Outline
Introduction
Background of the problem.
Description of opioid abuse in the United States.
Prevalence of opioid crisis.
Causes and most commonly abused opioids
Limitations to mitigation approaches
Inaccurate determination of the cause of death
Variations in the percentage of death recorded
Confusion in the classification of drugs
Inconsistencies in the drug testing approaches
Approaches to curbing opioid overdose
Use of alternative prescription drugs such as naloxone
Adoption of harm reduction services
Article Summary
In many jurisdictions, both governmental and non-governmental health practitioners are merging efforts to bolster the timeliness and accuracy in analyzing and responding to the rampancy of opioid/fentanyl abuse in the United States. Case studies show that the opioid epidemic has risen to become a health menace across several states in the United States and its severity has tripled since 1999-2014. Further case studies show deaths arising from excessive use of opioid drugs has doubled and the epidemic has now been evident across 30 states including the District of Columbia. Other states registered decreasing trend while 19 states remain stable. From 2014 to 2015, drug overdose deaths have risen by 11% signifying a spontaneously proliferating trend for over a decade now. Out of these deaths, over 70% is feared to be caused by illicitly manufactured fentanyl and heroin. Methadone abuse-related deaths increased by 9.1% while that caused by abuse of both natural and semisynthetic opioid drugs increased by over 2%. Extensive research also provides consistent reports of the increasing mortality rates involving the abuse of heroin and synthetic opioids on a larger scale. This ephemeral increase in the number of mortalities is associated with the abuse of legally manufactured fentanyl. Further studies show that increases in deaths across are 27 states is attributed by illicitly manufactured fentanyl.
Toxicological reports indicate a decline in methadone related deaths since 2008. This is probably because of the federal warning on drug administration to limit high dose formulation of opioid drugs and follow up to reduce consumption of methadone in suppressing pain. However, small increase in the abuse of natural and semisynthetic opioids indicates that there is a problem probably arising from prescription and administration of opioids. Potentially decreasing cases of the epidemic from 2013-2014 is believed to be because of changes in the health system, launching of drug prescription and monitoring program to review and legislate changes in naloxone and drug prescription guidelines.
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Extensive researches have indicated that the journey of fighting over the eradication of the opioid menace has been a tough one and faced five imminent limitations. First, factors related to the determination of death causalities approach is likely to influence the estimation rate of specific drugs. At the autopsy, for instance, there has been variation in both the mode of testing drug variation of composition and optimum conditions under which the testing is done due to reportedly perpetual variation in jurisdiction over time. Secondly, there is variation in the percentage of death recorded over time. For example, in 2014 and 2015, potential number of deaths recorded on death certificates did not include overdose of specific drugs. Additionally, there is notable variation in the percentage number of death recorded and related drug overdose on a wide scale and by state. Similarly, wide variation in the mode of reporting and responding to opioid epidemic across several states in the United States limits comparison. Also, pragmatic improvement in the mode of testing, addressing and reporting of specific drug is feared to have caused observable increase opioid-involved death rates. Fourthly, there must have been confusion in the classification of several drugs, for instance, heroin and morphine considering the fact both undergo similar metabolism. This will either result in either over-reporting or under-reporting of deaths caused by heroin consumption. Finally, the study of the rampancy of the opioid epidemic is restricted to about 28 states in the U.S, and as a result, generalizability of the opioid is limited.
Integrated multiregional scale analysis shows that the dissemination of the opioid epidemic and related deaths has prompted amendments of swift control measures to curb the menace. In the fall of 2016, drug enforcement administration has reported in preference to prescription drug, heroin and fentanyl pose most prolific drug-related menace in the United States. The agency also noted the intertwining misuse of prescription opioids and illicit opioids. The non-medical prescription use of opioids is a significant factor for heroin abuse calling for the need for continued prevention efforts around prescription opioids. Intensive efforts to distribute naloxone, enhanced access to treatment and implementation of harm reduction services such as scaling up of comprehensive syringe programs to reach persons with opioids disorder are urgently needed.
Discussion Questions
What are the manifestations of opioid overdose and abuse among teenagers?
What is the role of the community (teachers, parents, and peers) in managing curbing and mitigating the effects of opioid overdose in the learning institutions?
