The Opioid Epidemic:
How Did We Get Here?

Homeless Addicts

Few Americans at this point are unaware of the opioid epidemic that our country faces. Finally, after years of deaths, economic burden, and misery among millions of American families, we are starting to understand the true severity of this problem.

But how did we get here? How was it that this problem was allowed to get so far out of hand? How was it that powerful, addictive, pharmaceutical opioids were prescribed and are still prescribed to this day?

How America’s Efforts to “Improve” Pain Treatment Went Awry

The opioid epidemic didn’t just happen spontaneously. Nor did it just happen overnight.

This has been a painstaking process with errors made across the boards, faith put in the wrong places, wrong solutions devised to handle the right problems, and unethical profiteering sprinkled into the entire mix.

The opiate epidemic was a twenty-year whirlwind of negative decisions, bad judgment, and unethical practices.
Money and drugs

Evidence on opiate pharmaceuticals was misinterpreted as to their efficacy and relative addiction risk. Pharmaceutical marketing painted a picture of pharmaceuticals that inaccurately represented the products. Increases in pain advocacy made pain management a high priority for doctors. Weak regulation on pharmaceutical giants allowed for improperly tested and examined products being sold to patients. Insurance companies, doctors, and hospitals missed opportunities to support and insist on safer, holistic, non-opiate treatments for pain management. The opiate epidemic was a twenty-year whirlwind of negative decisions, bad judgment, and unethical practices.

  • In the late 1970s, fast-acting, quick-release opioid drugs came on the market as “short-term pain relief” medicines.
  • In 1980, medical journals first began to tout opioids as being a potentially “non-addictive” solution to pain.
  • In the early 1990s, nationwide concern began to grow across the U.S. over untreated or poorly managed pain amongst patients.
  • In 1995, the Food and Drug Administration approved OxyContin, the first “sustained-release” opiate drug, designed for long-term pain management (i.e. patients could be prescribed the drug for endless periods of time).
  • Also in 1995, pain was suggested as the “fifth vital sign.” Vital signs are the key indicators of a patient’s health and well being, and they include various signs like body temperature, pulse rate, respiration rate, and blood pressure. Pain was added as the fifth sign, making it a priority for doctors to address.
  • In the late 1990s, pharmaceutical giants responded to pain being implemented as the fifth vital sign by massively increasing their marketing campaigns to doctors. They offered opioid pharmaceuticals as “miracle cures” to both acute and chronic pain amongst patients.
  • In 1998, the Food and Drug Administration approved fentanyl for treating cancer pain only. Now fentanyl is used to treat far more than just cancer pain. This is concerning because fentanyl is fifty times stronger than heroin is.
  • In the early 2000s, overprescribing of opioids became more prevalent, and overdose deaths on opioids began to climb in tandem.
  • By 2012, overdoses from opioids were routine in hospitals nationwide. No one was fooling themselves anymore that the U.S. was in the grips of an opioid epidemic. In November of 2012, the Los Angeles Times published a series of investigations called “Dying for Relief,” the first of its kind that exposed the epidemic as being caused by Big Pharma.
  • In a red herring effort, Big Pharma introduced “abuse-deterrent” opioids between 2010 and 2014, opioid drugs that were supposed to be harder to abuse. Addicts found ways around the deterrent aspects of the drugs and abused them anyway.
  • In 2016, prescribing guidelines were tightened while the Surgeon General wrote his report on the opioid crisis. Still, opioid addiction hit highest-ever levels, killing more than forty-thousand Americans that year.
  • In October of 2017, President Trump labeled opiate addiction as a public health emergency, promising to end the epidemic.

Today, opiate addiction is more than a crisis. It’s more than an epidemic. It’s a national public health emergency. The president himself admitted to this fact. While it will take years to fully resolve the crisis, we all need to work to handle the problem by being educated on the signs and symptoms of heroin and opiate addiction and promoting effective prevention and rehabilitation.

Opioid Addiction in America Timeline Infographic




After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.