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CALIFORNIA SOCIOLOGY FORUM VOL. 6 

Opioid Addiction and Overdose in America 
Brian Benjamin Parsons 
Department of Sociology 

California State University, Los Angeles 
 
INTRODUCTION 

In 1971, Richard Nixon declared the war on drugs. Today, 
almost 53 years later, it’s clear the United States has not only lost 
this war but is also suffering the consequences. In 2014, the life 
expectancy of Americans decreased for the first time since World 
War I (Deweerdt 2019). The drug related death toll in 2017 alone 
surpassed American casualties (Minhee and Calandrillo 2019) 
from “the Vietnam, Iraq, and Afghanistan wars combined.” Three 
drugs in particular are to blame for what the American government 
has deemed a public health emergency: opioids, heroin, and 
fentanyl. Ironically, legally acquired prescription opioids are the 
biggest culprit as they have acted as a gateway and created a 
snowball effect into the more serious drug use of heroin and 
fentanyl. Drug addiction and drug overdose is now considered to 
be a number one threat to the American people (Minhee and 
Calandrillo 2019).  
 
CONTEXT 

To understand how the United States got here, let’s rewind 
to 1995 when Purdue Pharma began a manipulative and deadly 
anti-pain campaign. Prior to 1995, the medical community viewed 
opioids like Purdue’s OxyContin as medication only to be used by 
those who were terminally ill. Purdue hoped to expand the 
possibilities for who might be deemed appropriate to receive this 
kind of medication, so they went on a nationwide lobbying 
offensive. Their goal was to manipulate physicians into believing 
that these opioids did not pose a risk for their patients because 
opioids were not an addictive substance if used under the 
appropriate supervision of a medical professional. Purdue did this 
by citing a 1986 study, which only included 38 participants, to 
prove to physicians that opioids would only pose an addictive 
threat if used recreationally (Minhee and Clandrillo 2019), and 
invented a new term called “pseudoaddiction” to downplay the 



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actual threat their opioids would pose to the American people. 
Despite this history, it would be an oversimplification of a very 
complex situation to only blame Purdue Pharma for the current 
drug epidemic; they were not prescribing the opioids, medical 
professionals were.  
 According to an expert in pharmacology (Minhee and 
Clandrillo 2019), “the success of OxyContin stems partly from the 
fact that so many doctors wanted to believe in the therapeutic 
benefits of opioids.” Whether this was true or not, it was not long 
after the opioid flood gates were opened that it should have 
become very clear to all parties involved that something was going 
terribly wrong. Minhee and Clandrillo give one example of what 
should have been an alarming warning sign was the fact that 
“some counties and states had more prescriptions than people, yet 
distributors continued to let the drugs proliferate.” Purdue Pharma 
and the doctors would have been aware of the number of opioids 
they were selling and prescribing, and yet the number of drugs 
being introduced to the American public accelerated at hazardous 
levels. Jones et al. (2018) notes: “From 1997 to 2002, OxyContin 
prescriptions increased from 670,000 to 6.2 million.” A large part 
of why opioids like OxyContin skyrocketed in sales was because, 
unlike Purdue Pharma’s original claims, their drugs were 
extremely addictive and users were now needing larger doses 
(Ryan, Girion, and Glover 2016). Due to the benefit of hindsight , 
the Center for Disease Control and Prevention (CDC) now knows 
that “up to 24% of people on the drugs long-term become 
addicted.” With more and more negative statistics like this 
becoming known to the public, it was only a matter of time before 
Purdue Pharma had to pay for its wrongdoing. 
 After 12 years, Purdue Pharma had been sued and fined 
635 million dollars for marketing OxyContin as less addictive 
when they knew from the outset that this was false information. 
Unfortunately, this fine did nothing to help the millions of 
Americans who now suffered with addiction and were seeking out 
cheaper and more potent drugs (Minhee and Clandrillo 2019). At 
this point, phase two of the epidemic began. As restrictions 
mounted and legal opioids became harder to acquire, addicts 
began turning to heroin. If it seems like hyperbole that one drug 
can lead to another drug, Minhee and Clandrillo (2019) found 



