The Food and Drug Administration approved the prescribing of opioids by general health practitioners to treat chronic pain in the 1990s. Regardless of a lack of knowledge related to long term effects of opioids on the human mind and body, doctors were encouraged by large pharmaceutical companies to prescribe opioids (Wilson, & Dorn, 2016). The risk of overdose rose as the amount of prescriptions for opioids increased (Paulozzi et al., 2015). “By 2008, prescription drug overdoses were occurring at rates nearly twofold higher than overdoses caused by heroin and all other illicit drugs combined, surpassing U.
S. death rates caused by car accidents, suicides, or homicides. In 2010, annual health care expenditures nationwide, just for treating overdoses, but not addiction, reached $2.3 billion, nearly double the annual extramural budget of the National Institutes on Drug Abuse” (Sajid et al., p. 557).
Long before pharmaceutical companies, the U.S. saw drugs contribute to the deterioration of those addicted and the individuals around them as well. While the government has worked to deter drugs entering the U.
S and the distribution within the county it has failed at these attempts, simply because if demand exist the supply will always find a way to continue. American government has only recently begun to switch gears to address the demand.
For many decades, criminalization approaches towards addicted peoples have failed to result in changed behaviors that benefit society. The U.S. criminal justice system has historically placed individuals with addictive behaviors and drug related charges in prison without providing sufficient treatment for addiction.
This has contributed to the cycle of addiction continuing and increased related financial and social harms on society.
Historically, the American government has found ways to profit from the taxation of drug imports/exports and regulation. This has been a trend since the 1800s and has continued in present day with regulation laws related to marijuana. Legalization of marijuana has increased the growing of hybrid marijuana plants with increased tetrahydrocannabinol levels. In the 1970s marijuana had an average potency of 7% THC, while today the average is greater than 14% upwards to over 30%. This contributes to increased risk for addiction of the substance and related side affects including withdrawal with higher anxiety and depression symptoms. Additionally, over the past half a century, illicit drug use has increased, suggesting that drug trafficking remains a lucrative trade business despite War on Drugs efforts (Hall, 2018).
Overprescribing of opioids by general practice, internal medicine, and family doctors with little training in regard to opioid addiction has contributed to an influx in the amount of nonmedical users (Wightman, Perrone, Portelli, & Nelson, 2012). “Nonmedical use of prescription medications is defined as the use of these medications without a prescription from a health care provider, use in a manner other than as directed (e.g., taking a higher dosage than prescribed), or use only for the medication’s psychotropic experience (e.g., euphoria and sedation)” (Popovici, Maclean, Hijazi, & Radakrishnan, 2018, p. 294). According to a national survey on drug dse and health, seventy percent of nonmedical prescription drug users are opioid users (Popovici et al., 2018). The public health crisis of drug addiction has grown to epidemic proportions, with institutional maintenance of the issues including, “medical-cultural shifts happening over 2 decades that have promoted opioid prescribing from primary care doctors and specialist, at increased doses, in poly opioid combinations, for greater durations, and in more clinical contexts” (Sajid et al., 2016, p 557).
The lack of government regulation of the internet, especially social media has also kept the cycle of addiction growing. As individuals became addicted to prescription opioids, their mind and body began to experience intense cravings that drive an individual to think they must have the substance. This contributed to doctor shopping, going to different doctors for the same issue, in order to obtain more prescription opioids. In response to social costs, prescription drug monitoring programs (PDMPs) were developed in an effort to reduce rates of over prescribing of opioids and doctor shopping. PDMP’s have reduced the frequency of doctor shopping, but younger adults choose to utilize the internet as a main source of information and for shopping. There is a significant amount of information related to illicit drugs on the internet. Many individuals have reported buying illicit drugs, including but not limited to, prescription opioids from the internet (Nielsen & Barratt, 2009).
There is an essential demand for increased education related to the effects of drugs on the mind and body and appropriate evaluation and treatment accessibility. Studies support a more mitigated approach for addressing addiction.Advocating for the continued creation of treatment and prevention programs, funding to maintain such programs, and legislative policies to promote continued positive change is imperative when addressing the social problem of addiction.
Alternatives to traditional imprisonment is finding to be beneficial. Lichtenwalter et al. (2010) studied the House of Healing, a court ordered, community based residential program for female offenders. The program works towards successful community reintegration by allowing women to reside with their children while they receive substance abuse treatment, as well as health and mental health care (Lichtenwalter et al., 2010). House of Healing runs based on relational theory, which “posits that a woman’s primary motivation is to build a sense of connection with others” (Lichtenwalter et al., 2010, p. 81). The facilitators work with female offenders to strengthen healthy relationship skills, establish employment skills, and address substance use, health/mental health issues to aid in positive community reintegration. Lichtenwalter et al. (2010) found that a little over half of the women accepted into House of Healing successfully completed the program, providing savings for the child welfare system- as the child remains with mother and not in foster care, as well as resulting in a reduced recidivism rate of 40%. For drug court to be successful motivation to change must be enhanced, and the program should aim to include educational interventions, vocational training, and job placement assistance to aid in sustaining positive treatment outcomes and reducing recidivism rates