Introduction: Opioid Controversies: The Crisis — Causes and Solutions

• Published in: The Journal of law, medicine & ethics Vol. 48; no. 2; pp. 238 - 240
• Main Author: Sade, Robert M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-06-2020; Cambridge University Press
• Subjects: Chronic pain; Congresses as Topic; Drug addiction; Drug dosages; Drug overdose; Drug use; Drugs; Economic crisis; Health care; Health care expenditures; Health services; Health technology assessment; History, 20th Century; Humans; Law enforcement; Litigation; Marijuana; Medical education; Medical ethics; Medicine; Narcotics; Opioid Epidemic - history; Opioid Epidemic - prevention & control; Opioid Epidemic - trends; Opioids; Opium; Patients; Pharmaceutical industry; Prescription drugs; Productivity; Substance use disorder; United States; United States; United States > US
• ISSN: 1073-1105; 1748-720X
• DOI: 10.1177/1073110520935334

This symposium issue consists of papers presented at the 25th Annual Thomas A. Pitts Memorial Lectureship in Medical Ethics, April 4, 2019. The endowed lectureship, held annually since 1993, is funded by the Medical University of South Carolina Foundation through a bequest from Dr. Pitts, who served on MUSC's Board of Trustees for 36 years, including 25 years as its chair. The conference was presented by the Medical University of South Carolina, the Institute of Human Values in Health Care, the South Carolina Clinical and Translational Research Institute, the Office of Humanities, and the Office of Continuing Medical Education of the MUSC College of Medicine.The opioid crisis in the United States began in the 1990s, but the problem of drug addiction goes back much further: “Of all the nations of the world, the United States consumes the most habit-forming drugs per capita.” That statement was made in 1911 by Dr. Hamilton Wright, US Opium Commissioner.1 The massive increase in addictive drug use that began about 25 years ago has been variously described as a crisis or as an epidemic, but no matter the label, the problem is enormous. In 2018, 10.3 M Americans were classified as opioid misusers, and 2.1 M suffered from opioid use disorder (OUD).2 More importantly, 47,000 people died of opioid overdose in 2017, nearly 130 people a day.3 The economic cost of the crisis is considerable as well. In 2013 losses owing to addiction treatment, health care costs, loss of productivity, and law enforcement involvement amounted to over $78 B; those losses are probably much larger now.4