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that ”94% of opioid-addicted participants reported switching from 
prescription opioid pills to heroin because the former was far more 
expensive and harder to obtain.” Unlike opioids like OxyContin, 
which are synthesized in a lab and can almost guarantee that the 
user is getting a consistent dose, heroin is illegally manufactured 
and far less safe for the user. In fact, “between 1999 and 2016, 
heroin related overdoses increased by a factor of five” (Minhee 
and Clandrillo 2019). Unfortunately, this is because heroin is often 
laced with one of the most dangerous drugs of all time: fentanyl, 
which represented phase 3 of the epidemic.  
 Fentanyl poses such a danger (Minhee and Clandrillo 
2019) that it is only “medically appropriate for individuals facing 
imminent death. It is not only 100 times more potent than natural 
morphine, but 50 times stronger than heroin.” What adds to the 
level of danger that Fentanyl poses is that many users have no idea 
they are about to ingest it, as dealers cut either heroin or cocaine 
with it to increase its potency. By 2016 (Minhee and Clandrillo 
2019), “deaths involving synthetic opioids, mostly fentanyl, had 
risen 540 percent in just three years.” In a period of 18 years, the 
United States witnessed how a legally prescribed drug can ravage 
communities, morph into increasingly dangerous forms, and 
seemingly have very little in the way of effective responses for 
how to combat this deadly epidemic. It is past time for the United 
States to look for new solutions to end its 52-year war on drugs.  
 
UNDOING THE DAMAGE FROM THE WAR ON DRUGS 

Reversing the damage of the war on drugs requires major 
changes on federal, state, and local levels. Instead of punishing 
people who are addicted to drugs, we should be ensuring that they 
get the help that they desperately need. The Affordable Care Act 
and the Mental Health Parity and Addictions Equity Act of 2010 
were major steps in the right direction. The former increased the 
number of insured Americans, and the latter prevented insurance 
companies from blocking access to mental health. Individuals 
with substance use issues who previously had no insurance can 
now access life altering drug treatment programs and receive 
benefits (Jones et al. 2018) formerly not accessible to millions of 
citizens. When circumstances allow, witnesses can call 911 for 
help, apply first aid themselves and administer the lifesaving drug 



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Naloxone (Narcan) before it’s too late. The Opioid Overdose 
Education and Naloxone Distribution program seeks to distribute 
Naloxone more widely to opioid users and to educate the public 
about this non-addictive drug’s potential to save lives. The 
program distributes Naloxone to veterans at-risk (Dunn et al. 
2017) and has had favorable outcomes thus far. In addition to this 
initiative, the federal government has also taken positive steps to 
reduce the number of overdose deaths in America. 
 
STUDIES ON DRUG OVERDOSE RISK 

The ways in which drug addiction and overdose have been 
studied are numerous. When it comes to analyzing the yearly 
death toll, drug overdose numbers are a reliable metric of the 
epidemic because all deaths are required to be reported in all U.S. 
states and territories using standardized International 
Classification of Disease (Jalal et al. 2018). From this point, drug 
overdose deaths are categorized as either unintentional, suicide, 
undetermined intent, or homicide. This is a vital piece to consider 
when studying overdose mortality as it shows how most of the 
overdose are unintentional. A study by Dunn et al. (2017) 
administered a demographic survey for individuals who had 
overdosed, but not died from it, and used the Diagnostic and 
Statistical Manual (DSM)-5 checklist to review and categorize 
responses related to symptoms of opioid use disorder. One 
question asked opioid users if they used opioids exclusively or if 
they mixed them with other drugs--an important piece of 
information to understand about individuals who have survived 
overdoses. Mixing synthetic drugs like opioids with other 
dangerous drugs was found to greatly increase the likelihood that 
the user will experience an overdose.  
 Drug overdoses which result in death are reliably tracked 
on a yearly basis, so we have a good sense of the scope of the 
problem. Future research would not only focus on the 
overwhelming negative side of the epidemic but look to 
individuals who have gotten sober and live healthy lives despite 
having had an overdose and substance use issues. This kind of 
information would be very beneficial for people who are newly 
sober to understand what elements have and have not worked for 
actual opioid users who have been in similar circumstances. Like 



