by Sheila Polk, County Attorney, Yavapai County

What do prescription painkillers, heroin and fentanyl all have in common?

They are all opioid drugs. Americans make up 5 percent of our world’s population, yet in 2016 we consumed 80 percent of the world’s prescription opioid pain medications. Global drug traffickers smuggle heroin and deadly synthetic fentanyl across borders and seaports.

Although the national discussion centers on the opioid crisis and controlling prescription medications, the problem is much more complex and involves far more drugs. Drug overdoses are the leading cause of death for Americans younger than 50.1 In 2016, drug overdoses from heroin, cocaine, methamphetamine, fentanyl and opioid pain medications killed an estimated 64,000 people in the United States – an unbelievable 175 deaths a day.

The reality is this country not only has an opioid crisis, but a drug crisis. As the country rallies to stem the threat from opioids, other drugs will surface, particularly synthetic drugs chemically produced overseas. Doctors and pharmacies have already taken measures to stem their prescribing practices, but trending are alarming increases in seizures of meth, heroin, cocaine and fentanyl. Locally, methamphetamine is back in a big way.

The causes of this drug crisis are varied. Adolescent drug use makes a person much more susceptible to a lifetime of addiction to drugs. Nine of 10 individuals struggling with addiction began using drugs and alcohol as a teenager. The current plethora of prescription pain pills are widely diverted and improperly used. After marijuana was legalized in states like Colorado, Mexican drug cartels planted opium poppies to produce more heroin and lower their prices. Locally, our narcotics officers regularly bust drug dealers with a smorgasbord of illicit pain pills. Most alarming are heroin and fentanyl in the form of pills.

At the core of our nation’s drug problem is a growing acceptance for mind-altering substances. All drugs, including marijuana, hijack the brain’s reward system by stimulating massive amounts of dopamine to flood the brain’s receptors. The intense but momentary pleasure from drugs is anywhere from 10 to 100 times more stimulation than the brain naturally produces. Problems and addiction occur because, over time, the brain ceases to produce its own dopamine. Without the drugs, the user can no longer feel happy.

A recent study of over 30,000 American adults published in the American Journal of Psychiatry found that marijuana users are more than twice as likely to abuse prescription opioids.2 According to the Centers for Disease Control, those addicted to prescription pain pills are 40 times more likely to become addicted to heroin. Ponder how that will affect our drug overdose death rates with the movement to legalize recreational marijuana.

The solutions are as varied as the causes. In Arizona, doctors are using the state prescription drug database to avoid overprescribing. In Yavapai County, you can do your part by discarding your unused medications in the drop boxes at your local police or sheriff’s office.

But the simplest solution lies with all of us. As a country, we must focus on curtailing drug use from the get-go. Be a preventionist. Talk to your kids and your grandchildren about the perils of drugs. In the words of Nancy Reagan, give them the skills to, “Just Say No.”

Sheila Polk is the Yavapai County Attorney and Co-Chair of MATFORCE, the Yavapai County Substance Abuse Coalition