Opium is an important raw material for the legal manufacture of morphine, codeine and their derivatives as opioid pharmaceuticals. It is also the raw material for the illicit production of heroin. Morphine and codeine are responsible for both the medical and dependence-producing properties of opium are derived from its main constituents. These two substances, together with morphine-like substances of synthetic origin, have taken over opium's therapeutic role. Both the natural and the synthetic groups of narcotics include substances with varying degrees of desirable and undesirable effects, all of which are abused as prescription and non-prescription drugs to some degree.
Prescriptions for opioid painkillers have risen markedly. Americans use 80 percent of the world's opioids. As reported in 2017, fifteen percent of seniors on Medicare are prescribed an opioid upon discharge following an acute hospitalization and 42 percent of them are still taking it three months later, suggesting addiction may be an issue In 2015, more than one-third of American adults were prescribed an opioid drug and opioid overdoses have become the leading cause of death for Americans under the age of 50. In 2013, about 23,000 Americans died from overdosing on prescription drugs, and painkillers accounted for about 16,000 of those deaths.
Overall, studies show addiction affects about 26 percent of those using opioids for chronic non-cancer pain, eg each year, about 3 million Americans, most under the age of 25, have their wisdom teeth removed, and most if not all receive a prescription for opioids. Women, people over the age of 49 and those without college degrees were most likely to receive a prescription, and the unemployed, uninsured and adults with an annual family income below $50,000 had the highest prevalence of opioid misuse and addiction. An estimated 5 percent of adults (11.5 million people) misused the drugs and nearly 1 percent (some 1.9 million people) reported addiction. While women are prescribed opioids more frequently than men, men have a higher rate of misuse – 13 percent compared to 9 percent respectively. Of those misusing the drug: 64 percent said their use of the drug was motivated by need for physical pain relief; 41 percent reported getting leftover medication from family or friends; 11 percent said they took the pills to relax or get high.
The drug industry created the opioid addiction epidemic by introducing long-acting opioid painkillers like OxyContin and changing pain prescription guidelines to make opioids the first choice for many types of chronic pain. The drug industry also promoted the long-term use of opioids, even though there is no evidence that using these drugs long term is safe and effective, and downplayed the risk of addiction to these drugs. The U.S. government approved opioid legislation that feeds profits right back to the drug industry by focusing on treatment for painkiller addiction and making anti-addiction drugs more easily available. Between 2013 and 2015 alone, 68,177 physicians received in excess of $46 million in payments from drug companies marketing narcotic pain relievers. In all, that amounts to 1 out of every 12 doctors in the U.S.