When the Opioid Crisis was Declared a National Public Health Emergency and What Led Up to That

Man overdosed on opioids in his bed

At this point, few are unaware of the fact that the United States is struggling with a pretty terrible opioid epidemic. This has easily been the most problematic and difficult drug problem of them all, a crippling crisis that has caused endless, almost incalculable devastation across the nation.

The History—How We Got to Where We are Today

The development of the opioid epidemic is not something that happened overnight. And it is not something that should have ever been allowed to get as bad as it did. But unfortunately, the problem did develop and did grow and expand, all underneath our very noses.

It all began in the late 1990s when the American Medical Administration (the highest echelon of authority in American medicine) decided to make the phenomena of pain a priority to address. This was a very new development. Prior to that, doctors and nurses and general medical practitioners absolutely tried to make their patients comfortable, but it was not a priority.

What the American Medical Administration did was unprecedented. They added pain (as a classifiable phenomenon) as the fifth vital sign. In doing so, addressing pain became a huge priority, just as addressing the other vital signs are of the utmost priority. Now, the five vital signs are:

  • Pulse rate. The first vital sign is the patient's pulse rate. If a patient has no pulse, they are dying and need immediate attention. Furthermore, a patient’s pulse rate can be a good indicator of their health condition.
  • Respiration rate. The rate of breathing is the second vital sign. A human body can only go so long without oxygen. In fact, it is not that long at all. This must be checked and addressed rapidly by attending physicians.
  • Temperature. The body is not meant to survive in a very wide range of temperatures. If the body’s temperature rises too high or drops too low, a person can die. This is the third vital sign that doctors need to address.
  • Mental state. One’s mental state is a great insight into one’s health and overall condition. Doctors need to check and verify a patient’s mental state almost instantly.
  • Relative amounts of pain felt. This is the new one, the fifth vital sign. Doctors will now weigh a patient’s current condition and the severity of their condition partially based off of how much pain the patient is feeling.

When the AMA added pain as the fifth vital sign, doctors and all medical practitioners were under an entirely new demand for addressing pain in their patients. This brought on a massive need for methods to address and reduce pain, a process that the American pharmaceutical industry was more than happy to help with.

Pharmaceutical manufacturing corporations all across the country offered up opioid painkillers to doctors, promising that painkillers were the ideal solution and that painkillers and painkillers alone could help patients overcome pain. Such corporations also promised doctors that their painkillers were safe to use, almost completely side-effect free, and addiction-free. What a lie that was.

Around the turn of the century, American doctors began prescribing opioid painkillers to their patients, not having a very good idea at all of what they were getting themselves into. By 2005, the number of Americans on painkillers more than tripled. By 2015, the total numbers of Americans taking painkillers were more than five-hundred percent greater than the turn of the century figures were.

Addict walking on the beach.

And the opioid addiction epidemic came with the whole package too. From 1999 to 2015, more than six-hundred and forty-thousand Americans died from drug overdoses. Over four-hundred-thousand has been from opioids, and at least two-hundred and twenty-thousand of those deaths have been from opioid painkillers specifically. Furthermore, the advent of the opioid painkiller epidemic has made more than eight million drug addicts, addicts who have also brought other drugs like heroin back onto the scene.

What we can see from this history lesson is that just one change, just one crucial change in medical policy and how doctors were going to address pain ultimately led to a massive increase in addiction. It was a domino effect, a terrible decision that brought us to the last year that we have recorded statistics for, the year of 2016, with sixty-three thousand dead from drug overdoses in that year alone and about twenty-five million Americans addicted to drugs and alcohol.

The Federal Government Announces the Epidemic for What it Is

It took seventeen years, but the U.S. federal government finally announced the addiction epidemic for what it is. In an October 2017 statement, President Trump came forth and called the opioid crisis what it truly is, labeling it a “National Public Health Emergency.” President Trump said that:

The opioid crisis is an emergency, and I’m saying officially right now it is an emergency. It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis. There’s never been anything like what’s happened to this country over the last four or five years. And I have to say this in all fairness, this is a worldwide problem, not just a United States problem. This is happening worldwide. But this is a national emergency, and we are drawing documents now to so attest.

The president’s briefing and address were little more than an official recognition on the part of the federal government that the United States was, indeed, mired in perhaps the worst substance abuse epidemic that it had ever experienced.

The President was backed up by the United States Health and Human Services Secretary, Mr. Tom Price, who said that:

“When you have the capacity of Yankee Stadium or Dodger Stadium dying every single year in this nation, that's a crisis that has to be given incredible attention, and the president is giving it that attention.”
Dodgers Stadium
Dodger Stadium (Photo by Joseph Sohm/Shutterstock.com)

When you have the capacity of Yankee Stadium or Dodger Stadium dying every single year in this nation, that's a crisis that has to be given incredible attention, and the president is giving it that attention.

The President’s announcement about the opioid problem is not just the result of a brief and emotional overview of the American addiction situation. The White House's Commission on Combating Drug Addiction and the Opioid Crisis had just spent months reviewing this issue and compiling a report to give to President Trump himself. The report said that:

“With approximately 142 Americans dying every day, America is enduring a death toll equal to September 11th every three weeks…”

“With approximately 142 Americans dying every day, America is enduring a death toll equal to September 11th every three weeks. Yet only 1 in 10 people suffering from the disease of addiction have access to proper treatment and support to address their addiction.

It was hard hitting facts like these that the President touched on in his address.

Looking to the Future

As we look to the future, we all need to take massive action in reducing the drug epidemic once and for all. This is not a problem that can just be solved on the federal level. Not by a long shot. Every American, every community, every school, every workforce, every city, and every state needs to do their part to reduce this problem. It will take massive preventative efforts and consist rehabilitation efforts, but this is a problem that can be reduced. It will simply take far more work and comprehensive efforts to do so.




After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.