America is finally coming to grips with its opioid crisis
Hi there, welcome back to Plain English. I’m Jeff, JR is the producer, and you are listening to episode 191 of Plain English, the best podcast for learning English. The video lesson for today’s episode talks about how to use the word “within” to express time periods. And our flash cards are mostly about drugs. All those episode resources can be found on our web site at PlainEnglish.com/191.
Coming up today: The US has been grappling with a crisis in both legal and illegal opioids since about 2012. Now, investigators are finally starting to target the culprits and drug companies that aggressively pushed prescription opioids are having their day in court. Plus, I have a really good phrasal verb for you: “root out.” And JR has his song of the week.
Speaking of the song of the week: if you ever hear it on the podcast, but you can’t look it up right away, that’s totally fine. At least it is if you’re on the email list. Every time we send out our Thursday updates, we also include the song of the week right there in the email. So if you’re in the car and you want to add the song to your playlist, just check your email and the title and artist are right there, all courtesy of our producer, JR. To get those emails, just visit PlainEnglish.com/mail .
Opioid crisis in the US
It’s something that’s not frequently publicized internationally, but the US has been facing a serious crisis with opioids. Opioids are drugs, both legal and illegal, that seek to reduce pain and mimic the painkilling properties of opium, which is naturally occurring in poppy plants. The legal variety includes morphine, oxycodone, and hydrocodone. They are prescribed by doctors to patients who suffer from chronic pain. The illegal kinds include heroin, fentanyl, and others.
The number of overdoses has been on a terrifying increase since about 2012. About 20,000 people died of opioid overdoses in 2012—a worrying number that was increasing at a moderate rate each year. Within just five years, that had more than doubled to almost 50,000—the equivalent of a small American city dies each year from this one type of drug. Opioids now represent well over half the drug overdoses in the country. To put that in perspective, more Americans die of opioid overdoes than die from guns or car crashes; more than the AIDS epidemic killed at its peak; and almost as many every year as were lost in the entire Vietnam War.
The deaths from overdoses are only part of the story. Many, many times more people struggle with opioid addictions and all that means for them—financial ruin, lost jobs, ill health, broken family relationships. Over 2 million people suffer from opioid-related disorders. It tends to be the worst in rural areas and the Appalachian region. The states of Ohio, West Virginia, and New Hampshire have suffered the most.
Opioids are extremely addictive drugs. Even when taking the legal variety, like morphine, patients have to be very careful not to take too much of it; not to take it too quickly; and not to stay on it too long. For doctors, there is always a balance between the desire to alleviate extreme or chronic pain, on the one hand, and the ethical imperative to make sure patients take a responsible amount of the drugs on the other. For patients, especially those suffering from chronic pain, following the limits and guidelines of their doctors can seem unbearable. Too often, in search of relief, they look to find other doctors willing to prescribe them more—sometimes multiple doctors at a time.
And there were all too many unethical doctors willing to prescribe opioids irresponsibly. Pain relief clinics opened up, essentially selling opioid prescriptions with few protections or safeguards; they just wanted the money, oftentimes in cash. And the makers of these drugs pushed them on doctors, touting their benefits, but not fully explaining the risks of addiction and overdose. For years, the number of prescriptions increased alarmingly, as patients chased more and more pain relief. The drug makers insisted there was less than a 1 percent chance of addiction, even as the number of prescriptions rose to an implausible level. Patients were chasing more prescriptions than were safe; the drug makers were all too happy to continue selling the drugs; and unethical doctors and clinics filled prescriptions with abandon. At the peak, Americans were getting four times as many opioid prescription per person than Europeans were.
The US government was caught flat-footed as the crisis raged in the last several years. Now, however, there is wide recognition that the issue is a public health emergency and there is, at last, a national consensus that the issue needs to be addressed at the highest levels. State governments and the national government are targeting both drug makers and the doctors. Purdue Pharma, the maker of OxyContin, was the most high-profile opioid maker. It is being sued by thousands of local government entities for its role in the opioid crisis. It is likely to declare bankruptcy and turn itself into a nonprofit, donating all proceeds of future sales to a public trust. Other drug-makers, including some household names like Johnson & Johnson, are also being targeted in court.
Doctors are not escaping notice. The US government is using advanced data analytics to root out clinics that were overprescribing drugs. They found one location that consulted with a patient for 91 seconds before dispensing hydrocodone—for cash, of course. The investigators say there’s little difference between some of these clinics and drug dealers on the streets.
I feel so bad for the people caught up in this. This isn’t true in every case, but in so many cases you read about, it only took one injury or surgery or illness for someone to get prescribed OxyContin or Percocet something. And then, those pills are sitting right there in the bottle, the pain is worse than normal one day; one thing leads to another, and the person has taken more pills than prescribed. They have to go to another doctor to get a new prescription or they’ll be left short when the first one runs out. And that’s it. That’s all it takes to get addicted—those are powerful drugs. And it can be a really, really painful spiral down after that. It’s just really sad how many people have been affected.
I heard from several listeners that I’d like to say hi to. First—this is incredible—Jagoda from Poland got back from an epic trip of a lifetime, and after having traveled to so many places, she wanted to brush up on her English. Listen to what she did. She and her boyfriend rode their motorcycles from Poland, where they live, to Nepal—30,000 kilometers, camping the whole way. They went through Georgia, Pakistan, India, Iran, Tajikistan—not in that order. I’m pretty sure I couldn’t put the countries from Poland to Nepal in the correct order, much less plan a route from end to end. Jagoda sent me some pictures and it looked amazing—and let me just say she is brave. Anyway, she’s back home in Poland and after traveling so much, wanted to improve at English, so she’s been with us for about eight months. I also want to say hi to Peggy from Hong Kong and Ivonne and Steffany, both from Bogotá, Colombia.
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