When patients are in severe pain, medical doctors often prescribe opioids to eliminate the pain.
Reports show that nearly 100 million people suffer from chronic pain, particularly cancer patients. However, in 2012, the Centers of Disease Control and Prevention reported 259 million opioid prescriptions were written.
Drug overdose deaths, on the rise at a staggering rate, are the leading cause of death for Americans under the age of 50 and more common among adults in their 20s and early 30s. It has become a growing problem among women, who are more likely to experience chronic pain. Opioids are the common denominator.
What are opioids? The clinical explanation is its root, derived from opium, a narcotic poppy. From opium comes morphine, heroin, prescription painkillers such as oxycodone (found in a number of prescription medications), ocycontin (a time-released drug), Vicodin, and Percocet and together they are known as opiates. When combined with synthetic drugs, fentanyl and methadone, they become opioids.
The drugs work on opioid receptors in the nervous system and regulate pain, but can also be severely addictive.
The painkiller, responsible for more deaths from overdose than car accidents and guns combined, is largely accountable for 142 Americans dying from drug overdoses every day as reported by the Opioid Commission led by New Jersey Gov. Chris Christie. Ninety-one Americans die every day from an opioid overdose.
During a 15-year period, from 2000 to 2015, more than 500,000 people died of drug overdoses and opioids were the cause of the majority of those deaths.
The National Survey on Drug Use and Health reported in 2015, that an estimated 119 million Americans over 12 years old have been prescribed or illegally used psychotherapeutic drugs. The numbers break down as follows: 97.5 million people used pain relievers, 39.3 million used tranquilizers, 17.2 million used stimulants and 18.6 million used sedatives. Surveys estimate that about 12 million are using opioids without a doctor’s prescription.
More than 11 million Americans misused prescription opioids, nearly 1 million used heroin, and 2.1 million had an opioid use disorder due to prescription opioids or heroin in 2016.
While it is estimated that about 84 percent did not abuse or misuse the prescription drug, the numbers of people who are abusing and overdosing on the prescription drugs and overdose deaths was enough for the current presidential administration, as recommended by the opioid commission, to declare opioid crisis, a national emergency.
The National Center for Health Statistics also shows that long-term side effects of opioid prescription drug abuse may include slowed breathing and permanent brain damage.
National Institute on Drug Abuse study shows that prescription opioid abuse can also lead to adverse mental health issues, especially among adolescents.
NCHS and CDC tells us that heroin- and fentanyl-related deaths are on the rise and have hit several states such as Massachusetts, Rhode Island and Pennsylvania with the worst problems in Appalachia, the Rust Belt and New England. The emergence of fentanyl, a highly potent synthetic opioid about 50 times more potent than heroin, takes the lead in more than 50 percent of all overdose fatalities.
In 2014, according to the National Forensic Laboratory Information System, fentanyl became available in large amounts.
Several adverse outcomes from opioid prescription drug abuse are coma; constipation and bowel dysfunction; excessive mood swings; irregular heart rhythms; osteoporosis; sleep disorders; and death.
Why is it still available? Fentanyl is used for anesthesia and prescribed to treat pain. It’s the illicit manufacturing of fentanyl, according to the Drug Enforcement Administration, in China or Mexico and ordered by people in the U.S. through the mail or the dark web, which continues the supply stream. The fine-grained powder can be mixed and made to resemble powdered heroin or used to make counterfeit pills, which may explain why people are unaware they are ingesting fentanyl and risk poisoning.
What about treatment? It is reported that 90 percent of Americans struggling with addiction are not currently getting treatment. Experts stress the importance of having accessible treatment for those who are already addicted.
For 10 years, Christopher Metzler, PhD, has owned Gordium Healthcare, a drug rehabilitation clinic with 48 beds, in Boca Raton, Florida.
“When it comes to recovery, the most difficult thing to do is to wean them off the drugs,” Metzler said. “The process at our facilities is to remove the patient’s possessions, from non-essential clothing to [over-the-counter] drugs, administer urinalysis under supervision, assess their health and get them into sessions such as one-on-one counseling, group therapy and physical and mental strategy activities.”
Each patient is under 24-hour monitoring and provided with nutritional meals, especially since most suffer from malnutrition because drugs have served as their food source.
“We take in people from across the country and the profile of the users treated at the facility typically just want to be high and continuously seek the high and exhibit destructive behavior,” Metzler said. “Detox can be from 7 days to 30 days and beyond depending on the needs of the patient. Costs can range from $2,500 per day and up. Some costs can be covered by insurance.”
Metzler recommends that people, especially when suspecting that there are symptoms and signs of opioid addiction to: talk with the child/young adult; monitor social media used by the child/young adult (drugs can be ordered on line through the dark web); and seek professional support.
The American Psychiatric Association’s national poll released results that included, “One in five millennials think it’s OK to share prescription medicine,” and “Sixty-nine percent of American say they understand how someone accidentally gets addicted to opioids.”
“The other profile is someone who is dependent on the painkiller for the relief,” Metzler said. “Sometimes the root of the addiction is beyond the pain from an injury or disease or disorder but family dynamics, loss of a job, depression, unresolved emotional trauma, mental health issues, peer pressure, low self-esteem, a generational cycle of substance abuse, possibly genetic factors, and can lead to self-destructive behavior.”
Declaring a national emergency would increase funding to the federal Department of Health and Human Services. In response, five specific opioid strategies that HHS will bring to fight the epidemic are:
•Improving access to treatment and recovery services.
• Promoting use of overdose-reversing drugs.
• Strengthening the understanding of the epidemic through better public health surveillance.
•Providing support for cutting edge research on pain and addiction.
• And advancing better practices for pain management.
In the meantime, widespread distribution of naloxone will be made available.
“We must equip all law enforcement in the United States with naloxone to save lives,” the commission’s report stated. Naloxone is the opioid antidote used by first responders to save people who have overdosed.
Based on the demographics of the opioid epidemic, the white population has been hit the hardest, and is slowly changing to spread to other ethnic groups.
While the abuse of opioids is considered the deadliest drug crisis in American history, we may want to dig deeper and question the nation’s response to the 1980s crack cocaine epidemic predominately affecting blacks, which was not handled as an epidemic and/or disease that needed to be treated and strategies funded to save those communities.
Substance Abuse and Mental Health Services Administration – www.SAMHSA.gov
National Center for Health Statistics – www.cdc.gov/nchs
Centers for Disease Control and Prevention – www.cdc.gov
U.S. Department of Health and Human Services – www.hhs.gov
Gordium Healthcare – www.gordiumhealthcare.com
Marie Y. Lemelle, MBA, a public relations consultant, is the owner of Platinum Star PR and can be reached on Twitter @PlatinumStar or Instagram @PlatinumStarPR. Send “Health Matters” related questions to email@example.com and look for her column in The Wave.