Americans have been caught in a cyclical struggle with the abuse of pain medications since before the 1900s with the advent of morphine and the commercial production and sale of heroin as a cough suppressant, according to CNN.
The nation's current opioid abuse epidemic took root in the late 1990s with the release and dissemination of drugs like OxyContin. The past year brought several new developments in America's modern struggle with opioids.
Here are four ways the opioid epidemic changed in 2016.
1. New CDC pain medication prescribing guidelines: In 2016, the CDC released new guidelines for opioid prescription for chronic pain. The new guidance recommends nonopioid therapies as the preferred treatment methods for chronic pain. The new guidelines garnered quick reactions industry groups.
While organizations like the American Pharmacists Association expressed support for the new guidelines, others like the American Cancer Society Cancer Action Network reacted with concern over possible unintended consequences of the recommendations.
"We are disappointed that the CDC guideline...did not address our previously stated concern about needed access to opioid analgesics for cancer survivors who experience severe pain that limits their quality of life," said ACS CAN President Chris Hansen. "We remain concerned that without a balanced approach that accounts for the full continuum of care for cancer survivors, the emphasis on reducing inappropriate use of pain medications will impede access to necessary pain relief for individuals fighting pain from cancer."
The push and pull between how to humanely treat pain and curb drug addiction will be one to watch in 2017.
2. Surging heroin overdoses: In 2016, the country's troubles with heroin continued. As policies come into play to crack down on freewheeling pain medication prescribing habits — which helped fuel the nation's current drug epidemic — addicts turned to cheaper, easier-to-obtain street drugs with deadly potency.
In 2016, the CDC released data on opioid-related deaths for the year prior. More than 30,000 people died of opioid overdoses in 2015, nearly 13,000 of which were at least partially attributable to heroin. The number marks the first time in modern U.S. history heroin surpassed gun homicides as the more prolific killer.
3. The rise of synthetic opioids: The surging rates of heroin overdoses are closely linked to the rise of synthetic opioids. Heroin laced with drugs like fentanyl, which is 50 times more potent than morphine, was responsible for a wave of overdoses across the nation in 2016. The drug is primarily manufactured in China and often pushed into American streets by drug cartels. However, the U.S. Postal Service unknowingly delivers a substantial amount of fentanyl via orders placed on black market websites.
The synthetic opioid carfentanil — which is 1,000 times more potent than fentanyl and designed to sedate large animals like elephants — also found its way into America's illicit drug supply in 2016 and was linked to opioid overdose deaths in states like Indiana and Ohio.
In what could be a harbinger of what's to come, fentanyl surpassed heroin as the more deadly opioid in Massachusetts in 2016.
4. Federal actions taken: In addition to CDC guidelines, the federal government also took legal action to combat the nation's opioid epidemic in 2016. On July 22, President Barack Obama signed the Comprehensive Addiction and Recovery Act bill into law. The new law was designed to expand alcohol and drug prevention education, increase collaboration with law enforcement and criminal justice systems and create more disposal and turn-in sites for unwanted prescription medications. The passage of the law creates substantial opportunities to change the way America addresses drug abuse.
In early October, the Drug Enforcement Administration reduced the number of almost every opioid medication approved for manufacturing in 2017 by 25 percent or more.
Some experts, however, expressed doubt regarding the potential effectiveness of the DEA's actions.
"It's really too little too late," Jerry Epps, MD, CMO of University of Tennessee Medical Center in Knoxville, told Becker's during an interview. "If this had happened 10 to 15 years ago when the epidemic was surging, I might have a different answer. In 2013, the DEA allowed manufactures to increase opioid production by 25 percent because they thought there was going to be shortage. The new reduction still puts us above where we were in 2010 and 2012...I don't think DEA's efforts are going to make that much difference at all."
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