A Brief look into the History of Opiate Addiction
Posted: October 27th, 2022
The current social problem and the population it impacts.
According to the Substance Abuse and Mental Health Service Administration (SAMSHA, 2021), opioid use disorder (OUD) has impacted all populations across the United States, with the most vulnerable populations being found in impoverished inner cities, rural/farming communities, and communities whose primary industries all rank within the top 10 of the most dangerous occupations in the country such as commercial fishing, coal mining, farming, and significant industrial manufacturing (CDC, 2021). According to the National Institute on Drug Abuse (NIDA), West Virginia, Ohio, Kentucky, and the entire New England region have the country's most significant number (per capita) of overdose deaths. However, Philadelphia, PA., Baltimore, MD., Birmingham, AL., Warren, MI., and Knoxville, TN. rank highest as the top major U.S. cities for OUD overdose and overdose deaths (NIDA, 2021).
When has this problem been identified historically, and what were the actions taken to address this concern?
The first congressional action taken to alleviate the morphine/opium trade dates back to 1890, when states were given the power to levy taxes against the drug, leading to the Smoking Opium Exclusion Act of 1909, which banned the smoking of opium (Jenkins, 2021). However, in the medical field, opiates were still used legally as they are today. According to Ritter, the “war on drugs” was led by Harry Anslinger (founder of the Federal Bureau of Narcotics) in the 1930’s. Over the next 30 years, Anslinger, and this newly founded department in the federal government, saw their primary goal in trying to end opiate (morphine/heroin) addiction, which was yet to be considered illegal in this country (Ritter, 2016).
How have the populations affected by the social problem changed over time?
In his book, Chasing the Scream, Johann Hari gives a detailed account of the evolution of opiate addiction (opium became morphine, then heroin, to modern-day synthetic opiates such as fentanyl) and the systemic racism that played a significant role in the heroin epidemic continually being ignored/maltreated amongst inner-city minorities (Hari, 2015). Hari also points out that the “opioid epidemic” making the news over the last 30 years only did so because of the shift in the populations now dying from the drug. When big pharma began its infiltration into targeted rural areas whose people were seen as uneducated and had a high risk of injury due to their occupation, the “front-page news” began to pay attention. According to Jenkins, the opioid epidemic was in the headlines daily when White suburban middle and upper-middle-class adolescents and young adults started overdosing in the early 1990s (Jenkins, 2021).
How might this social problem be incongruent with social work values/ethics?
The most glaring way I see this problem being incongruent with the NASW Code of Ethics is not the OUD epidemic but the continued systemic racism and discrimination in how this “system” failed to address the issue. Many minority populations suffering from OUD have continued to be marginalized and underserved when one considers the core principles such as social justice and the dignity of the human person, among others (NASW, 2021).
Describe the next steps for how you will identify a policy.
The 2016 Comprehensive Addiction and Recovery Act is where I will begin, seeing what other federal and state policies have been implanted over the last six years to fight OUD. This piece of legislation authorized the necessary funding for local treatment efforts. In my opinion, the OUD epidemic must be fought on all levels of the social work profession to be effective. Micro, mezzo, and macro practice must become a united front in helping to alleviate the suffering and continued marginalization of all people suffering from this lethal disease.
Hari, J., (2015). Chasing the scream: The first and last days of the war on drugs. New York:
Jenkins, R., (2021). The fourth wave of the US opioid epidemic and its implications for the rural
Ritter, A., (2016). Chasing the scream: First and last days of the war on drugs: A Critique, Drug and alcohol review, 35, 650. National Drug and Alcohol Research Center, Sydney, Australia.
Centers for Disease Control and Prevention, (2017). Annual surveillance report of drug-related risks and outcomes, United States, MMWR Surveill Summ 2017.
National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers.
Substance Abuse and Mental Health Services Administration, (2021). Opioid overdose.
Retrieved from: https://samhsa.gov/opioid-overdose