Many people wonder, “how did we get into so much trouble with opioids?” Sometimes people who take opioids feel they are being blamed for the problem. The opioid epidemic has multiple causes and it is unfair to blame people who use them, even those who are misusing them, for the problem.

How It Began

  • 1850–1914. The first opioid epidemic in the United States occurred between the 1850s and 1914. Unregulated and highly promoted medicines with opium and morphine were sold as miracle cures or syrups to soothe children. By 1874, heroin (from the German for “heroic”) had been synthesized as a nonaddictive substitute for morphine. False claims of safety and effectiveness for opiates have been made before.
  • Medical advertising was launched in the United States by the Sackler family who bought Purdue Frederick in 1952.
  • Many national and international organizations became concerned that chronic pain was not being well managed and were told expanded use of opioids would help. There were no drug trials showing that opioids are effective longer than 12 weeks for chronic pain or that benefits outweigh risks for most people. We are now learning opioids can actually make pain worse. Learn more about how drug manufacturers influenced modern medicine.
  • Purdue released MS Contin, which was marketed to cancer patients.
  • Purdue released Oxycontin, a major driver of the opioid epidemic. Executives of Purdue were fined over $600 million in 2007 for misrepresenting the risks of Oxycontin. The United States remains the only country in the world, besides New Zealand, which allows drug companies to market directly to consumers. Currently, the United States uses 99% of the world’s supply of hydrocodone and 80% of the world’s opioids overall. Yet there is no evidence that Americans experience more pain than others do.
  • 2002–present. Evidence that opioids often do more harm than good has accumulated. Deaths of celebrities have sharpened public awareness. Four out of five heroin users began first with recreational use of prescription painkillers. About 10 years ago drug overdoses began to cause more US deaths than car accidents, according to Sam Quinones, author of Dreamland: The True Tale of America’s Opiate Epidemic and 2015 winner of National Book Critics Circle Award for non-fiction.

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