Prescription opioids are pain medications that act on the opioid-receptors to relieve chronic and acute pain. They range from mildly strong painkillers such as oxycodone to extremely strong ones such as fentanyl (Morris & Mir, 2015). The use of opioids has become the subject of intense debate as it is being considered a mortal danger to the society, causing tens of thousands of deaths annually through overdoses and adversely affecting millions of lives through addiction. Many commentators are of the opinion that the right solution is to exponentially limit any availability of opioids in the US market, whether legal or illegal. It has, however, been argued that any limitation of availability of prescription opioids will cause wanton suffering on Americans, hence a solution that circumvents the availability of opioids should be developed. Whereas the opioid crisis in America has illuminated how dangerous opioids can be if misused, it should not obscure the fact that opioids are indispensable due to the crucial role they play in modern clinical care . Any solution to the opioid crisis must, therefore, not interfere with the role opioids currently play in clinical care.
Opioids can neither be limited nor eliminated from the market, due to the crucial role that they play in modern clinical care; hence the need to find a solution that does not affect the availability of prescription opioids. According to Skolnick and Volkow (2016), “…more than 125 million adults in the United States suffer from either acute or chronic pain ” (p. 295). A reasonable cross-section of Americans thus need opioids on a regular basis for their survival, and any ill-advised solution to the opioid crisis can trigger a larger and worse healthcare crisis. These facts exponentially complicate the process of finding a solution for the opioid crisis. Opioids are an integral and currently irreplaceable part of the modern healthcare system. With clinical care being at its most advanced stage in history, many people who would otherwise have died of cancers, major accidents, and other diseases have been saved but most live under acute and chronic pain (Skolnick & Volkow, 2016). Due to this need, solving the opioid crisis must be done in a manner that saving the tens of thousands of lives that are lost through opioid overdoses does not come at the cost of the tens of millions of lives that depend on prescription opioids to survive. A careful balance must be maintained in developing any solution to the opioid crisis, to avoid triggering a worse pain crisis.
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Opioids in themselves are not the problem hence the crisis can be stemmed if opioids are only used safely and judiciously under clinical supervision. An effective solution for the opioid crisis would be to ensure that any and all patients that have to use opioids as prescription painkillers use it in the right manner. Right usage begins with the right prescription, which places the obligation of professionals to carefully screen patients who have been placed on prescription drugs. Screening includes carefully vetting patients for potentially addictive behavior: “ Aberrant behavior such as early refill requests, treatment noncompliance, or reports of “lost or stolen” prescriptions should be documented ” (Morris & Mir, 2015). A vigilant prescriber of opioids can be able to tell and forestall the sliding of ordinary prescription opioid-using-patients into opioid abusers, addicts, and potential overdose candidates. Careful superintendence will prevent patients from transiting into opioid addicts. To prevent the greater crisis of death through overdose, at-risk patients should always have sufficient supplies of opioid overdose medication like Naloxone. The loved one of the patients should be trained on how to detect an overdose and administer Naloxone effectively. Finally, Chronic patients who are temporarily being put on high doses of opioids should be carefully weaned when the chronic condition is fully managed (Morris & Mir, 2015). Using opioids in the right way will exponentially mitigate the opioid crisis.
The current opioid crisis is just one in a long list of substance abuse epidemics in the USA, with past epidemics having alcohol, crack cocaine, or marijuana as the abused substance; hence the need to understand and solve the underlying social problems. Opioids are just a fashionable tool for substance abuse just as marijuana, alcohol, and cocaine have been used before (Dasgupta, Beletsky, & Ciccarone, 2018). Due to the drug menace, the USA has invested heavily both in the war on drugs and academic study to evaluate the social causes of drug dependence, abuse, and addiction. The wealth of wisdom developed through studying social factors can be used to reverse and mitigate the opioid crisis. For example, the underlying issues such as psychological problems, financial issues, domestic problems, and unemployment are the drivers of substance abuse. However: “ social structures generate resilience that mitigates negative impacts from the collision of economic hardship, substance use, and depression ” (Dasgupta, Beletsky & Ciccarone, 2018, p. 184). The conjunction of the need to use opioids for genuine clinical reasons and underlying social issues and problems is among the primary drivers of the opioid crisis in America. The solution includes mitigating issues such as unemployment, mental health problems and loneliness for senior citizens through social projects. Seeking to solve the social and cultural issues will stop the recurring cycle of substance abuse epidemics including the opioid crisis.
