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Why are opioids so dangerous?

Opioids, often called narcotics, are drugs with strong pain-relieving effects.

Some are produced from opium, a mixture of substances obtained from the opium poppy or royal poppy (Papaver somniferum), while others can be synthetic (developed in laboratories).

Among the best known opioids are heroin, codeine, fentanyl (Actiq®, Duragesic®, Sublimaze®), hydrocodone (Vicodin®, Norco®, Zohydro® and others), hydromorphone (Dilaudid®), Meperidine (Demerol®), Methadone (Dolophine®, Methadose®), Morphine (Duramorph®, MS Contin®), Oxymorphone (Opana®), Oxycodone (Percodan®, Percocet®, and OxyContin®, the latter produced by Purdue Pharma).

They can be found in different presentations: capsules, liquid, lozenges, suppositories, or tablets.

How do they affect the body?

Opioids are chemically related and interact with opioid receptors on nerve cells in the body and brain, thus allowing pain relief.

While they are generally safe when taken for a short time and as directed by your doctor, they can cause side effects, such as drowsiness, nausea, constipation, or confusion.

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They can also cause euphoria, so it is common for them to be used inappropriately, that is, differently than indicated, in higher doses or without a doctor’s prescription.

However, even following the doctor’s instructions, opioids can lead to dependence and, if used inappropriately, to overdose or death.

Serious consequences

Opioid abuse, addiction, and overdoses are serious public health problems in the United States.

It is estimated that almost 100 million Americans suffered from pain chronic, so health authorities began to require less stringent regulations for the use of strong painkillers.

Many pharmaceutical companies sought to convey reassurance to the medical community and the public, ensuring that prescription opioid painkillers were not capable of creating addiction.

This led to an increase in their prescriptions, which, together with the deviation from their original use and the abuse actually caused by their addictive effects, led to the opioid crisis or epidemic.

The National Institute on Drug Abuse (NIDA) reports the following data on this public health problem:

  • Approximately 21-29% of patients who are prescribed opioids to treat chronic pain use them inappropriately.
  • About 8-12% develop an opioid use disorder.
  • It is estimated that between 4 and 6% of those who use prescription opioids inappropriately start using heroin.
  • It is estimated that about 80% of people who use heroin previously abused prescription opioids.

In combination with alcohol, opioids can dangerously slow your heart or breathing rate, leading to a coma or even death.

Different investigations also found that if they are abused during pregnancy they can cause spontaneous abortion, low birth weight or neonatal withdrawal syndrome.

Another problem derived from the opioid crisis is the fight against withdrawal, which often causes restlessness, pain in the bones and muscles, insomnia, diarrhea, vomiting, chills and involuntary movement in patients.

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Opioid addiction is a disease that affects the brain and its behavior. Its pleasant effect eventually makes the person want to continue consuming it.

Over time the brain actually changes, so it develops a powerful urge to use the medicine.

Resolution and conviction

On Wednesday, October 21, 2020, the United States Department of Justice announced that Purdue Pharma, maker of the highly addictive opioid OxyContin, pleaded guilty to three federal criminal charges.

He received more than $ 8 billion in fines (the largest ever imposed on a pharmaceutical manufacturer) to solve criminal and civil investigations against him.

The company has become synonymous with the opioid crisis that, since the 1990s, has led to the deaths of nearly half a million Americans from overdoses.

The criminal charges against Purdue Pharma, as reported by the United States Department of Justice, included conspiracy to defraud the United States and two counts of conspiracy to violate federal laws against kickbacks, after it paid two doctors to induce them to prescribe more opioids.

The company also admitted to hindering the Drug Enforcement Administration (DEA) by transmitting misleading information.

“This resolution closes a particularly sad chapter in the ongoing battle against opioid addiction,” said Tim McDermott, DEA assistant administrator.

The settlement money will go to state, local and tribal governments to address the opioid crisis.

“With criminal guilty pleas, a federal settlement of more than $ 8 billion, and the dissolution of the company and reuse of its assets entirely for the benefit of the public, the resolution announced today reaffirms that the Department of Justice will not back down in its many efforts. for fighting the opioid crisis, “said Jeffrey Rosen, Assistant US Attorney General.

Sources consulted: US National Library of Medicine, Centers for Disease Control and Prevention, Mayo Clinic, National Institute on Drug Abuse.

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