Opioid abuse is a significant problem that affects millions of Americans. The pandemic has developed drastically over the past two decades resulting in several consequences. Approximately 3 million citizens in the United States suffer from opioid use disorder (Huecker &Cummins, 2017). Similarly, about half a million citizens in the country struggle with heroin addiction (Huecker &Cummins, 2017). Opioid abuse is a significant problem that is responsible for individual, social, and economic issues such as poor health, addictions, and crime. There have been concerted efforts by the federal and state governments to fight this epidemic. Both administrations have used legislation and other initiatives to control opioid use in the country. This documentation will look at the growing opioid pandemic in the United States, focusing on the epidemic's etiology, prevalence, impacts, and efforts geared towards controlling the pandemic.
Etiology of the Opioid Epidemic
The opioid pandemic in the United States has grown significantly over the years. The problem began in the 1980s when opioids were widely used as analgesics (Dasupta, Beletsky & Ciccarone, 2018). At this time, opioids were a controlled substance. To address this, the state governments in the U.S. begun ratifying bills that eliminated the threat of persecution for doctors who administered opioids to patients (Dasupta, Beletsky & Ciccarone, 2018). The prescription of controlled drugs augmented steadily through the 1980s until the mid-1990s when pharmaceutical companies such as Purdue Pharma presented opioid-based drugs to the medical fraternity (Dasupta, Beletsky & Ciccarone, 2018). These companies convinced the medical community that opioid-based drugs were safe, efficient, and had a low potential for addiction. They convinced the medical fraternity through sponsoring their continuing medical-education courses, funding patient and professional organizations, and sending representatives to talk to individual doctors.
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The pharmaceutical companies then managed to convince the medical community that the drugs were meant to help patients when administered on a short term basis. The doctor’s believed them because opioids were only effective for treating chronic pain for a short term and long term use could only cause tolerance to the drugs and increase chances of becoming more sensitive to pain (Dasupta, Beletsky & Ciccarone, 2018). Unfortunately, Purdue Pharma had lied about the low addiction capacity of its opioid-based painkillers. The widespread prescription of opioids resulted in widespread misuse and diversion of the drugs (Dasupta, Beletsky & Ciccarone, 2018). Soon after, cases of opioid overdose began to increase in the U.S. By 2010, heroin had become a leading cause of death among Americans who were addicted to opioids (Cerda et al., 2015; Phillips et al., 2017). The opioid crisis remains an issue because of the introduction of synthetic opioids such as fentanyl.
Prevalence
The growing opioid misuse and associated deaths have become a source of concern within the medical community. Opioid abuse has grown radically over the past two decades, with research indicating that the U.S. remains the biggest market for opioid-based drugs (Cicero & Ellis, 2017). The use of opioids has augmented from 76 million in 1991 to 219 million in 2011 (Cicero & Ellis, 2017). This has seen a corresponding spike in drug-associated emergency room appointments, overdose fatalities, and hospital admissions. It is estimated that 25 million people started using these drugs for nonmedical use between 2002-2011 (Cicero & Ellis, 2017). The cycle of dependence on opioids stems from the additional benefit of opioid-based drugs prescribed for pain or from the first exposure from experimentation to get high, resulting in dependence then to withdrawal symptoms when they stop taking the drugs (Cicero & Ellis, 2017). This then leads them to continue using opioid-based drugs to relieve themselves from life’s miseries.
The increase in incidences of opioid-based prescription drug abuse has resulted in the abuse of other opioids such as heroin. Individuals who have ever used these drugs for nonmedical use are likely to use heroin (Cerda et al., 2015). Research carried out by Cerda et al. (2015), found that the prevalent commencement age for recreational drug use was between 16-18 years. Of all their test subjects, the researchers found that 76% of those who began abusing opioids are currently using heroin (Cerda et al., 2015). Many use heroin as an alternative to prescription drugs, as they are more expensive (Phillips et al., 2017).
