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Health Dept.: Opioids in America, then and now

A smart, well-educated woman from a comfortable family begins using opioids and as a result, she is dragged down from a place in high society, has her children removed from her care, and eventually dies of an overdose.

Ella Henderson could have lived in Carroll County — she could have been our niece, our neighbor, our coworker — but she actually died in Detroit in 1877, according to her obituary titled “The Beautiful Opium Eater.”

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While the opioid epidemic currently ongoing in the United States has new players, such as synthetic opioids like fentanyl and prescription painkillers like oxycodone and hydrocodone, the story actually goes all the way back to the American Civil War. Soldiers were given millions of opium pills and powders to treat pain during the war, and afterward veterans were given morphine (a medicine derived from the opium poppy) to relieve pain from war wounds or to treat opium addiction — so widespread that it was sometimes called “the soldier’s disease.”

By the late 1800s, doctors and pharmacists relied heavily on morphine as a “wonder drug” to relieve ailments ranging from chronic pain to asthma, diarrhea and menstrual cramps. As a result, morphine and opium addiction became widespread across the US.

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America’s first opioid epidemic began to decline in the early 1900s thanks to a combination of government regulation, improved training for doctors, and advancements in public health, but illegal use of opium and heroin continued through the 20th century. Then, in the 1990s, a combination of factors including increased emphasis on pain management and the introduction of a new, supposedly low-risk opioid pain medication set the stage for a resurgence of opioid addiction and led to the epidemic we see impacting our community today.

After the widespread problems caused by overuse of morphine and other opioids in the 19th century, doctors around the world were hesitant to prescribe opioids for pain. However, beginning in the 1980s, a push for improved pain management combined with a few scientifically-dubious articles claiming a low risk of addiction led to an increase in opioid prescriptions in the United States. Add to these pressures Purdue Pharma’s aggressive marketing of their new opioid drug OxyContin (including all-expenses-paid conferences, millions of dollars in bonuses for sales representatives, and patient coupons for free limited-time prescriptions), and the result was a dramatic increase in opioid prescriptions beginning in the 1990s. More opioids in the community led to more misuse, more diversion (drugs being given to people to whom they were not prescribed), and more overdoses before it became clear that opioid drugs could indeed be highly addictive.

The late-1990s saw a significant increase in rates of overdose death due to prescription opioids, followed by a second wave of deaths due to heroin overdose beginning in 2010, and finally a third wave of deaths beginning around 2013 due largely to synthetic opioids such as illicitly-manufactured fentanyl. All told, between 1999-2018 over 450,000 Americans died of an opioid-related drug overdose. Now, communities all over the country are making changes to fight the opioid epidemic and reduce overdose deaths.

What can you do?

· Become a part of the Opioid Prevention Coalition. The Coalition is a group dedicated to reducing opioid misuse and overdose in Carroll County and includes health professionals, first responders, people in recovery, local leaders, and concerned community members like you. The next meeting will be held virtually on Wednesday, July 8 from 9 a.m. to 10:30 a.m. To learn more and get a link to attend, go to cchd.maryland.gov.

· Talk to your doctor about the risks of opioids and other drugs any time you or a loved one receive a prescription.

· Safely store prescription drugs in your home and dispose of unneeded or expired medications.

· Learn how to save a life with naloxone and receive a free kit when you get trained through the Carroll County Health Department: 410-876-4449.

· Thank your first responders and emergency response personnel for saving lives in our community every day!

Michelle McVay is a substance abuse prevention coordinator with the Carroll County Health Department.

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