Americans are dying on a daily basis from an opioid overdose. Statistics indicate that over 130 individuals die following overdosing on opioids. Many families are impacted by opioid use disorder, with the inclusion of pregnant females, resulting to increased numbers of infants being born with abnormalities (Sandoe, Fry & Frank, 2018). Furthermore, kids are experiencing trauma following a parent or other family member’s substance use disorder (SUD). The CDC cites that America spends about $78.5 billion
per annum due to misuse of prescription opioid. Other expenses are due addiction treatment, healthcare and criminal justice involvement (Feinberg, 2019).
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The opioid epidemic is rather considered a national health crisis with devastating effects entailing escalating opioid misuse as well as related overdoses. It is also attributed to the increased cases of neonatal abstinence syndrome due to opioid abuse and use during pregnancy (Charlton, 2018). As observed, science is an integral part of the solution in resolving this particular public health epidemic. This paper will discuss the issue of increasing opioid epidemic, taking a look at its history, how the epidemic differs from other drug issues, and system vulnerability with regards to opioid epidemic. It will also suggest ways of addressing the opioid epidemic, providing a conclusion at the end.
Discussion
Brief History of the Opioid Epidemic
The opioid epidemic has so far taken place in three major waves. The initial one started back in 1991 when deaths linked to opioids began to increase due to an increase in the prescription of the drug and opioid-mixed drugs fir alleviating pain (Rothberg, 2018). Increased opioid prescriptions were influenced by guarantees offered to prescribers by pharmaceutical organizations and medical entities asserting that the risk of addiction to such prescriptions was quite low. This is also a time when pharmaceutical organizations began promoting the use of opioids in patients suffering from non-cancer connected pain, even though there was lack of information about the advantages and risks in these patients (Scholl, et al., 2018). Communities where opioids were easily accessible and approved freely were the initial places to experienced increased opioid abuse and diversion, the shift of opioids from the individual with the prescription to others in an illegal manner.
The second wave of the opioid epidemic took place in 2010 where there were high mortality caused by abuse of heroin (WHO, 2014). As untimely efforts began to have an impact, making prescription of the drug difficult to get, the concentration turned to heroin which is a widely accessible, cheap, and potent unlawful opioid. The use of heroin rose in sexes, all socioeconomic groups, and most age brackets. Between 2002 and 2013, deaths connected to heroin overdose increased by 286%, and about 80% of heroin users confess to misusing prescription opioids prior to turning to heroin (Dowell, Haegerich & Chou, 2016). Those who abused heroin were more prone to injection-associated illnesses such as hepatitis B and C, HIV/AIDS, diseases of the heart, skin infections, and bloodstream diseases (Turk, Wilson & Cahana, 2011).
The final wave of the opioid epidemic took place in 2013 as increased deaths connected to synthetic opioids such as fentanyl were observed (Bokat-Lindell, 2019). The sharpest increase in drug-connected deaths took place in 2016 where over 20,000 deaths from fentanyl and associated drugs took place (NIDA, 2019). This increase has been connected to illicitly produced fentanyl used as a substitute or to contaminate other abused drugs. In an attempt to minimize risks and maximize advantages of available pain treatment alternatives, the Center for Disease Control and Prevention, CDC, issues all-inclusive directives for prescribing opioids for chronic pain outside of cancer treatment, end-of-life care, and palliative care (Volkow, et al., 2019). These recommendations cite that non-opioid treatments are the chosen initial step of treatment of chronic pain. Additionally, opioid medications should only be added following careful evaluation of pain management and trailed by constant examinations of their continued need.
Who is more prone to the Opioid Epidemic?
