It’s no secret that the start of the new millennium was one of the main turning points of opioid addiction in America. The 2000s sparked what is now considered to be one of the worst drug epidemics in history with millions of lives affected, and thousands more being added to that number every day. The FDA declared the over-prescribing of opioid painkillers to be a leading driver of the astronomical rate of people who succumb to opioid addiction, including the 64,000 who died in 2016 due to overdose and the 2 million who are currently addicted. Despite efforts being made by many doctors to cut down the number of opioid painkillers prescribed to patients, the current numbers have nearly tripled since 1999. This information is alarming and the statistics are staggering, but how do we make sense of it all? Will these efforts being made by doctors help reduce addiction rates and overdose deaths in the years to come? The answers are deeply dependent on recent data and statistics but the good news is that there is hope.
Why Are Opioids Prescribed?
Doctors often write scripts for painkillers when patients need to treat moderate to severe pain caused by injury, illness, or surgery. When these medications are taken as prescribed, they can remarkably help ease pain and limit painful conditions that can prevent people from living full lives. However, prescription dosing should be carefully considered and, more often than not, limited, to avoid potential dependence due to the very addictive nature of these drugs. Any use of opioids beyond the prescribed dose instantly increases the risk of possible addiction. This is why the CDC is now discouraging doctors from prescribing opioid medications, even for chronic or long-lasting pain. While these medications do serve a medical purpose, their presence is becoming increasingly used as a recreational drug. This is likely because people view prescription drugs as “safe” due to being recommended by a doctor despite having the same chemical make up as illicit or “illegal” drugs like heroin.
People at Risk for Opioid Addiction
Opioid addiction affects people from all walks of life, but when looking at statistics, there are specific variables that come into play representing those who are more likely to be impacted. Gender, age, race, socioeconomic status, geographical area, genetics, and medical history can all play a role in the progression of opioid abuse. While all these factors correlate, they are not to be used as predictors of potential opioid misuse.
Most of all, those who are at the highest risk of opioid addiction are people who begin to self-medicate and seek recreational highs once they are prescribed painkillers by a doctor. 60% of opioid deaths occur in those who were given a prescription by a physician. The other 40% of deaths are caused by people who obtained opioids by “doctor shopping,” and receive multiple scripts at once. The perceived safety and easy accessibility of these drugs have presented the highest risk for most users, even if they eventually seek out illicit opioids or “street drugs.” In 2014, only 22.1% of non-medical users obtained opioids through a doctor, meaning that the diversion rate of these drugs is very concerning. Many people are getting these medications illegally or without doctor supervision.
How Can Doctors Help Stop Opioid Misuse?
Opioids are very effective at stopping acute and chronic pain, which it makes it very difficult to address the opioid crisis in a way where doctors can moderate their recommendations of medicines to help patients with pain issues. However, due to the skyrocketing number of opioid prescriptions that are written every day, the use of opioids has become a societal concern and hot-button topic in medical communities. There have been various ideas proposed to help get the opioid crisis under control including decreasing or stopping the effectiveness of opioids in higher doses, having drugs produce negative or undesirable effects when used outside of dosage limits, and developing a physical or chemical barrier for methods of abuse. While these deterrents may all be effective in specific ways, much more research and development must be done before these misuse-resistant options can become readily available to patients.
As of 2016, the CDC has revised their opioid prescription guidelines and no longer advises opioid use for treatment of chronic or acute pain unrelated to cancer. Along with discouraged use, the CDC also recommends frequent check-ins with doctors and the promotion and availability of treatment for those who need it. Revising these prescription guidelines can help medical professionals effectively prescribe medication for people to help them, but also minimize risk potential.
Doctors have also been recommending alternative pain management plans, stressing the benefits of non-opioid anti-inflammatory medications. Along with non-habit-forming pain reducers, stress reduction, acupuncture, physical therapy, and even medical marijuana have been alternatives for some patients dealing with chronic pain. Overall, it’s been found that the most effective approach combines several different methods for treating pain before resorting to opioid medications.
Looking Into the Future
The most recent efforts that have been made to reduce the use of opioid painkillers have begun to show some positive effects, but there is much more work to be done. With more science-backed research being done on the disease of addiction, people are becoming more aware of just how addictive and dangerous opioid medications can become, and just how quickly and easily it can happen to anyone. The most critical factor in making changes in the future is educating both consumers and doctors of the considerable risk opioids pose and taking into consideration the full range of factors that put people at risk of addiction. While opioid addiction rates are still very high, it seems that the changes being made on a state and governmental level are the first steps towards creating a shift in this deadly and devastating epidemic that has needlessly destroyed many lives.
Sources:
http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
http://www.cdc.gov/drugoverdose/pdf/guidelines_factsheet-a.pdf
http://www.ncbi.nlm.nih.gov/pubmed/22786463
https://www.ama-assn.org/delivering-care/prescription-drug-misuse-overdose-death
https://www.ama-assn.org/ama-sees-progress-declining-opioid-prescriptions
