The Opioid Crisis continues to be a long-standing problem in America. It has particularly thrived because of two main factors: the continued production of more lethal and addictive synthetic opioids and increased misinformation on opioids. A common myth is the demographics of people affected that has led to various state governments channeling their interventions toward particular demographics, neglecting other significant victims, creating a silent pandemic all over America. This paper will explore the drug problem in America by focusing on fentanyl and how it has provided insight into how the drug problem transcends economic boundaries.
The history of the drug problem in America mostly starts with inner communities riddled with crime, drugs, and poverty. Silverman, Hotlyn, and Toegel report that as of 2018, over 40 million of the United States population lived in poverty, and their living standards predisposed them to drug use and abuse. The authors point to inequality in healthcare services, including informational services that will promote better health behaviors. A survey by the National Survey on Drug use points to a distinct relationship between income and drug use, and that is, as the income level decreases, so do the injection drug use increase (Silverman, Hotlyn & Toegel). The most common injection drugs used in America are cocaine and heroin. Fentanyl is becoming prominent because it is mostly mixed with heroin, which is also the main reason it currently has the highest number of fatalities in America compared to other opioids.
Media houses in America continue to give numerous reports on fentanyl overdoses all over the country, with a significant number ending in deaths. The reports continue to be great eye-openers into how the War on Drugs in America failed because of a poor understanding of the potential victims. Gladden et al. studied an annual change in unintended opioid deaths and found that illegally manufactured fentanyl led to opioid deaths, and there was a particular increase in illegal opioid deaths, with a significant decrease in deaths from prescription opioids. The statistics point to the need for drug-specific interventions to decrease the rate of deaths from the drugs.
When one begins a conversation on drug abuse, the homeless population and individuals from low-income communities become the target demographic on this conversation. One would ask themselves why and the answer is always that poverty is almost certainly complementary to drug abuse. Silverman, Hotlyn, and Toegel concur with these sentiments by noting that there is a direct increase in the probability of a person using and abusing drugs if their income decreases. The recent reports on drug use show that this is almost always far from the truth. Fentanyl has become a prominent drug not only because of the impact it has, which is leading to deaths and overdoses, but because it has revealed how the drug problem is rampant among the elite.
The death of musician Prince and the recent death of actor Michael K. Williams shed light on how even celebrities and the elite are victims of this extremely potent drug. Kuczynska et al. note that fentanyl use is directly associated with heroin use because heroin is usually laced with fentanyl, and this is what causes most fatal overdoses. This crucial piece of information shows that most fentanyl users are already heroin users who moved to a more potent drug or simply used their usual drug without knowing it is laced with fentanyl. The unsuspecting and sometimes informed users continue to use heroin, oblivious of the deadly side effects of the extremely dangerous component that fentanyl adds to the drug.
News reports have given a glimpse into different victims of fentanyl overdoses, and there is a clear change in the demographics. Instead of inner-city youths with dysfunctional families living in poverty, we have seemingly adjusted teenagers and young adults with loving families in rich neighborhoods. Consequently, it is clear that poverty is not the main driver of drug abuse and drug-related fatalities in modern America but rather mental health issues. Rosenblum, Unick, and Ciccarone note that there is a significant change in drug use in the United States characterized by a significant reduction in deaths caused by prescription opioids and an increase in deaths due to illicit opioids, with fentanyl taking the lead.
Live Science quotes a study by the Development and Psychopathology Journal that revealed that upper-middle-class young adults are twice more than the national average, likely to be diagnosed with drug addiction. The journal showed that there is an alarming increase in the rate of addiction among teenagers from affluent communities compared to those from less affluent communities. Wenhua et al. attribute this phenomenon to an increase in major depression among adolescents. A longitudinal study conducted by these authors from 2011-to 2019 showed that there is a worrying trend of depression co-occurring with substance abuse among teenagers, and the existing disparities in treatment make it worse to curb the silent pandemic. The result is the recent deaths due to drug overdoses, as seen in the news recently.
The study above indicates the need to change and focus on the modern potential drug victim, who is the American youth, regardless of their socio-economic status. When coming up with interventions, it is crucial to tailor them to the needs of the specific person, rather than assuming that drug addictions are a poor man’s problem. Nierenberg gives a different perspective to the problem by noting that most addictions start as experimentation. According to this author, wealthier students have the luxury of money and can always access the drugs in plenty; it thus makes addiction easy for them because they can finance a drug habit. Further, the study shows higher rates of intoxication among wealthy students compared to those from low-income communities, which points to the urgent need to study and come up with interventions targeting all populations.
Studies on teen experimentation and possible addiction show that there is no homogenous path with different factors determining outcomes. Gray and Squeglia name resilience, risk factors, and underlying neurobiological factors being significant determinants of whether a teenager can develop an addiction following experimentation. For instance, these authors point out mental health issues and a history of addiction being crucial biological factors that could lead to a teen progressing from experimentation to addiction. The heterogeneity of this phenomenon requires person-specific interventions for sustainable positive outcomes. The article also shows that drug experimentation and subsequent addiction do not discriminate along socio-economic lines; rather is a problem that affects youths from all walks of life.
