According to the National Institutes of Health’s National Institute on Drug Abuse (NIH), “Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.” The same source goes on to say that “these drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain.”
What makes these drugs interesting is that they are all derived from chemicals found in the notorious opium poppy. The flower, while colorful and beautiful to look at, actually produces a sap that creates the highly addictive substance opioids. As DrugAbuse.com warns, “Opiates are among the most abused drugs in the United States as they’re easy to get hold of, readily prescribed, and very addictive–a dangerous combination.”
Yet if they are prescribed by doctors, then perhaps the bad rap they are getting are from people who are just abusing them? Unfortunately, this is not always a clear-cut case, as NIH says, “Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to overdose incidents and deaths.”
Let’s take a closer look at this picture.
The truth about opioids
An article published on the Journal of Pain, the official journal of the American Pain Society, says that “More than 50 million Americans suffer from chronic pain, and approximately 25 million experience acute pain.” For majority of these patients, the only relief they get from chronic pain conditions are from painkillers. Unfortunately, conventional painkillers can stop working overtime, particularly when chronic pain is involved.
Due to the staggering amount of pain the patients are in, and the pressure to relieve this pain, more and more doctors are prescribing opioids pain relievers to address their patients’ discomfort. According to SaferLockRX.com, “Prescriptions for opioid painkillers have steadily increased over the past 25 years, from 76 million prescription in 1991 to 259 million prescriptions in 2012; more than enough to give every adult American their own bottle of pills.”
This is echoed by a federal study that showed one in three Americans had a prescription opioid painkiller. The study says, “In 2015, 91.8 million (37.8%) of U.S. civilian, noninstitutionalized adults used prescription opioids.” This is where the figures take a turn for the worse as the study goes on to say, “11.5 million (4.7% misused them; and 1.9 million (0.8%) had a use disorder. Among adults with prescription opioid use, 12.5% reported misuse; of these, 16.7% reported a prescription opioid use disorder.”
This therefore shows that the growing number of prescriptions can also be attributed to promoting widespread addiction, and, in turn, the growing numbers of overdose deaths. The study points out that some of the addiction is from patients who were prescribed opioids but do not need them, and so they gave them to relatives or friends who were suffering from pain. As a result, these people are taking the prescription medication without the go signal from the doctor—and they also are not getting treated for their chronic pain. In fact, over 50% of people who tend to abuse prescription opioids got them through these methods. The study also went on to say that over 60% of the misuse of the medication was from people who were taking them without a prescription.
How opioids can kill
Opioids are highly addictive substances, particularly if they are taken without the doctor’s prescription. As DrugAbuse.com warns, “Because of the intense high produced by the interaction of several opiates and the brain, the drugs remain extremely addictive, sometimes causing measurable symptoms of addiction in under three days.” The higher the dose, the “better” the high. In which case feelings of euphoria and pleasure are felt by the patient, aside from pain relief. This “high” and pain relief make it a prime candidate for substance abuse.
In most cases of prescribed medication, patients are advised on the proper way to take the drugs. Yet for those who were using the drugs as hand-me-down from relatives and peers, they tend to take more drugs to manage their pain. Unfortunately, this can lead to a downward spiral that would spark an addiction—and overtime, overdose.
According to the Centers for Disease Control and Prevention (CDC), “Today, nearly half of all U.S. opioid overdose deaths involve a prescription opioid. In 2015, more than 15,000 people died from overdoses involving prescription opioids.” The drugs that had the highest occurrence of overdose were methadone, oxycodone (OxyContin®), and hydrocodone (Vicodin®). From 1999 to 2014, those who died from prescription opioid overdose were among the ages of 25 to 54 years old. Men were also more likely to die from overdosing in comparison with women, while overdose rates were higher among American Indians, non-Hispanic whites, and Alaskan natives, in comparison with Hispanics and non-Hispanic blacks.
According to NIH’s National Institute on Drug Abuse, there were over 64,000 drug overdose deaths in 2016. Of these deaths, over 20,000 were attributed to abusing fentanyl and fentanyl analogs (synthetic opioids). The total number of drug overdoses were also “nearly double in a decade,” marking a “2.2-fold increase in the total number of deaths” from 2002 to 2015.
What the medical community can do to help
Improving medical care has a long way to go to ensure that overprescribing opioids will not be as prevalent in the future as it is today. The figures all show that there is an overflow of excess opioids—meaning to say that the doctors are prescribing more than what the patients need. To counteract this, doctors can prescribe the opioids in lesser qualities.
Another way to counteract the growing need for opioids is to consider other pain-relief methods. Prescribing other forms of pain medication, such as ibuprofen or acetaminophen, can also benefit patients whose pain were not as intense as those who would need the opioids. Other laws are also being put in place to allow pharmacists to fill only half of a prescription, if they think the patients have been abusing the pills.
Yet the fact remains that while it is easy to dispense opioids, doing so should be done with more care. After all, for a potent pain reliever that can cause significant levels of highs, then you don’t want your patients to grow dependent on them in the long run.