Although opioid prescription rates dropped by 13%, the number of deaths related to opioids increased by 38% (Dasupta, Beletsky & Ciccarone, 2018). Cumulatively, between 2000 and 2014, the number of opioid-involved deaths increased by 200% (Phillips et al., 2017). Moreover, between 2013 and 2016, the number of deaths related to opioids misuse spiked by 540% nationally, which then saw the opioid crises categorized as a public health emergency (Dasupta, Beletsky & Ciccarone, 2018). Currently, about 3 million citizens within the U.S. suffer from opioid use disorder (Huecker & Cummins, 2017). Similarly, about half a million citizens in the country struggle with heroin addiction (Huecker & Cummins, 2017). The opioid misuse in the U.S. is a public health disaster with overwhelming costs.
Impacts of Opioid Abuse
The impacts of opioid abuse are severe and affect many citizens in the U.S. Opioid medication binds to opioid receptors in the peripheral and central nervous system (Huecker & Cummins, 2017). This process leads to effective treatment of pain while also resulting in a feeling of intense euphoria. Many individuals who get addicted to opioids are often looking to experience the feeling of euphoria (Huecker & Cummins, 2017). People who misuse opioid-based drugs argue that they use them for pain relief, although long term use of the substances as analgesics is currently being disputed (Huecker & Cummins, 2017).
Opioid abuse can lead to reinforcing effects that motivate drug-seeking behavior. Individuals who abuse opioids explain that they were willing to go to extreme lengths to get them (Cicero & Ellis, 2017). These individuals sometimes find themselves indulging in criminal behavior to enable their drug-seeking behavior. They are more likely to end up incarcerated as a result of their criminal activities (Huecker & Cummins, 2017). People who abuse opioid-based drugs often end up addicted. In extreme instances, addiction can be fatal, especially when people overdose on opioids. The growing rate of opioid-based drug addiction has resulted in the rise of the opioid pandemic in the U.S.
Efforts to Control the Opioid Epidemic
There are national initiatives on reducing the prevalence of opioid use and bills that have been ratified to regulate the prescription of these drugs. One such initiative is the National Drugs Early Warning Systems. This is a program that monitors and coordinates online mentions of drug-related trends, terms, and data and also has a host of webinars and listserv (Phillips et al., 2017). The government can also use bills such as capital punishment bill on opioid dealers (Hall & Farrell, 2018). This bill was enacted to control the sale of opioid-based drugs by instituting sterner penalties for the illegal sale of the analgesics.
Additionally, there have been efforts from state governments to control opioid use. To achieve this, administrations have eliminated script doctors and have also closed off “pill mills” (Cicero & Ellis, 2017). Prescription monitoring programs have been created to decrease the use of opioid-based drugs. Another solution is the rise of abuse-deterrent formulations of extended-release opioids that have been used in place of opioid analgesics (Cicero & Ellis, 2017). The public is also sensitized on the effects of opioids. This is done through media coverage on the growing opioid epidemic and campaigns by different organizations on the problem (Hall & Farrell, 2018). All these efforts are geared towards mitigating the opioid pandemic in the U.S.
Conclusion
The paper addresses the rising opioid pandemic in the U.S. To attain this, the paper explores the pandemic's etiology, prevalence, impacts, and efforts geared towards controlling the epidemic. The opioid epidemic is attributed to the use of the opioid-based drug as analgesics. The crisis has become a source of concern within the medical community because of the drug connected emergency room appointments. The epidemic has resulted in individual, social, and economic issues such as addiction, poor health, and increased crime. To mitigate this crisis, federal and state governments have enacted legislation and implemented initiatives to control opioid use.
References
Cerdá, M., Santaella, J., Marshall, B. D., Kim, J. H., & Martins, S. S. (2015). Nonmedical prescription opioid use in childhood and early adolescence predicts transitions to heroin use in young adulthood: a national study. The Journal of pediatrics, 167(3), 605-612.
Cicero, T. J., & Ellis, M. S. (2017). The prescription opioid epidemic: a review of qualitative studies on the progression from initial use to abuse. Dialogues in clinical neuroscience, 19(3), 259.
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.
Huecker, M. R., & Cummins, D. (2017). Opioid, Addiction .
Hall, W. D., & Farrell, M. (2018). Reducing the opioid overdose death toll in North America. PLoS medicine, 15(7), e1002626.
Phillips, J. K., Ford, M. A., Bonnie, R. J., & National Academies of Sciences, Engineering, and Medicine. (2017). Trends in Opioid Use, Harms, and Treatment. In Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. National Academies Press (US).