Research also shows a change in interventions targeting drug abuse, which points to inequality because the elite are now affected. Gladden et al. note that the main intervention in the opioid problem is increasing access to naloxone, commonly known as Narcan. The drug is administered through the nose and can be administered by anyone by simply spraying it in the victim’s nose. First responders point to the ease in administration being the main reason why increasing access will be a significant way to reduce opioids, especially fentanyl- related deaths.
While most studies on demographics most affected by the drug problem show that minorities, especially those in the low-income bracket, make the most affected population, this essay counter-argues that this is far from the truth. Other communities in the upper-middle-income bracket are equally affected, but the damage is about to be the same if the government doesn’t take immediate action to curb the problem. Gray and Squeglia note that understanding other affected demographics ensures that the United States can secure its future. The study shows a potentially explosive drug problem among adolescents and notes that drugs impede cognitive development and thus, substance use during early years can translate to addictive behavior in the future.
It is thus safe to say that the drug problem commonly covered by the media and numerous organizations depicting it as significantly concentrated in inner communities is far from the truth. Other communities, besides the minority, are equally having a drug problem, especially an opioid epidemic, whose devastating impacts are felt all over America. The National Academies of Science reports that as of 2017, young adults between the ages of 18-and 26 recorded the highest level of nonmedical opioid use. The study shows that opioid use is not indiscriminate of gender or ethnicity, which places high alarm on America’s future. One of the reasons why this phenomenon exists is that illegally manufactured opioids such as synthetic fentanyl are easily and cheaply available.
While targeting affected populations is an essential and typical approach to fighting the drug problem in America, understanding root causes is a proactive approach to addressing the problem. For instance, there are clear trends of individuals who transitioned from prescription medication to illegal opioids, and that shows the need for intervening in this demographic before they crossover through better approaches to pain management. Further, the root causes of the drug problem among teenagers include mental health issues, especially major depression and anxiety (Wenhua et al.). The manufacture of these drugs is also a crucial part of eliminating the problem, which will be a better approach compared to the War on Drugs by President Nixon, which further fueled the problem through discrimination, mass incarceration, and further victimization of drug and crime victims.
In conclusion, the changing trends in drug and substance abuse show there is a need for a change in preventive interventions, especially the demographics. While there is a clear problem of drug abuse in low-income communities, the same problem is extremely rising among upper-middle-income communities. Consequently, interventions should provide wholesome solutions that can address drug issues among Americans from all walks of life instead of neglecting some demographics. The neglect points to potential inequalities in the perception of problems that affect different communities, and a change that includes eliminating such stereotypes will go a long way to preventing inequalities in drug abuse interventions.
As identified before, misinformation is one of the main reasons why the drug problem continues to thrive, and increasing accurate information is an excellent way to curb the problem. A significant part of misinformation is on the most affected demographics, and the 21set century shows that it is time to accept that all demographics in America are susceptible to drug problems. As a result, it is essential to ensure that while most affected communities receive immediate interventions for the problem, less affected communities receive preventive interventions for better and sustainable outcomes.
Works Cited
Gladden, Matt, et al. Changes in Opioid-Involved Overdose Deaths by Opioid Type and Presence of Benzodiazepines, Cocaine, and Methamphetamine — 25 States, July–December 2017 to January–June 2018, Morbidity and Mortality Weekly Report 68(34), 737-744. https://dx.doi.org/10.15585%2Fmmwr.mm6834a2
Gray, Kevin & Squeglia, Lindsay. Research Review: What have we learned about adolescent substance use? The Journal of Child Psychology and Psychiatry 59(6), 618-627. (2018). https://doi.org/10.1111/jcpp.12783
Kuczynska, Katarzyna et al. Abuse of fentanyl: An emerging problem to face, Forensic Science International 289(8), 207-214. https://doi.org/10.1016/j.forsciint.2018.05.042
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse; Phillips JK, Ford MA, Bonnie RJ, editors. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (DC): National Academies Press (US); 2018, Jul 13. 4, Trends in Opioid Use, Harms, and Treatment. https://www.ncbi.nlm.nih.gov/books/NBK458661/
Nierenberg, Carl. Rich Kids and Drugs: Addiction May Hit Wealthy Students Hardest. (2018). https://www.livescience.com/59329-drug-alcohol-addiction-wealthy-students.html
Rosenblum, Daniel., Unick, Jay & Ciccarone, Daniel. The Rapidly Changing US Illicit Drug Market and the Potential for an Improved Early Warning System: Evidence from Ohio Drug Crime Labs, Drug and Alcohol Dependence 208(1), 1077779. https://doi.org/10.1016/j.drugalcdep.2019.107779
Silverman, Kenneth., Holtyn, August & Toegel, Forrest. The Utility of Operant Conditioning to Address Poverty and Drug Addiction, Association of Behavioral Science International 42(3), 525- 546. (2019). https://dx.doi.org/10.1007%2Fs40614-019-00203-4
Wenhua, Lu., Laboy, Miguel & Sohler, Nancy. Trends and Disparities in Treatment for Co-occurring Major Depression and Substance Use Disorders Among US Adolescents From 2011 to 2019, Psychiatry 4(10), e2130280. (2021). https://doi:10.1001/jamanetworkopen.2021.30280
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