The most prominent contrary argument to the mitigation of opioid crisis is that solving the crisis requires either a full ban on opioids or extreme limitation of opioid availability in the market. This is inter alia because the opioid crisis and its underlying bearing factors are too complicated to understand, let alone solve: “ The only systematic review on causation suggests that the factors are multiple, intertwined, and frequently changing ” (Johnson, Eriator, & Rodenmeyer, 2018. P., 595 ). The argument is also based on the fact that the primary issue relating to the opioid crisis in the United States is the prominence given to opioids by pharmaceutical industries despite the availability of equally effective alternatives. Since 1906, different regulators have developed measures to curb abuse of opiates but the current crisis reflect a failure of all the collective measures. It is noteworthy that a substance that is killing tens of thousands of Americans annually should not be legally available. This is despite the fact that there are tens of non-opioid painkillers that are as effective as opioids and should be used as alternatives for opioids. Furthermore, opioids can be harmful even when used properly. The solution to the current opioid crisis is banning opioids altogether or exponentially limiting their usage (Johnson, Eriator, & Rodenmeyer, 2018 ) . Based on this argument, the substantive solution to the opioid crisis is the elimination of opioids in the market or in the very least strictly limiting availability and usage of opioids.
Whereas the contrary argument above is based on sound research, analysis and reasoning about the issues at hand, it cannot be successful due to the potential practical impossibilities. As outlined above, there are over a hundred million people who live with acute chronic pain in America who require opioids for their mere survival (Morris & Mir, 2015). Banning or limiting the use of opioids in the market will adversely and extremely affect their lives leading, them to seek solutions. The rich and affluent will find a legal way to overcome the barrier to find opioids, just as they reacted to the Alcohol prohibition in the 1920s. The poor on the other hand will result in alternative means of finding opioids. The result will be increased discrimination in health care, the rise in illegal and dangerous synthetic opioids, and the fueling of organized crime as the opioid black market will grow exponentially. It is on this basis that the alternative approaches outlined above are more effective than the approach suggested on the contrary argument.
The opioid crisis in America is a massive problem that is deeply rooted in the society; hence cannot have a quick fix due to a variety of complexities. Among the most prominent complexities is the urgent and continuous need for opioids as a means to control pain for tens of millions of Americans. Any solution that limits the availability of opioids in the market may thus be counterproductive. Among the viable solutions is creating proper rules and regulations for opioid prescription usage including the effective best practice of prescribing clinicians. Similarly, anti-overdose drugs should be availed while those who no longer need opioids should be carefully weaned. Social issues that drive opioid abuse must also be comprehensively handled. Eliminating opioids from the market or limiting their availability may be an effective interim solution, but it will only create worse long-term ramifications. The temptation to result to this extreme and seemingly knee-jerk solution must, therefore, be avoided. Opioids are a danger to the society, but they are not as dangerous as they are useful, hence the solution to the opioid crisis must be handled delicately.
References
Dasgupta, N., Beletsky, L., & Ciccarone, D. (2018). Opioid crisis: No easy fix to its social and economic determinants. American journal of public health , 108 (2), 182-186
Johnson, M., Eriator, I., & Rodenmeyer, K. (2018). Backstories on the US opioid epidemic good intentions gone bad, an industry gone rogue and watch dogs gone to sleep. The American Journal of Medicine. 131 (6). 595–601
Morris, B. J., & Mir, H. R. (2015). The opioid epidemic: impact on orthopaedic surgery. JAAOS-Journal of the American Academy of Orthopaedic Surgeons , 23 (5), 267-271
Skolnick, P., & Volkow, N. D. (2016). Re-energizing the development of pain therapeutics in light of the opioid epidemic. Neuron , 92 (2), 294-297
