The Opioid Crisis: How did we get here?

Written by Dr. Ryner Lai
July 30, 2020

The Opioid Crisis – how did we get here?


The United States is in the midst of a serious opioid epidemic that has its origin decades ago and continues to this day. The Centers for Disease Control and Prevention (CDC) estimates that more than 700,000 Americans have died from a drug overdose between 1999 and 2017 – a period of 18 years. An average of 130 Americans die every single day from an opioid overdose. That’s about 5 every hour.

It’s clear that the opioid crisis is still ravaging through our towns and communities in an alarming rate. But how did we get here?

The Three Waves

The US opioid epidemic came in 3 distinct waves, starting in the 1990s. Let’s look at all 3 of them:


First Wave: The Rise in Prescription Opioid Overdose Deaths

The first wave began in the 1990s when pharmaceutical companies began to promote opioids as an effective and “non-addictive” medication in treating pain. There was a public campaign to convince practitioners that opioids were safe for widespread use. This was despite the lack of data about the risks of prescribing opioids. The result was that more and more patients were put on opioid medication for non-cancer pain, resulting in the first wave of opioid-related deaths.



Second Wave: The Rise in Heroin Overdose Deaths

The second wave took place in the early 2010s, when greater restrictions were introduced to limit the prescription of opioid medications. However, many patients who were initially put on opioids have already begun to develop an addiction to the medication. When opioid prescriptions became limited, illegal heroin started to flood the streets. Heroin was a relatively cheap alternative to prescription opoids. The proliferation of widely available heroin contributed to the rise of the second wave in opioid-related deaths.



Third Wave: The Rise in Synthetic Opioid Overdose Deaths

The third wave of opioid-related deaths occurred in the mid-2010s and was related to the proliferation of synthetic opioids, such as fentanyl. As a crackdown on heroin began to take effect, illegal drug manufacturers turned to producing fentanyl, sometimes packaged in fake pills and produced in combination with other opioids.



Where do we go from here?

The fight against the illicit use of opioids and opioid-related deaths is far from being won. It takes all of us to play a role to prevent opioids from causing more deaths and damaging our homes and communities any further.

If you suffer from opioid addiction, it’s never too late to begin the road to recovery. Here are some resources to get you started.

You may also talk to one of our doctors about your opioid use and see if Medication-Assisted Treatment (MAT) via telemedicine using buprenorphine might be an option.



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