America has been plagued by an opioid epidemic for over two decades, devastating millions of families and causing a population decline of the millennial generation, but is there an end in sight? There have been measures taken by doctors across the nation to reduce the number of opioids that are prescribed to people in efforts to reduce the addiction risks, but since 1999, the overdose rates have increased four-fold. It has been estimated that nearly 115 Americans die from opioid overdoses every day. Not only is this epidemic killing people at an alarming rate, it also costs the nation $78.5 billion per year in health care costs, including addiction treatment .
Over the past year, prescriptions for addiction treatment medications have nearly doubled as opioid pain killer prescriptions have declined. This means more people are being prescribed medications to help with opioid addiction management. Policy makers and medical groups have been making considerable efforts to change the way pain management is handled. However these efforts have resulted in unexpected consequences. There has been a recent surge in overdose deaths caused by illicit opioids like heroin, especially when laced with the deadly and powerful drug fentanyl. While people are not getting pain medications from their doctors, they are still seeking out illicit drugs to feed their opioid addiction.
Of all people with substance use disorders, only 20% are receiving methadone or naltrexone treatment, which accounts for a very small margin of those who are regularly taking some kind of opioid medication. Prescriptions for opioid painkillers have been dropping since 2011, and in 2017, that trend accelerated even more. Opioid prescriptions in 2017 rates dropped 10% from January and December, according to IQVIA. This drop in prescription rates may be due to insurance companies who are pushing new policies asking doctors to rethink their prescribing practices, as well as tracking policyholders and patients who practice “doctor shopping” to acquire multiple prescriptions. In New Jersey, it was reported that the new policy of only prescribing 5-day supplies of opioids for patients has helped decrease the overall prescription rate by 15%.
It should be stated that the people who are in need of opioids for chronic pain are not the ones who are driving this epidemic. It has been reported that 80% of misused prescription opioids were obtained without consent from someone else or a drug dealer. Drug makers have also begun to create new formulations for opioids that include extended-release to lessen misuse. These formulations make it difficult for users to achieve a “high” due to the pills dissolving slowly, keeping the dosage steady throughout the day. These new pills can also help deter users from associating taking their pain pills with a “good” feeling, which can quickly lead to addiction. The quick drop in opioids in blood levels can also be avoided this way, as it prevents people from feeling intense withdrawals when they stop taking their medication. It’s been shown that with the reformulation of OxyContin, misuse of the drug has dropped significantly.
These abuse-deterrent formulations for opioids could be a solution to the ever-rising epidemic by preventing new people from forming addictions, however, what can be done about the millions of Americans who are already faced with an opioid addiction? The reality is, once someone is addicted to opioids, a reformulation will not stop them from obtaining what they need. This is why the number of opioid deaths from illicit substances like heroin continue to skyrocket.
Sky-rocketing Heroin Deaths
The annual growth rate of deaths involving prescription opioids slowed down in 2010, but deaths from heroin and fentanyl are spiking rapidly as people are no longer able to obtain pills easily as it was in the past. The growth rate of heroin deaths has gone up from 13.7% to a dramatic 36.5% since 2010. It’s obvious that a considerable amount of attention needs to be focused on people who are now using illicit drugs sold on the street. Some are unknowingly injecting drugs like fentanyl or carfentanil, an animal tranquilizer which has killed many people. Even worse, drug dealers are now creating counterfeit pills, combining heroin with other dangerous drugs and pressing them into pill forms and selling them to people who are unknowingly buying doses much higher than what they’re used to.
One possible solution to tackle the “root issue” of this addiction epidemic is making people more aware of the drugs they’re taking from the doctor to prevent future addiction. It’s not enough to simply stop prescribing opioids, because it will only create more illicit drug users in the long run. Ideally, if everyone with an opioid addiction could be placed in treatment and put on medical-assisted treatment, the national epidemic could potentially start to decrease. However, with the rapid increase in illicit drug use, it seems like a lofty goal.
The opioid crisis hasn’t just killed millions of people and destroyed families nationwide; it has also severely impaired the American economy. An estimated 1 million people are unable to work due to their opioid addiction in 2015. The job market took a huge hit due to loss of employees and productivity costing the US economy a whopping $702 billion, or less than $44 billion a year from 1999 to 2015. Employers have even reported difficulty hiring new workers because so many are unable to pass required drug tests.
The opioid epidemic seems to be evolving and getting worse. With the science behind addiction becoming clearer and new developments being made to help identify addiction “genes” in people’s DNA, there may be a time in the future when people who are dealing with an opioid addiction can more effectively receive help. Currently, the overwhelming stigma that surrounds addiction still causes many people to avoid seeking help. The future of the opioid epidemic may look grim, but the prevalence of outpatient treatment centers across the nation is making it easier for people to treat their addictions while continuing to live their lives. Hopefully, more people will feel encouraged to go into treatment and embark on the road to long-lasting recovery.