The Heroin Epidemic

January 31, 2017

Employee Benefit & HR News

Over the last few years, it is likely you have seen news reports chronicling the escalating problem of heroin addiction in this country.

Heroin use has been at an epidemic level for years.  Heart-breaking statistics are tracked by several organizations.

Perhaps remembered as an illicit drug of the 60’s, heroin at one point in time was actually sold legally in this country.  In 1906, the American Medical Association approved the drug for general use with the recommendation that it be used in place of morphine.  At the time, heroin was promoted as non-addicting.  Before long, 200,000 people in New York City alone were addicted.  The Harrison Narcotics Act was passed in 1914 with the hopes it would put an end to the abuse.

Opiates, to which heroin is a subset, have been around for thousands of years and were originally produced from the opium poppy.  Morphine is another opiate derivative also produced from the poppy.

In 1874, scientists created heroin while attempting to create a less additive form of morphine.  The end result actually ended up being twice as strong with even greater potential for addiction.  This new “wonder drug”, as it was thought of at the time, was dispensed over-the-counter to treat an array of maladies down to a simple cough and cold.  Its propensity for addiction was not discovered until later.

The typical heroin user in the United States today is a white male, aged 18-25 years old, living in the suburbs.  Heroin use is found across all segments of society; in urban, suburban and rural areas.  It is not limited by income or socioeconomic standing.

The heroin of today is more potent and pure which increases the risk for addiction, overdose and death.   Some of the factors contributing to the escalating use of these drugs include the creation of synthetic opioid prescription pain relievers.  Synthetic opiates such as Vicodin, OxyContin and Percocet were approved by the Food and Drug Administration in the 80’s and 90’s.  The fact that they are synthetic does nothing to remove the risk of addiction.

Addictive behavior can develop innocently from a prescription given by a physician to manage pain.   The risk is particularly high for adolescents.  The structure of the adolescent brain puts them at risk for quickly developing addictive behaviors.  Abusers of synthetic opioids often make the switch to less expensive heroin once their addiction is set.

Heroin has been flooding into the United States from Mexico as drug farmers make the switch from marijuana to more profitable opium poppies.  This is a side result of the decriminalization of marijuana which has caused the wholesale price of pot to drop.  It is now more profitable for Mexican drug farmers to fill their fields with poppies in lieu of cannabis.  Cheap heroin continues to flow in this country at a time when controls have tightened on prescription opioid pain killers making them more difficult to obtain and expensive.

In 2016, two million people were reported to have a substance abuse problem related to prescription opioid pain medication and almost 600,000 were addicted to heroin.  The CDC estimates the annual cost of the opioid epidemic in the United States at $78.5 billion including the cost of providing health care, lost productivity and treatment programs.

For employers, employees prescribed just one opioid medication have average workers’ compensation claims costs that are four times more than those who are not prescribed these medications according to the National Safety Council.   Opioids comprise about a quarter of all prescription drug costs for workers’ compensation.  Experts in the field cite that an employee taking opioid medications for over three months typically does not return to work due to drug dependency and other illness and effects.

Today’s heroin is so pure that users who would normally shy away from it as an intravenous drug can instead choose to inhale or snort heroin as a powder.   Sadly, after becoming addicted, many users later turn to I.V. drug use.  Addicts report first time drug use as young as age 12.

Heroin is one of the most difficult drugs of addiction to beat because of the way it affects the pleasure centers of the brain.  Recovery statistics are hard to track but it is estimated that only about 1 in 5 addicts successfully escape the vice-like grip of this drug.  Multiple relapses are common along with legal and criminal consequences.  The typical user (and family) struggle through the cycle of recovery and relapse for many years.

The explosive growth of this epidemic has resulted in new strategies being formulated to fight the battle.  The traditional thinking of treating addicts as criminals by jailing them for drug possession is being re-thought in many communities.  The realization addiction is not a crime but instead an illness is reshaping the way to fight this epidemic.

On February 2, 2016, President Obama announced his proposal to fund $1.1 billion toward the heroin and prescription opioid epidemic.  This funding was subsequently approved by Congress and provides:

  • $920 million to support cooperative agreements with states to expand access to medication-assisted treatment for opioid use disorders. States will receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States can use these funds to expand treatment capacity and make services more affordable.
  • $50 million in National Health Service Corps funding to expand access to substance use treatment providers. This funding will help support approximately 700 health providers who can administer substance use disorder treatment services, including medication-assisted treatment, in areas across the country most in need of these specialists.
  • $30 million to evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.

In an effort to save lives, the drug Naloxone is being made more readily available across the country.  Naloxone is able to reverse the effects of an overdose which can be lethal by shutting down a person’s respiratory system.   This drug, also known under the brand name Narcan, can save lives if administered in time.   Police in many cities are being trained and supplied with Narcan as they are often the front line responders in many overdose situations.  Pharmacies in some communities are able to sell this medication without a prescription.

Messaging is being delivered in communities to let addicts know they will not be prosecuted for heroin possession for simply bringing an overdosing friend to appropriate treatment.

Hopefully these efforts are successful in turning the tide of this terrible epidemic.  Opioid and heroin addiction destroys the life of the addict.  It also can deeply affect the lives of everyone around them in the process.  The agony of dealing with a loved one with addiction is at times almost unbearable.  If you have not personally been affected you can be sure a friend, neighbor or co-worker probably has.

It’s important for parents of adolescents and teens to learn and be vigilant for clues signaling their children may be using.  Changes in behavior and appearance are usually noticeable as addiction becomes more severe.

Discovery of paraphernalia used to prepare or consume heroin in places such as a child’s room, car or clothing is another definite early warning sign of heroin abuse.  Some of these items may be easy to overlook at first so it is important to be wary.  They include small plastic bags with residue, burned spoons, aluminum foil or gum wrappers with burn marks, short straws possibly melted or burned, shoelaces missing (used to tie off for injection), glass pipes and needles or syringes.

If you suspect or have discovered someone close to you is using do not panic.  Resources are available to assist you and your loved ones with addiction.  The path to recovery from heroin addiction can be a long one but it is important to get help right away.

Here are some resource links:

As an employer, there are steps you can take to join the fight while protecting your employees and their families.

  • Provide education on the risk presented by prescription opioid pain medications.  Advise your employees to question if an alternative medication can be used to control pain such as ibuprofen.
  • Train supervisors to recognize signs of possible impairment and promote understanding of your company drug use and testing policies.  It is also important to understand how the federal Americans with Disabilities Act provides protection to employees with disabilities being treated with over-the-counter or prescription medications.
  • Promote your Employee Assistance Program as confidential access to substance abuse treatment resources.  Be sure your medical plan provides employees full access to quality treatment.
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About Rick Ewers

Mr. Ewers is an analytical consultant providing financial analysis, vendor evaluations, market & compliance analysis, as well as national industry trending for group employers.

View all posts by Rick Ewers

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