The number of individuals dying of accidental opioid overdose eclipses any other drug combined, thus introducing the term opioid epidemic. In 2015, America witnessed over 50,000 deaths from drug overdoes. Over 20,000 of those were from prescribed pain relievers, and close to 13,000 were from heroin (Dasgupta, Beletsky & Ciccarone, 2018). This means that about 63% of drug deaths in American that year were connected to opioids. The number of opioid-associated deaths rose by about 10,000 in 2016. Recent studies indicate that young adults aged between 18 and 25 years are the most prone to the opioid epidemic (Hedegaard & Minino, 2017). This group of individuals abuse and misuse opioids for all kinds of reasons, such as believing that the prescribed opioids will help them study better or that it gets them high.
Research also indicates that females are more prone to have an opioid use illness due to chronic pain than their male counterparts. The opioid epidemic has so far impacted both males and females at a disturbing rate. However, it generally impacts these two groups differently. Men are more likely to overdose on opioids than women. Due to special and biological gender-associated biology, females experience opioid abuse distinctly from their male counterparts (Fraser & Plescia, 2018). Additionally, women are more prone to becoming dependent on opioids than males. This is perhaps because of the fact that females between 40 and 59 years are usually prescribed more opioids compared to any other age group and thus have the most death rates from misuse (Sandoe, Fry & Frank, 2018).
The CDC confirmed that females, compared to males, have greater chances of encountering chronic pain, and use prescription opioid pain drugs for a longer period and in higher doses. It is important to note that opioid addiction does not lay out a clear pattern of inheritance, although most affected persons have family histories of addiction to opioids or other substances (Feingberg, 2019). Individuals who have family members with an addiction appear to have a more superior risk of addiction themselves. This increased risk is possibly due to shared genetic factors, but may also be linked to the environment, other non-genetic influences, and lifestyle that are common among the family members.
Overall, the uninsured, low income earners, and unemployed have a superior prevalence of both prescription opioid misuse and use illnesses. Statistics indicate that about 12% of adults who used prescription opioids and had a yearly family income below $50,000 misused medication compared to those earning about $75,000 yearly (Charlton, 2018). Interestingly, 60% of those who misuse opioids do not have their own prescription for the drugs. Over 40% of people who misuse painkillers cite that the last time they misused opioids, a relative or friend offered them the medication free of charge (Rothberg, 2018).
System Vulnerability With Regards To Opioid Epidemic
Most physicians fail to examine information often shared pharmaceutical representatives or retrieved from medical learning training regarding prescription opioids. This is partially caused by poor experience. Moreover, doctors hardly receives enough pain management trainings (Scholl et al., 2018). The structure of the healthcare system in America has greatly contributed to the over-prescription of opioids. Given that most physicians are in the private sector, they gain more fiscally by adding the sum of patients seen, and by guaranteeing them of great satisfaction, which in turn can propagate for the over-prescription of pain killers (WHO, 2014). Prescription opioids are also pretty affordable in the short term. Unfortunately, Patients’ health-insurance plans tend to cater for pain relievers but fail to incorporate pain control strategies such as bodily therapy. The encouragement was meant for persons to prescribe more and more, more specifically after they have been convinced it was the most ideal decision, and also the most compassionate.
Similar to the United States, Canadian physicians are also businessmen who often receives their payment from the unit. The Canadian physicians found themselves subjected to competitive marketing mainly from opioid producers, hence, the reason why the country continues to experience an opioid epidemic (Dowell, Haegerich & Chou, 2016). Notably, cultural distinctions between North America and Europe further impacts the regions’ differing luck with opioids. Recent studies indicate that there is a common prevalence of pain in Italy and France as there is in America. However, American physicians write five and a half times more opiod prescriptions compared to their counterparts in France and Italy (Turk, Wilson & Cahana, 2011). This has been attributed to Americans expecting to get a prescription when they visit the hospital with a health problem. Moreover, direct advertising of pharmaceuticals to consumers more often tend to encourage patients to request for specific drugs from their doctors.
