SAFE Glen Cove Coalition: A History of the Opioid Epidemic

A recent article published in the American Academy of Pediatrics discusses the history and etiology of the opioid epidemic. The current epidemic has arguably been the most recalcitrant in the nation’s history and was recently declared a public health emergency. Although the initiation of substance use most often occurs during adolescence, opioid addiction has been largely restricted to adults in previous generations. The conditions that led to the current epidemic entangled adolescents in substantial numbers for the first time.

Opioids were first brought to the United States by European settlers. The opioid solution, extracted from poppy seeds was used to treat pain associated with common illnesses. Around the time of the Civil War the hypodermic needle and pain relief for soldiers started a morphine epidemic. Morphine became the “cure all” drug choice during that time period.

The market started putting opioids into many different medications from toothaches to stomach pain. Children at the time were even given exposure to the opioid concoction for example Mrs. Winslow’s Soothing Syrup which was used and marketed to calm infants. During that time period of the soothing syrup opioid overdose deaths increased in infant deaths. The Harrison Drug Act of 1914 put an end to the epidemic and limited health professionals the ability to write prescriptions for opioids for relief of minor pain issues.

The article states that in 1973 1 in 5 soldiers were addicted to heroin. Soldiers fighting the Vietnam War 1971 announced a heroin epidemic. Twenty years after the Vietnam War powerful oral opioid pain medications had entered the market for treatment. During this time the National Academy of Medicine encouraged physicians to treat pain – opioids were marketed to both medical professionals and patients as safe and nonaddictive. A National Cultural movement to be pain free began.

New strategies for prevention and treatment are required to reverse the current epidemic of opioid addiction. Substance use initiation most often occurs during childhood or adolescence; hence, prevention efforts are well within the purview of primary care pediatricians. Furthermore, providing interventions for substance use, including Opioid Use Disorders treatment that incorporates Medication Assisted Treatment within primary care pediatrics, is a logical strategy for creating developmentally appropriate access for youth with opioid addiction.

In addition to helping bring the current epidemic to an end, the integration of Substance Use Disorders treatment into primary care offers the additional benefits of extending treatment for the more common alcohol, marijuana, and tobacco use disorders and also builds an infrastructure that helps to prepare us for the next epidemic of drug addiction.