The Future of America’s Opiate Crisis: 8 Ways to Address the Problem

How did we get here? Where will the opiate crisis likely lead? Here, we review what government can do to reduce and combat America’s opiate crisis. Actionable ideas from former DEA agent, Warren Rivera, here.

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Too many prescriptions opioids!

Over 100 million Americans suffer with chronic pain, causing Americans to consume approximately 80% of the global opioid supply. In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers. The opiate crisis will likely continue until the number of opioid prescriptions are drastically reduced.

Here, we’ll take a look at steps the U.S. should take to address America’s opiate crisis. Then, we invite your questions and comments in the section at the end.

The main statistics

According to statistics from SAMHSA (Substance Abuse and Mental Health Services Administration), Americans are more likely to die from an accidental opiate overdose than to gun violence or in a car crash. Americans continue to consume approximately 80 percent on the global opioid supply. According to the Institute of Medicine (IOM), over 100 million Americans suffer with chronic pain which may explain why so many opioids are prescribed and why so many Americans are addicted to them. In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers.

The opiate crisis will likely continue until the number of opioid prescriptions are drastically reduced.

According to ASAM, The American Society of Addiction Medicine, there were 52,404 lethal drug overdoses in America in 2015, with 20,101 related to prescription pain relievers. Furthermore, the CDC has reported that 91 Americans die every day from an overdose of prescription opioids, heroin, or other synthetic opiate. The amount of overdose deaths have more than quadrupled since 1999 and tragically as a result, so have the amount of babies born to addiction.

The most vulnerable victims of the opiate crisis are babies experiencing Neonatal Abstinence Syndrome (NAS) which occurs when the expectant mother takes opioids during pregnancy. Babies born with NAS go through excruciating opiate withdrawal and must be treated with opioids or other drugs to minimize their symptoms which can last up to six months.

Who’s cashing in on the crisis?

It is not just the pharmaceutical industry that is capitalizing on America’s opiate crisis, it is also the drug dealers. The amount of heroin and fentanyl seizures by the Drug Enforcement Administration (DEA) and other law enforcement agencies have risen dramatically over the past five years. The number of unintentional drug overdoses is not only attributable to prescription pain killers, but also the increase in the consumption of street heroin, fentanyl and other synthetic opiates. The availability of synthetic opiates on the street and the Internet is another factor driving this opiate crisis.

The recent increase in DEA seizures of clandestinely produced fentanyl has prompted the DEA Administrator to meet with China’s Narcotic Control Bureau Director to discuss strategies to control the illegal importation of this substance.

The DEA has determined that clandestine labs in China produce mass quantities of this substance in powder or pill form and ship it to Mexico or Canada where it is smuggled across the U.S. border. These substances are also sold over the

Internet and shipped to the U.S from China. The DEA Special Testing Lab is inundated with requests for analyses of various seized synthetic drugs manufactured and illegally imported from China.

The downturn in Rx meds: Fear of investigation

The CDC (Centers for Disease Control and Prevention) established their controversial Opioid Prescribing Guidelines last year which recommend non-opioid therapy for patients with non-cancer related pain. These guidelines, along with the increase in DEA criminal cases against physicians with questionable prescribing practices, are causing a downturn in opioid prescriptions for chronic pain sufferers. Many Primary Care Physicians will no longer prescribe Schedule II pain killers for fear of being investigated by the DEA.

However, this downturn comes at a price. There are countless stories of chronic pain patients becoming suicidal after being denied their pain killer prescriptions. Some patients who have their prescribed pain killers discontinued are self-medicating with heroin or clandestinely produced fentanyl purchased on the street or on the Internet. Many patients and addicts are simply switching to street drugs to avoid the painful withdrawal of opioid dependence or addiction.

Some who may be willing to receive treatment for opioid addiction do not have access due to lack of resources. The lack of physicians who treat addiction disorders and the lack of treatment centers are other major contributing factors to our continuing opiate crisis.

Steps we can take to save lives

How to prevent prescription drug abuse? What steps should we take to reduce and combat America’s opiate crisis?

1. Physicians should follow the CDC’s Opioid Prescribing Guidelines which will ultimately reduce the amount of opioids susceptible to abuse and diversion.

2. Prescriber education relative to DEA Compliance and the Diversion of Pharmaceuticals should be mandatory.

3. The DEA needs to eliminate Pill Mills and continue to investigate and prosecute violators who commit all crimes involving prescription drugs.

4. U.S. Government authorities should continue to prosecute persons who import, manufacture, sell and distribute synthetic opioids.

5. Prescription Drug Monitoring Programs for Prescribers should be mandatory.

6. Increase access to Naloxone, a lifesaving opiate/opioid blocker used in overdose situations.

7. Increase availability of Addiction Treatment for Opioid Use Disorder.

8. Drug Demand Reduction Programs in Americans schools targeting our youth in K-6th grade should be mandatory.

Unfortunately, the opiate crisis continues to plague our country and will continue to do so as long as there is a demand for opiates. But there are simply too many opioid prescriptions being dispensed in our country. There is no legitimate explanation why Americans consume over 80% of the global opioid supply other than we are over medicated.

KEEP THIS IN MIND: Recovery and treatment programs must be expanded for those struggling with addiction.

About the Author: Practitioners desiring to learn more about DEA compliance or anyone who would like to receive training on the diversion of pharmaceutically controlled substances from retired DEA Special Agent Drug Diversion Expert Warren Rivera, please visit or
Reference Sources:  The Washington Post: Prescription painkillers are more widely used than tobacco, new federal study finds 
CNBC: Americans consume vast majority of the world’s opioids
WebMD: 100 Million Americans Have Chronic Pain
The New England Journal of Medicine: Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies
American Society of Addiction Medicine: Opioid Addiction
CDC: Understanding the Epidemic
About the author
Warren Rivera is a retired Assistant Special Agent in Charge from the U.S. Drug Enforcement Administration. Mr. Rivera is an experienced public speaker, trainer and an expert in the diversion of pharmaceutical controlled substances. Mr. Rivera currently owns Training Idea, LLC, a private consulting firm that provides training on DEA matters to the healthcare industry, law enforcement and the community.
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