Addressing the Issue of Opioid Epidemic
As healthcare systems, government agencies, and communities work together in the effort of reversing the opioid epidemic overdoses and solving the opioid problem, it is not sufficient to concentrate all resources on treating individuals who are already addicted to the drugs. Preventing those who are not opioid addicts from becoming addicted is equally an important task (Bokat-Lindell, 2019). Addressing over-prescription of pain medication via enhanced pain control and prescription monitoring is among the most significant prevention approaches. Even as illegal opioids such as imported fentanyl and heroin become more widespread, minimizing the supply of such substances via law enforcement efforts is also critical (NIDA, 2019). Nevertheless, reducing the demand for opioids by looking at reasons why individuals opt for them and become addicted in the first place is just as important and vital. This in turn guarantees that a new drug epidemic does not emerge once the opioid problem is contained.
Policymakers must implement solutions that concentrate on families struggling with other substance use disorders and address the immediate opioid problem. Recently, must attention has been paid to the opioid epidemic by the Congress, at the state level, and by the administration (Volkow, et al., 2019). Efforts to address the opioid epidemic and overdose must focus on scientific proof that indicates a substance use disorder is actually a chronic illness of the mind that can be successfully managed and treated. Given that much has been achieved to date with regards to the opioid epidemic, transformations in political authority, the present opioid crisis, and available funding and information continue to have a huge impact on the implementation of the National Pain Strategy (Dasgupta, Beletsky & Ciccarone, 2018). This plan acts as the initial all-inclusive approach to addressing pain and offers a guideline with substantial wide and particular policy proposition.
Presently, a majority of healthcare stakeholders understand and respond to the opioid epidemic mainly as a societal issue. This response is understandable, given the scope and size of the issue and the rather complicated interrelationship between addiction and numerous non-healthcare factors such as crime, education, economics, and culture (Hedegaard & Minino, 2017). It is only when leaders of healthcare organizations acknowledge and confess that the opioid epidemic is a healthcare priority and a business issue, that fighting will become a genuine institutional priority. Government agencies must consider taking a look at their main policies, directives, and regulations. Payers should investigate their medical policies, fomularies, provider incentive programs, network configuration and management, and utilization management protocols (Fraser & Plescia, 2018). Furthermore, healthcare systems need to investigate their clinical directives and protocols, capital expenditures, care coordination programs, and physician alignment.
Pharmaceuticals, on the other hand, must invest in optional pain control solutions, overdose reversal drugs, and innovations in Opioid Use Disorder treatment. Given that there is need for much innovation, some stakeholders will have to make daring bets to inspire innovation (Feinberg, 2019). It is thought that the possible advantages will usually make the effort worthwhile. Most of the efforts to combat the opioid epidemic could gain significantly from more collaboration amongst stakeholders, including rivals.
One of the biggest challenges for individuals with substance use illnesses is stigma. This usually prevents them from enthusiastically seeking the necessary assistance and also prevents communities from making it a main concern to take action and combat the opioid epidemic (Charlton, 2018). Faith leaders are being engaged across the United States to take a stand on the opioid epidemic within their communities. They are also trusted sources of information and encouragement. As a way of combating this particular issue, people must change the way they discuss the epidemic. Drug users need compassion and love just like the one who is suffering from chronic illnesses such as diabetes or cancer (Rothberg, 2018). Presently, there is proof that opioid substitution treatment greatly minimizes the risk of mortality, as long as doses are enough and continuation of treatment is upheld.
Conclusion
From the discussion above, worldwide, overdose is considered the leading cause of avoidable death amongst individuals who inject drugs. The groups most prone to experiencing overdose are those with an opioid dependency and those who inject them. The paper has provided a brief history of the opioid epidemic, highlighting those most prone to addiction. Both environmental and genetic factors play some part in the vulnerability of opioid misuse. Additionally, lack of reaction or insufficient interventions by those observing overdoses generally increases the risk of an overdose occurrence having a severe consequence. That is why governments and the community as a whole should consider implementing strict policies and guidelines on the prevention of opioid addiction in order to curb the epidemic.
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