The opioid crisis
Is the UK on the cusp of an opioid epidemic? In America, you are more likely to die from an overdose than a road accident. And experts have warned that Britain now faces a crisis of its own…
What are opioids?
Opioids are drugs which come from opium poppies, or which have been synthetically produced to mimic the poppy’s effects. That includes legal medicines like morphine and codeine, as well as the illegal drug heroin.
Opium poppies have been used to ease pain and aid sleep for centuries. They were used in ancient Sumerian, Egyptian and Greek civilisations; the opium trade sparked two wars between Europe and China in the 19th century; around the same time, morphine was being used as a painkiller for hundreds of thousands of soldiers in the American civil war.
Today, they are still used by doctors to treat severe pain. They work by blocking the body’s pain signals. They also produce the hormone dopamine, which creates the euphoric feeling of being “high”.
Why are they so dangerous?
Opioids are good at stopping pain in the short-term. But they are extremely addictive, and as the body builds up tolerance they become less effective at stopping pain.
If they are not used properly, this can lead to a dangerous spiral, in which someone takes higher and higher doses as the drugs get less effective. However, coming off them is extremely unpleasant. It is easy to become trapped.
If an opioid dosage is too high, breathing begins to slow — sometimes so much that it stops altogether.
What is happening in America?
The US is in the grip of an opioid epidemic which killed more than 47,000 people in 2017 alone, and 350,000 people in the last 20 years. That’s more than six times the number of US soldiers who died in the Vietnam war.
Overdose is now the leading cause of death among Americans under 50. The numbers are so large that the average US life expectancy has dropped three years in a row for the first time since the First World War.
Is there an epidemic in the UK too?
Not on the same scale as in the US. However, in February 2019, The Sunday Times published an investigation into Britain’s rising numbers of opioid prescriptions, deaths and overdoses over the last 10 years. It found that around five people were dying from the drugs every day.
That includes deaths from heroin, as well as legal painkillers. Britain’s poorest areas, such as Wales and the North, were the worst affected.
Dr Andrew Green, of the British Medical Association, told the paper there was “no doubt” that the UK was experiencing an “epidemic of opioid use”.
What can be done about it?
In 2017, US President Donald Trump declared the American opioid epidemic a “national public health emergency”. Last year, he unveiled a three-part plan to tackle the crisis, including funding for education, job-seeking help for recovering addicts, and harsher punishments for drug traffickers — including the death penalty.
However, in both the US and the UK, illegal drugs are only part of the problem. While addicts may eventually turn to illegal drugs or the black market, they often start with painkillers which were given to them by doctors.
In Britain, the director of the charity DrugWise told The Sunday Times that there is a “perfect storm” of GPs “under huge pressure” and an ageing population, meaning more patients complaining of chronic pain. “It is not surprising that more and more prescriptions are being written as demand increases.”
In other words, tackling the crisis will probably involve finding alternative pain medicines, changing the amount of drugs prescribed, or supervising patients more closely.
I’m worried about drugs — what should I do?
FRANK has more information about drugs (including opioids) on its website, found under Become an Expert. You can also call their helpline on 0300 123 6600.
- How should the UK combat the growing numbers of opioid overdoses?
- The most common medical opioids are co-codamol, tramadol, codeine, co-dydramol, dihydrocodeine, oxycodone and fentanyl. Choose one and produce a fact sheet which explains how it works, what it is used for, and potential side effects.
- Opium poppies
- The same plants also produce edible poppy seeds. Opium is made from the milky substance found inside the seed pods.
- Two wars
- From 1839-1842, and again from 1856-1860. Britain had begun growing opium in India and trading it in China. As addiction rose in China, the government had tried to restrict its use; Britain used its military power to keep the trade flowing.
- American civil war
- Fought from 1861-1865 between northern and southern states, mostly over the issue of slavery.
- A neurotransmitter (a chemical which carries signals around the nervous system) often associated with feelings of happiness and satisfaction.
- Six times
- There were 58,220 American military deaths in the Vietnam War (1955-1975).
- Life expectancy
- In 2017 this was 78.6 years, down from 78.8 in 2015. The decline was also fuelled by rising suicide rates.
- Five people
- There were around 2,000 deaths per year between 2015-2017. The investigation by The Sunday Times involved analysing data from the NHS and the Office for National Statistics.