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The opioid epidemic has been a long-standing public health issue since the 1990s, affecting many parts of the United States, including Alameda County.
While the crisis is relatively well acknowledged today, when it was first starting, there were many misconceptions about it. Even now, there are still misunderstandings about how the opioid crisis came to be what it is today.
As documented by the Federal Communications Commission (FCC) and the Food and Drug Administration (FDA), this is a timeline of the crisis as it evolved in the past few decades.
Wave 1 (1990s)
Early 1990s: The opioid crisis has its roots in the pharmaceutical industry. As noted by the Cleveland Clinic Journal of Medicine, pharma companies pushed for “pain as the 5th vital sign”. This made it so medical professionals would take a stronger approach to pain and medicating pain. Opioids as pain killers became a more viable option in the medical industry’s eyes.
1995 to 1996: In 1995 the FDA approved Purdue Pharmaceuticals’ OxyContin for pain treatment. While the drug was initially marketed as less additive by Purdue, as highlighted by the Department of Justice, it was later found out that was not the case. By 1996, the drug had become widely popular within hospitals. The FDA has since acknowledged how misleading marketing from Purdue led to the widespread usage and popularity of OxyContin.
1999 to early 2000s: According to the CDC, between the late 1990s and the early 2000s, prescriptions for opioids increased 400%. This was mainly due to mislabeled marketing and higher average doses.
2007: In 2007, a lawsuit was filed against Purdue and it was uncovered that there had been misleading information regarding OxyContin. This was the beginning of people viewing opioids for what they really are and for the government to start regulating their usage.
Wave 2 (2010 – 2013)
2010: 2010 saw an increase in regulations regarding opioids, which also left many people who had become reliant on the substances unable to access them. This led to an increase in non-doctor prescribed drugs acquired from other places, as noted by the Health Research Policy and Systems.
2010s: There was also an increase of heroin usage throughout the U.S. as it was cheaper and more accessible. The CDC noted that Mexican drug trafficking contributed to this greatly and heroin-related overdoses more than doubled in this period.
Wave 3 (2013 – Present)
2013: The CDC marks 2013 as the beginning of the third wave. The rise of fentanyl is a key factor of the third wave, as it became more widespread to have fentanyl mixed into other less-deadly drugs, called polydrugs.
2016: Congress passed the Comprehensive Addiction and Recovery Act (CARA) to help those affected by the opioid epidemic. This Act increased access to naloxone, a drug that can reverse overdose, provided funds for community-based prevention strategies and made prescription drug monitoring programs (PDMPs) stronger.
2018: Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) was signed, making support for individuals affected by the opioid epidemic better supported through increased access to medical addiction treatment (MAT) and expanded Medicare coverage for opioids.
2020: The Covid-19 pandemic served to further worsen the opioid epidemic because of limited access to clinics and the worsened mental health isolation caused.
2023: The year 2023 saw a 2% decrease in synthetic opioid overdose deaths, according to the CDC. It was also the year that Alameda Country, along with many others, were given funding to help their communities face the opioid epidemic.
Within Alameda County
Alameda County Health Care Services Agency
According to reports from the Alameda County Health Care Services Agency (ACHCSA), 2017 was the start of a steep increase in opioid deaths. There was a rise in fentanyl production and trade at this time as the third wave was hitting its peak in the county. Fentanyl was seen to be an easier alternative to produce when compared to other drugs. This factor, along with others, greatly fueled the rise of the third wave and the subsequent rise seen in the graph.
The agency noted that “overdose deaths are increasing each year with people experiencing homelessness accounting for about 30% of all overdose deaths”. The rise of poly drugs was also a main factor in both increased usage and deaths from Opioids as many unknowing people were given hard drugs.
In 2018, Alameda County along with other counties across America filed a lawsuit against several pharmaceutical companies that aided the rise of the opioid epidemic. In 2022, a settlement was reached and, over the next six to 18 years, Alameda will be receiving funds to better handle the crisis.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
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