The Opioid Epidemic: A Breakdown of one of America’s Top Public Health Problems
When a doctor prescribes a medication, the expectation of both patient and physician is that that prescription will better a patient’s condition; what if it instead complicates it? More alarmingly, what if that prescription causes a distressing, life-altering addiction that threatens mortality, as it has for millions already?
This fear was the reality for some 1.9 million Americans in 2014, who suffered opioid use disorders related to prescription pain relievers.[1] Though drugs like Percocet, OxyContin, and Vicodin might seem relatively harmless for temporarily relieving migraines or back pain, their effects if continued long-term can be lethal. With approximately 78 Americans dying every day from opioid overdoses, many have declared the U.S. opioid problem an epidemic.[2] With the personal, medical, and legal implications of this crisis, understanding the details is important, so in this article we’ll present a basic breakdown of the what, the why, and the how of the situation.
What are the statistics?
- Opiate overdoses have increased by 265% among men and 400% among women since 1999[3]
- 75% of heroin addicts used prescription opioids before turning to heroin[4]
- More than 650,000 opioid prescriptions are dispensed daily in the U.S.[5]
- The health and social costs related to prescription opioid abuse each year is $55 billion[6]
Why did this happen?
- Pharmaceutical companies: In the 1990s, pain treatment became a main concern in hospitals and medical centers, and the producers of opioids took note.[7] Purdue Pharma created the painkiller OxyContin in the mid ’90s, and just one year after aggressive add campaigns, the overall number of opioid prescriptions filled jumped by 11 million.[8] Purdue sponsored major resources published by important medical non-profits to influence ongoing physician education, claiming “there is no evidence that addiction is a significant issue when persons are given opioids for pain control.”[9]
- Ease of prescription: Opioids are quick, easy care for immediate results, which is convenient for busy physicians who may only have a short amount of time to consult with a patient. Because of the immediate effect, it also increases patient satisfaction.
How can we fix it?
- Admit responsibility: In 2007, Purdue Pharma pled guilty for misbranding OxyContin and downplaying the possibility of addiction, settling with the U.S. government for $635.[10] Other large producers of opioids soon followed.
- Provide non-opioid therapies: Doctors should be wary of prescribing opioids unless they are absolutely necessary. The CDC has issued guidelines for the use of nonopioid therapies, including non-opioid medications, aerobic exercises, and physical therapy.[11]
- Implement prescription drug monitoring programs: These programs give healthcare providers information to improve patients safety and prevent abuse.[12]
- Expand access of naloxone: This is a safe antidote to reverse opioid overdose, and is now used frequently by emergency medical responders.[13]
- Increase access to rehabilitation: When drug-seekers show up in the emergency department, they are immediately pushed out, allowing a documented illness to essentially go untreated. Rehabilitation and treatment need to be made possible, whether that means expanding programs or reforming insurance plans.
In issuing a new regulation to make addiction treatment available to millions more Americans, President Obama said, “The only way we reduce demand is if we’re providing treatment and thinking about this as a public health problem, and not just as a criminal problem.”[14] Prescription opioids are a problem faced by over a million Americans of all backgrounds, and it’s time they had the support to overcome challenges they never asked for.
[1] “Substance Use Disorders,” Substance Abuse and Mental Health Services Administration, Oct. 27, 2015, http://www.samhsa.gov/disorders/substance-use
[2] “Understanding the Epidemic,” Center for Disease Control and Prevention, June 21, 2016, https://www.cdc.gov/drugoverdose/epidemic/
[3] “Substance Use Disorders”
[4] Seelye, Katherine Q., “The Numbers Behind America’s Heroin Epidemic,” The New York Times, Oct. 30, 2015, http://www.nytimes.com/interactive/2015/10/30/us/31heroin-deaths.html
[5] “The Opioid Epidemic: By the Numbers,” U.S. Department of Health and Human Services, June 2016, http://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
[6] Ibid
[7] Moghe, Sonia, “Opioid history: From ‘wonder drug’ to abuse epidemic,” CNN, Oct. 14, 2016, http://edition.cnn.com/2016/05/12/health/opioid-addiction-history/
[8] Ibid
[9] Ibid
[10] Ibid
[11] “Nonopioid Treatments for Chronic Pain,” CDC, n.d., https://www.cdc.gov/drugoverdose/pdf/alternative_treatments-a.pdf
[12] “Understanding the Epidemic”
[13] Ibid
[14] Wayne, Alex, “Obama Calls for Aggressive Steps to Curb Opioid Abuse Epidemic,” Bloomberg Politics, Mar. 29, 2016, http://www.bloomberg.com/politics/articles/2016-03-29/obama-confronts-opiate-abuse-epidemic-as-death-toll-mounts