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What's Going On with the Opioid Crisis?

The Justice Department is suing Walmart, alleging that the company helped fuel the opioid crisis that's been devastating America for years.

According to the Associated Press, Walmart may have unlawfully provided controlled substances to its customers, providing thousands of people with prescriptions that should not have been filled. The suit alleges that Walmart's system made it impossible for pharmacists to properly screen and vet the prescriptions they filled, ignoring warnings from pharmacists in the process.

This comes after Walmart sued the Justice Department and the DEA, arguing that hundreds of doctors who should not have been allowed to prescribe controlled substances at all were still actively registered with the DEA.

Both suits are ongoing, but one thing is clear: A lot of powerful organizations are to blame for the opioid crisis.

How the Opioid Crisis Began

The US's opioid crisis has been festering for a long time. In 1991, the first wave of the opioid crisis occurred when a sharp rise in the prescription of opioids led to multiple deaths. At this time, many pharmaceutical companies claimed the risk of addiction to opioids was very low.

In 1995, Purdue Pharma received approval for OxyContin, leading many patients to get hooked. In 2007, they paid a $634 million dollar fine for lying about the drug's addictive nature.

Prescriptions for opioids began to increase over the next few decades, tripling between 1991 and 2011. The second wave of the crisis occurred in 2010, when prescriptions to opioids became harder to obtain and more people started turning to heroin and illegal drugs. The third wave began in 2013, when drugs like fentanyl and synthetic opioids began to rise in popularity, leading to another spike in deaths.

Today, overdoses are the leading cause of death for people under 50 years old. In 2017, there were more than 70,237 deaths related to overdoses and 47,600 were related to opioids. An estimated 130 people die each day from opioid-related misuse. The opioid epidemic has claimed a total of over 400,000 lives.

Who Is to Blame?

The opioid crisis is a complicated issue that can't be neatly blamed on any one company or action. Certainly, the root of the problem lies with Big Pharma — the Purdue Pharmas and Sacklers of the world who lied about the addictive nature of their products and relentlessly sold these dangerous products. Drug company executives and opioid salesmen also have blood on their hands.

In addition, the government is to blame. Evidence continues to find that Congress was and is influenced by pharmaceutical lobbyists, and Congress has passed legislation that crippled the DEA's power.

In addition, Department of Justice-led investigations that should've burned drug corporations to the ground failed to adequately persecute the corporations. Furthermore, the FDA also failed to act when they should have; in 2001, they approved OxyContin for anyone suffering from chronic pain, despite scientists previously finding that the drug is only effective in the very short-term.

Over-prescription and doctors are to blame, as well. Many believed they were doing the right thing but prescribed far, far more than safe limits of drugs to their patients. In addition, distributors like Walmart and other pharmacies are also to blame for not taking adequate precautions.

The root of the issue, however, can't be separated from other systemic crises, like economic inequality, a broken healthcare system, and the chronic health issues that plague many Americans.

"Greed drove opioid manufacturers to oversell and overproduce the drugs, the lawsuits allege," writes Melissa Healy for the Los Angeles Times. "Greed drove companies that distribute prescription drugs to oversupply pharmacies… And greed drove pharmacies to overdispense the drugs to patients who were becoming hooked, to criminals who were diverting them to the black market, and to addicts shopping for a fix."

Arguably, greed also prevents America — one of the richest nations in the world — from offering its citizens healthcare and the ability to live safely.

How Do We Solve the Opioid Crisis?

Solving the opioid crisis won't be simple or easy.

In an immediate sense, any solution to the crisis will have to treat friends and family members of people who suffer from addiction as well as the people themselves. Treatment will have to be made broadly available, as will ongoing support.

"We need to treat opioid use disorder like we treat other chronic health disorders — managed in primary care, using specialists for exacerbations, consultations, and particularly challenging cases," says Bradley Stein of the RAND Drug Policy Research Center.

But to really solve the crisis, we'll have to take a deeper look at what's causing it. Millions of people are still suffering from chronic pain — another root of the opioid crisis — and healthcare workers will have to figure out how to treat pain without using opioids. Solutions might lie in "interventional" pain therapies or other approaches that lead to long-term relief instead of just putting a band-aid over the problem.

In addition, many people are driven to use opioids due to emotional issues or mental health issues. To treat the root causes of the opioid epidemic, we also need to treat mental health issues and treat reasons why people are suffering from such extreme emotional pain in America today.

Those solutions might lie in deepening community ties, in education, and in healing some of the economic inequality that has created so many of our issues. It might also mean making healthcare, housing, healthy food, and opportunity more affordable so people don't wind up in so much pain and distress. It might also mean reducing pollution and other issues that lead people, particularly low-income people and communities of color, to develop chronic health issues.

In short, simply cracking down on prescriptions and distributors and making Big Pharma pay up isn't the solution. It's just the beginning. The solutions of the opioid crisis are bound up with solutions to climate change and economic inequality, and until we understand the interconnectedness of it all, we'll never really treat the crisis at its source.

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