Opioids have been present in Western society for a long time, with morphine first being synthesized in 1804. So why are we facing an opioid crisis now?
To understand this, we need to go back to the 1990s. At the time, a pharmaceutical company called Purdue Pharma was about to lose the patent on its best-selling drug, MS Contin. In search of a new blockbuster medication, Purdue developed and patented OxyContin. Determined to make OxyContin its next major success, Purdue claimed that this opioid was different from all others on the market. How? They insisted it had a less than 1% addiction rate and provided 12 hours of pain relief—meaning patients only needed to take it twice a day for continuous relief.
The promise of a less than 1% addiction rate grabbed attention. Purdue heavily marketed OxyContin as a miracle pain pill, suitable for treating a wide range of ailments, from minor back pain to sprains. When it was released in 1996, Purdue wasted no time aggressively promoting its use, offering lucrative bonuses to pharmaceutical reps based on prescription sales. Doctors were whisked away to lavish weekend conferences where the supposed benefits of this new painkiller were celebrated.
As prescriptions for OxyContin soared, so did opioid-related overdoses. Initially, the increase in overdoses was dismissed as a natural consequence of increased prescribing. However, by the early 2000s, doctors began noticing alarming signs of addiction in patients using this supposedly "non-addictive" drug. Soon, researchers and other pharmaceutical companies attempted to replicate Purdue's claims—but they couldn’t. Instead of a less than 1% addiction rate, studies found rates closer to 80%.
The cracks in Purdue's narrative widened as investigations revealed that the company had falsified its claims about OxyContin’s addictiveness. It was, in fact, just as addictive as other opioids. Adding to the problem, many patients reported that the drug did not actually provide 12 hours of relief; for many, pain returned around the eight-hour mark, often accompanied by withdrawal-like symptoms. The only way to stave off these symptoms was to take another dose, reinforcing and deepening the cycle of addiction.
As the truth about OxyContin emerged, doctors began cutting back on prescriptions, leaving millions across North America dependent on opioids but with no legal means to access them. Desperate to avoid withdrawal, many turned to heroin—an opioid that had long existed in the unregulated drug market. Overdose rates, which had been climbing alongside prescription opioid use, now shifted toward heroin.
The surge in heroin demand created a supply problem for drug dealers, who quickly found a solution: fentanyl. By cutting heroin with baking soda, powdered milk, or other fillers, they could stretch their supply—and then restore its potency by adding fentanyl, an opioid 50 times stronger than heroin. This discovery soon spread beyond heroin, as dealers began using fentanyl to boost the potency of other unregulated substances. Why? It was simply a way to maximize profit in what has now become a $4 billion-a-year industry.
While fentanyl quietly infiltrated the unregulated drug supply, it was also gaining traction in the legal market. Enter Insys Therapeutics. In 2012, Insys launched Subsys—a fentanyl spray intended to treat breakthrough pain in cancer patients already using opioids. However, Insys saw cancer patients as a limited market and needed to expand. Rather than developing a new drug, they pushed doctors to prescribe Subsys "off-label" for conditions like migraines and chronic pain. To drive sales, Insys created speaker programs that served as a front to bribe doctors into prescribing more Subsys, directly contributing to the growing demand for fentanyl.
All these factors converged to create the perfect storm for today’s opioid crisis. Countless individuals were placed on these drugs—often without fully understanding their addictive potential—and when the legal supply was cut off, many turned to the unregulated market, where fentanyl had taken hold. Now, fentanyl has spread like wildfire, devastating communities and families across North America. The opioid overdose crisis has only worsened, with no clear end in sight as policymakers focus on restricting supply rather than addressing the root causes of demand.
*Purdue Pharma was fined $600 million in 2007. However, they had already profited $2.8 billion from OxyContin sales.
*Insys Therapeutics’ CEO was sentenced to 5 ½ years in prison in January 2020 but served only two years before being released in June 2023.
Read more:
General Information on the Opioid Crisis
Government of Canada – Opioid Overdose Crisishttps://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids.html
U.S. National Institute on Drug Abuse (NIDA) – Opioid Crisishttps://nida.nih.gov/research-topics/opioids
Centers for Disease Control and Prevention (CDC) – Opioid Data and Resourceshttps://www.cdc.gov/opioids/index.html
Harm Reduction Resources
National Harm Reduction Coalition (U.S.)https://harmreduction.org
Canadian Centre on Substance Use and Addiction (CCSA) – Harm Reduction Approacheshttps://www.ccsa.ca/harm-reduction
Brave App – Digital Harm Reduction & Supporthttps://www.brave.coop
Treatment & Support Services
211 Canada – Addiction & Mental Health Support Serviceshttps://211.ca
Substance Abuse and Mental Health Services Administration (SAMHSA) – Treatment Locator (U.S.)https://findtreatment.samhsa.gov
Lifeguard App – Overdose Prevention Toolhttps://lifeguarddh.com
Advocacy & Policy
Moms Stop the Harm – Advocacy for Drug Policy Reform (Canada)https://www.momsstoptheharm.com
Canadian Drug Policy Coalitionhttps://drugpolicy.ca
Drug Policy Alliance (U.S.)https://drugpolicy.org
Comments