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the study previously mentioned, one could administer a survey 
about past use of synthetic opioids and ask specific questions 
about what has helped them get and remain sober. In terms of what 
hasn’t been studied about this epidemic, “there are few empirical 
data regarding the experience and understanding of opioid 
overdose risks among CP (chronic pain) patients, and this 
information is necessary to develop overdose prevention 
resources for this population” (Dunn et al. 2017).  
 
CONCLUSION 
  Almost 53 years ago, the United States waged a War on 
Drugs. They used aggressive and forceful tactics often against 
communities of color to combat this “domestic enemy.” At the 
time of President Nixon’s declaration, no one would have guessed 
that the most dangerous threat we would eventually face in this 
war would come from legal, physician prescribed drugs. Yet, 
through manipulation and lies from Purdue Pharma, which is 
exactly what transpired. It is now time for the United States to 
rethink and come up with a brand-new strategy if it hopes to 
provide a safe and healthy environment for its citizens. The War 
on Drugs is a war that the United States has lost miserably, but it 
is not too late to help those in need now and for future generations.  
 
 
 

REFERENCES 
Deweerdt, Sarah. 2019. “The Natural History of an Epidemic.” Nature. 573(7773):10-12. 
Dunn, Kelly, Frederick S. Barrett, Michael Fingerhood, and George E. Bigelow. 2017. 

“Opioid Overdose History, Risk Behaviors, and Knowledge in Patients Taking 
Prescribed Opioids for Chronic Pain.” Pain Medicine. 18(8):1505-1515. 

Humphrey, John A., and Frank Schmalleger. 2021. Deviant Behavior. Thousand Oaks, 
California: SAGE Publications. 

Jalal, Hawre, Jeanine M. Buchanich, Mark S. Roberts, Lauren C. Balmert, Kun Zhang, and 
Donald S. Burke. 2018. “Changing Dynamics of the Drug Overdose Epidemic 
in the United States from 1979 Through 2016.” Science. 361(6408):1-6. 

Jones, Mark R., Omar Viswanath, Jacquelin Peck, Alan D. Kaye, and Jatinder Gill. 2018. 
“A Brief History of the Opioid Epidemic and Strategies for Pain Medicine.” 
Pain and Therapy, 7(1):13-21. 

Martins, Silvia S., Laura Sampson, Magdalena Cerda, and Sandro Galea. 2015. 
“Worldwide Prevalence and Trends in Unintentional Drug Overdose: A 
Systemic Review of the Literature.” American Journal of Public Health. 
105(11), 29-49. 

Minhee, Christine & Steve Calandrillo. 2019. “The Cure for America’s Opioid Crisis? End 
the War on Drugs.” Harvard Journal of Law and Public Policy, 42:547-623 



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Ryan, Harriet, Lisa Girion, and Scott Glover. 2016. “Oxycontin Goes Global – ‘We’re 
Only Just Getting Started.’” Los Angeles Times. 
https://www.latimes.com/projects/la-me-oxycontin-part3/ 

 
 
Brian Benjamin Parsons (He/Him) will get his CSULA Bachelor of Arts 
degree in sociology in May of 2024 and will be graduating cum laude. He 
has recently been accepted into Antioch University’s Master of Arts in 
Clinical Psychology Program with an emphasis in addiction and recovery 
studies. Brian hopes to earn his master’s degree and begin a career helping 
people overcome their issues with addiction and help them toward recovery. 
This paper examines the failed war on drugs and highlights some of the 
reasons why the United States finds itself in the ‘fourth wave’ of an opioid 
overdose crisis. This is Brian’s first published paper, and he is extremely 
grateful to CSF for this publishing opportunity. 

https://www.latimes.com/projects/la-

	Opioid Addiction and Overdose in America - Brian Benjamin Parsons



