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and heroin production. The increase in heroin production exacerbated the violence of an already out- of-control Mexican crim- inal market, increasing the political capital of criminal groups able to sponsor the labor-intensive poppy cultivation.”This trend has continued into today, with an explosion of higher legal prescription rates and an increasingly large illicit market. STEADY STATE Certain states, likeWest Virginia, Kentucky and Missouri, have been partic- ularly crippled by the wide- spread use and dependency of these drugs. For exam- ple, in Kermit,West Virgin- ia, the town of only 400 residents was supplied with 13 million prescription opioid pills to a single town pharmacy – amounting to more than 30,000 pills per resident. This is just one of many examples of towns that have been decimated by the crisis, while nationally it is estimated that only 1 out of 5 persons who require treatment receive it. This, coupled with an increasing

trend of unhealthy dieting and exercise habits in the general population, further exacerbates the presence of chronic pain and the subsequent cycle for more opioids. LOOKING FORWARD As the issue has grown over the years, steps have been taken to address it at a federal level. The ‘21stCen- turyCuresAct’ was passed in 2016 by Congress, which authorized $6.3 billion in funding to help states address the epidemic. In 2017, President Trump also formally declared the opi- oid crisis a national public health emergency. Various law enforcement agencies have ramped up ef- forts to curb the inflow of illicit drugs and reduce the supply in the market. There has also been increased at- tention on the importance of rehabilitation programs that not only help patients recover, but also function- ally integrate back into society. However, it will take considerable effort at a national and global level to truly push back and solve this crisis for good.

EARLY CAUSES Starting in the late 1990’s, prescriptions of opioid pharmaceuticals were pri- marily used to treat acute or chronic pain for severe ailments – mainly can- cer diagnoses. However, pharmaceutical companies later began lobbying for an expansion of use and prescription of general pain medications. Drugs like ‘OxyContin’ were soon prescribed for lesser and lesser ailments; such as high school sports injuries, arthritis, and general back pain. By the early 2000’s, deaths related to opioids were increasing rapidly. Despite the introduction of new regulations, a wide- spread dependency and pat- tern of abuse had already taken hold in the country. Further, tighter regulations and limitations on prescrip- tions pushed a portion of the ‘market’ for opioids towards illegal sources and other drugs such as heroin. According to the Brookings Institute: “The growth in U.S. demand for opioids in turn triggered a signifi- cant expansion of Mexico’s opium poppy cultivation

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