(CNN) - The opioid epidemic has roots that date back to the 1800s when heroin was believed to be less addictive than morphine. Below is a timeline of how the United States got to where it is today.
1861-1865 - During the Civil War, medics use morphine as a battlefield anesthetic. Many soldiers become dependent on morphine after the war.
1898 - Heroin is first produced commercially by the Bayer Company. At the time, heroin is believed to be less habit-forming than morphine, so it is dispensed to individuals who are addicted to morphine.
1914 - Congress passes the Harrison Narcotics Act, which requires that doctors write prescriptions for narcotic drugs like opioids and cocaine. Importers, manufacturers and distributors of narcotics must register with the Treasury Department and pay taxes on products
1924 - The Anti-Heroin Act bans the production and sale of heroin in the United States.
1970 - The Controlled Substances Act becomes law. It creates groupings (or schedules) of drugs based on the potential for abuse. Heroin is a Schedule I drug while morphine, fentanyl, oxycodone (Percocet, OxyContin) and methadone are Schedule II. Vicodin - a hydrocodone-acetaminophen combination - was originally a Schedule III medication but wasn't recategorized as a Schedule II drug until October 2014.
January 10, 1980 - A letter titled "Addiction Rare in Patients Treated with Narcotics" is published in the New England Journal of Medicine. It was not a study and looked at incidences of addiction in a very specific population of hospitalized patients who were closely monitored. However, it would become widely cited as proof that narcotics were a safe treatment for chronic pain.
1995 - OxyContin, a long acting version of oxycodone, which slowly releases the drug over 12 hours, is introduced and aggressively marketed as a safer pain pill by manufacturer, Purdue Pharma.
May 10, 2007 - The federal government brings criminal charges against Purdue Pharma for misleadingly advertising OxyContin as safer and less addictive than other opioids. The company and three executives are charged with "misleading and defrauding physicians and consumers." Purdue Pharma and the executives plead guilty, agreeing to pay a $634.5 million in criminal and civil fines. The three executives plead guilty on criminal misdemeanor charges and are later sentenced to probation.
2010 - FDA approves an "abuse-deterrent" formulation of OxyContin, to help curb abuse. However, people still find ways to abuse it.
May 20, 2015 - The DEA announces that it has arrested 280 people, including 22 doctors and pharmacists, after a 15-month sting operation centered on health care providers who dispense large amounts of opioids. The sting, dubbed Operation Pilluted, is the largest prescription drug bust in the history of the DEA.
March 18, 2016 - The CDC publishes guidelines for prescribing opioids for patients with chronic pain. Recommendations include prescribing over-the-counter pain relievers like acetaminophen and ibuprofen in lieu of opioids. Doctors are encouraged to promote exercise and behavioral treatments to help patients cope with pain.
March 29, 2017 - President Donald Trump signs an executive order calling for the establishment of the President's Commission on Combating Drug Addiction and the Opioid Crisis. New Jersey Governor Chris Christie is selected as the chairman of the group, with Trump's son-in-law, Jared Kushner, as an adviser.
July 31, 2017 - After a delay, the White House panel examining the nation's opioid epidemic releases its interim report, asking Trump to declare a national public health emergency to combat the ongoing crisis
September 22, 2017 - The pharmacy chain CVS announces that it will implement new restrictions on filling prescriptions for opioids, dispensing a limited seven-day supply to patients who are new to pain therapy.
November 1, 2017 - The opioid commission releases its final report. Its 56 recommendations include a proposal to establish nationwide drug courts that would place opioid addicts in treatment facilities rather than prison.
February 27, 2018 - Attorney General Jeff Sessions announces a new opioid initiative: the Prescription Interdiction & Litigation (PIL) Task Force. The mission of the task force is to support local jurisdictions that have filed lawsuits against prescription drug makers and distributors.
March 19, 2018 - The Trump administration outlines an initiative to stop opioid abuse. The three areas of concentration are law enforcement and interdiction; prevention and education via an ad campaign; and job-seeking assistance for individuals fighting addiction.
April 9, 2018 - The US surgeon general issues an advisory recommending that Americans carry the opioid overdose-reversing drug, naloxone. A surgeon general advisory is a rarely used tool to convey an urgent message. The last advisory issued by the surgeon general, more than a decade ago, focused on drinking during pregnancy.
May 1, 2018 - The Journal of the American Medical Association publishes a study that finds synthetic opioids like fentanyl caused about 46% of opioid deaths in 2016. That's a three-fold increase compared with 2010, when synthetic opioids were involved in about 14% of opioid overdose deaths. It's the first time that synthetic opioids surpassed prescription opioids and heroin as the primary cause of overdose fatalities.
June 7, 2018 - White House announces a new multimillion dollar public awareness advertising campaign to combat opioid addiction. The first four ads of the campaign are all based on true stories illustrating the extreme lengths young adults have gone to get a hold of the powerful drugs.
October 24, 2018 - Trump signs sweeping legislation into law that includes provisions aimed at promoting research to find new drugs for pain management that will not be addictive. It also expands access to treatment for substance use disorders for Medicaid patients.
December 12, 2018 - According to the latest numbers from the CDC's National Center for Health Statistics, fentanyl is now the most commonly used drug involved in drug overdoses. The rate of drug overdoses involving the synthetic opioid skyrocketed by about 113% each year from 2013 through 2016.
January 14, 2019 - The National Safety Council finds that, for the first time on record, the odds of dying from an opioid overdose in the United States are now greater than those of dying in a vehicle crash.
January 15, 2019 - A court filing in a Massachusetts lawsuit reveals that members of the Sackler family, who own Purdue Pharma, misled doctors and patients about the dangers of OxyContin.
September 12, 2019 - Arizona Attorney General Mark Brnovich has agreed to join a tentative settlement over the role OxyContin maker Purdue Pharma played in the nation’s opioid addiction crisis. A little less than a month later, Brnovich expressed misgivings about the deal, saying Purdue Pharma "sought to undermine material terms of the deal."
September 15, 2019 - Purdue files for bankruptcy as part of a $10 billion agreement to settle opioid lawsuits. According to a statement from the chair of Purdue’s board of directors, the money will be allocated to communities nationwide struggling to address the crisis.
September 30, 2019 - The FDA and DEA announce that they sent warnings to four online networks, operating a total of 10 websites, which the agencies said are illegally marketing unapproved and misbranded versions of opioid medicines, including tramadol.
October 21, 2020 - The Justice Department announces that Purdue Pharma, the maker of OxyContin, agree to plead guilty to three federal criminal charges for its role in creating the nation’s opioid crisis. They agree to pay more than $8 billion and close down the company. The money will go to opioid treatment and abatement programs. The Justice Department also reached a separate $225 million civil settlement with the former owners of Purdue Pharma, the Sackler family. In November 2020, Purdue Pharma board chairman Steve Miller formally pleaded guilty on behalf of the company.
March 15, 2021 - According to court documents, Purdue files a restructuring plan to dissolve itself and establish a new company dedicated to programs designed to combat the opioid crisis. As part of the proposed plan, the Sackler family agrees to pay an additional $4.2 billion over the next nine years to resolve various civil claims.
July 14, 2021 - Drug overdose deaths rose by close to 30% in the United States in 2020, hitting the highest number ever recorded, the US Centers for Disease Control and Prevention reported. The CDC's National Center for Health Statistics reported that overdose deaths from opioids rose from 50,963 in 2019 to 69,710 in 2020.
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