as medication.

Western Europe and North America have the largest appetite for opioids. In an interview with CNBC, Vinesh Singh assistant professor of medicine at Johns Hopkins University said the United States, Canada, and Europe account for the majority of the consumption of opioids.

"If you include Canada and Western Europe, [consumption of global opioid supply] increases to 95 percent, so the remaining countries only have access to about 5 percent of the opioid supply,"
The United States alone consumes 80 percent of the world's opioids. Today, the illegal supply of opioids is coming from China, Mexico, and illicit drug makers in the United States.

Fentanyl is more powerful than heroin.
[Image by Vanderveiden/iStock]

The market for the drug is hardly a secret and gone are the days of ordering it in a dark alley from a shady character. People can go online and order the drug direct from manufacturers in foreign countries. They companies then arrange to smuggle the drugs through the usual smuggling methods, hidden in shipping containers and boxes, marked as other, legal, items.

The most dangerous of the opioids in the drug fentanyl. Fentanyl is a synthetic form of opiates, and it is 50 times more potent than heroin and 100 times stronger than morphine.

Fentanyl is the drug Prince and Paul Gray of Slipknot used, and which eventually led to their deaths. The Drug Enforcement Administration classified Fentanyl as a schedule II narcotic, the level of restriction given to drugs with a high probability of abuse. The highest restriction is schedule I, the level for drugs that have no currently accepted medical use.

Fentanyl was created as an alternative for patients dealing with chronic pain and intolerant to the effects of lesser opioids. In other words, fentanyl was made for people dealing with a significant amount of pain and running out of options for relief. To ban the drug would leave many patients with a void in their pain management program.

The drug is so powerful that overdoses may require higher doses of naloxone, a drug administered to overdose victims. The problem with the illegally produced fentanyl is nobody knows how much of the drug is in each dose, or the ingredients used in manufacturing. This lack of quality control makes the use of illegally produced fentanyl even more dangerous for users.

[Featured Image by Chris O'Meara/AP Images]