Addiction usually begins as innocent experimentation with drugs that are thought to be safe because they are legal. But when alcohol and marijuana are no longer enough, and recreational drug users get bored with their experiences, prescription opioids and heroin are often the next step. But even one dose of heroin can start a person on the path to addiction.
Opioid and heroin abuse are currently finding their way into every community in America. According to a recent People Magazine report, one person dies of a heroin overdose every 10 minutes in the United States. The opioid epidemic claimed more than 52,000 lives in 2015, killing more Americans than guns or automobile accidents.1
With new efforts to control prescription opioid abuse, alternative sentencing programs in designated drug courts and greater access to naloxone to reverse opioid overdose, steps are being taken to stop the growing problem. But at the rate the current epidemic is expanding and with the ongoing conversations about decriminalizing more drugs, the future of drug use in America is difficult to predict. A look at the history of drug abuse, as well as how addiction develops and what it does to the brain, can help lawmakers and citizens take steps to better shape the future of drug use in the United States.
A Look Back at Drug Abuse
It may seem as though addiction is only a problem for modern society, but opium use in America may have gotten its start as early as the Mayflower.2 Laudanum, a tincture of opium and alcohol created by 16th century alchemist Paracelsus, was considered an appropriate treatment for a variety of illnesses. It became especially popular during the Victorian Era, where it was known as the “aspirin of the 19th century,” and was used for coughs, rheumatism, cramps and even as a sleep inducer for babies and children.3
Morphine was also first extracted from opium in the early 19th century and quickly became the most popular pain reliever of its day. In the United States, morphine was the primary painkiller for wounded soldiers during the Civil War, many of whom came home addicted to the drug.4 In 1893, chemists worked to find a less addictive form of the drug and created heroin for the first time. However, they soon learned that the heroin they produced was twice as potent as morphine and just as addictive.4
By 1905, opium had been banned by Congress, and the Pure Food and Drug Act was created, requiring ingredient labeling on all medicines. In 1937, as the world of medicine continued its search for a less-addictive painkiller than morphine or heroin, German scientist Max Bockmuhl synthesized methadone, which some say is more habit-forming than either of the other drugs.4
The drug culture of the 1950s, ‘60s and ‘70s saw an increase in marijuana use, as well as experimentation with LSD. According to the first Gallup Polls taken about illegal drug use in 1969, 48 percent of Americans said that drug addiction was a serious problem in their community.5 By 1978, 66 percent of all Americans said that marijuana use was a serious problem in high schools or middle schools in their community, and 35 percent said the same about other illicit drugs.6
The 1980s found the United States in the middle of the “Just Say No” campaign and a zero-tolerance policy for illegal drug possession. It also saw the first drug education program, D.A.R.E., implemented in schools across the country. Crack cocaine was the new drug on the scene, and arrests and incarcerations for drug possession continued to skyrocket.7
By the 1990s, lawmakers were just beginning to look at alternative sentencing programs and treatment as potential options for nonviolent drug offenders, as the use and sale of methamphetamines dramatically increased. By 2005, new laws were enacted to stem the tide of home-lab meth production by limiting the sale of pseudoephedrine and making it only available from a pharmacist.8
Drug Abuse Today
Today’s opioid epidemic is at the forefront of the war on drugs and is predominantly driven by need, availability and price. Because of new patient monitoring systems in most states, it’s much more difficult for users to “doctor shop” for new prescriptions than ever before. A hit of heroin is often easier to obtain than a new prescription, and it’s far cheaper than black market prescription opioids. That’s why those whose addiction began with opioids prescribed for pain after surgery or injury may move quickly to heroin when current prescriptions run out.
Unlike the surge in heroin use in the 1930s, ‘40s and ‘50s, where heroin supplies came mostly from France and Sicily, today’s heroin comes primarily from Mexican drug cartels through US southern borders.6 Regardless of how the drug is making it into the United States, more people are dying from heroin addiction and overdose than ever before.
In response to the current drug crisis, many states have developed drug courts to keep nonviolent drug offenders out of the prison population. For those whose relationship with the criminal justice system is primarily rooted in drug addiction, drug courts offer treatment and recovery rather than a revolving door in and out of the prison system.9 Drug courts also save communities money and provide compliance with court orders for treatment that regular probation from prison cannot accomplish.
A big part of today’s drug abuse culture is the changing public opinion about certain illegal drugs. The decriminalization of marijuana in many states, making it legal to use for medical reasons, has made the drug available to those who need it to control the pain and nausea associated with cancer treatments and other diseases. Marijuana is now also legal for recreational use in some states, although restrictions on usage amounts and locations vary from state to state. A total of 26 states currently have laws legalizing marijuana, either for medical purposes only or for both medical and recreational use.10
Drug Abuse in the Future
With the new surge in legalized marijuana, the jury is still out on how making one of the most popular drugs in America easy to get will change the future of drug abuse. If recreational marijuana follows in the footsteps of alcohol, legalizing it could make it more accessible to young people exposed to regular substance abuse in the home.
There is evidence that use of marijuana prior to the age of 18 is associated with severe cognitive consequences in young people. This includes poorer attention, reduced visual search, reduced verbal IQ and reduced mental control and self-regulation.11 Making marijuana legal for those 21 and over may decrease use in adolescents during the later years of brain development. However, because the brain is not fully developed until the age of 25 or later, recreational marijuana may still have adverse side effects on the brains of young adults.
When it comes to predicting the future of drug abuse in America, one thing is clear: Those with a genetic predisposition or a family or personal history of addiction are always at greater risk of addiction. Whether a drug is legal or illegal cannot be the main predictor of addiction rates or the primary reason a person does or does not use a substance for recreational purposes. Alcohol is currently the most popular drug of choice for teenagers, second only to marijuana.11 Although legal, these drugs in the wrong hands can quickly lead to dependence and addiction. This opens the door to other drugs like cocaine, methamphetamines and heroin.
Continued efforts at early education, expansion of drug courts and treatment options, and the proper identification and treatment of mental illnesses can all help prevent the damage that addiction causes in our communities both now and in the future.
1 Helling, Steve, and Alexandra Rockey Fleming. “Faces of an Epidemic: Stories of the Victims of America’s Opioid Crisis — and the Fight to Save Lives.” People, August 9, 2017, Accessed August 14, 2017.
2 Nevius, James. “The strange history of opiates in America: from morphine for kids to heroin for soldiers.” The Guardian, March 15, 2016, Accessed August 14, 2017.
4 “Painkillers: A Short History.” Foundation for a Drug-Free World, Accessed August 14, 2017.
5 Robison, Jennifer. “Decades of Drug Use: Data From the ’60s and ’70s.” Gallup, July 2, 2002, Accessed August 15, 2017.
6 “A Social History of America’s Most Popular Drugs.” PBS, Accessed August 14, 2017.
7 “A Brief History of the Drug War.” Drug Policy Alliance, Accessed August 15, 2017.
8 “Timeline (Meth).” PBS, Accessed August 15, 2017.
9 “Drug Courts Work.” National Association of Drug Court Professionals, Accessed August 15, 2017.
10 “State Marijuana Laws in 2017 Map.” Governing Magazine, Accessed August 15, 2017.
11 Lisdahl, Krista M., et al. “Dare to Delay? The Impacts of Adolescent Alcohol and Marijuana Use Onset on Cognition, Brain Structure, and Function.” Frontiers in Psychiatry, Frontiers Media S.A., July 1, 2013, Accessed August 15, 2017.