Opioid Crisis- Causes, Consequences, and Interventions

Opioid Crisis- Causes, Consequences, and Interventions

Opioids are a group of drugs that include prescription drugs and the illicit drug heroin. These prescription drugs are pain relievers, including fentanyl, morphine, codeine, hydrocodone, and oxycodone (Dowell, Haegerich, & Chou, 2016). Opioids are related chemically and act by interacting with brain nerve cell receptors and the nervous system to relieve pain and give the user a pleasurable effect. Addiction is defined as a chronic and relapsing disease of the brain where a person pursues a reward pathologically and/or uses substances to relieve themselves of pain or unwanted feelings (Dowell et al., 2016).

Addiction is a global problem that has no discrimination against race or social standing and affects individuals, families, and entire communities. According to the Surgeon General (2018), addiction is also not a respecter of age; for example, in 2014, there were close to 435,000 individuals using heroin aged 12 years and above. Additionally, 4.3 million in this age group reported using prescription opioids for reasons outside of prescription. Addiction, like heart disease and diabetes, is a chronic disease and has no cure. However, addiction is manageable, and people who are addicts can recover, and in fact, there are those that have recovered. Treatment using helpful and safe methods and administered by trained clinicians can result in a positive and healthy way of life. This is what is called recovery. The most effective choice of treatment involves medication in combination with support and counseling (Surgeon’s General, 2018). This paper will discuss the causes of opioid addiction, its prevalence, and potential treatments.

Causes of Opioid Addiction

Several behaviors and practices result in opioid addiction. Bogdanowicz et al. (2015) point out that in the US, there is an insatiable appetite for opioid prescription drugs. As of 2015, more than 91 million people were using prescription opioids. These drugs end up being misused because of the potential they present for abuse, with a significant percentage of patients becoming totally dependent on the. Patients prescribed opioid medication for moderate or mild pain will often continue using the same with no intention of ceasing or tapering in their consumption. Opioids are highly addictive because of their pharmacological compositions (Bogdanowicz et al., 2015). A person develops tolerance in a very short period with severe symptoms following withdrawal.

Part of the reason behind the increased use of opioids is the over-prescription rates of the medications. Barlas (2017) notes that in the 1990s, healthcare providers increased opioid prescriptions following a campaign dubbed ‘pain as a 5^th vital sign.’ Additionally, these providers downplayed the potential for opioids to be abused and also were aggressive in the marketing of opioid drugs such as Opana and oxytocin. Webster (2017) adds that the risk factor of opioids is the introduction of the medications to children, a family history or previous history of alcohol or illicit drug abuse, adverse experiences in childhood years, female sexual abuse, and psychological comorbidities such as ADHD, Bipolar disorder, and Depression

Prevalence of Opioid Addiction

Business (2020) asserts that in the US, opioid addiction and Opioid Use Disorder (OUD) are at epidemic levels. Three million people have or currently suffer from OUD. More than half a million people living in the US are heroin addicts. Addiction afflicts persons of all ages, educational, and socio-economic backgrounds. Four million people currently use opioid prescriptions for non-medical purposes. Close to 80% of opioid users state that they initiated the addiction by first using pills and ended up with OUD. Additionally, Emergency Department visits in hospitals have continued to increase over the years due to overdose and complications linked to opioid use since 2010 (Kurland, 2018). In 2017, the US declared opioid overdose a national emergency

Potential Treatments for Opioid Addiction

According to the World Health Organization, Methadone and Buprenorphine are the “essential medicines” used in the treatment of OUD. Additionally, studies have shown that when treatment for opioid addiction is initiated, a combination of buprenorphine/naloxone and naltrexone extended-release formulation is also effective in the treatment of OUD (Dugosh et al., 2016). However, because full detoxification is necessary with naltrexone, it is difficult for clinicians to initiate treatment with this medication among active users. However, when detoxification is successful, the treatment also becomes effective. In addition, the medication should be done alongside behavioral counseling. Doing so offers a holistic approach to the treatment, referred to as medication-assisted treatment (Dugosh et al., 2016).

Salz (2019) adds that less than 50% of OUD treatment programs that are privately funded offer MAT, and still, only a 1/3 of their patients actually access this treatment option. The treatment admissions that involve medication as well have continued to decline over the years since 2002. Close to all states in America lack the sufficient capacity for treatment using MAT to all OUD patients.

Lastly, it should be pointed out that Buprenorphine and Methadone do not substitute one addiction for another (Schuckit, 2016). This means that the medication dosage given to an OUD patient does not get the patient high; rather, it helps reduce the patient’s withdrawal symptoms and cravings. The brain circuits’ balance is restored by these medications, which were initially affected by opioid addiction. This then allows the patient’s brain to heal, even as the patient works at getting recovered. It is uncommon for buprenorphine diversions to occur, and when it happens, it is to manage the patient’s withdrawal. The most common diversions occur with prescription painkillers such as hydrocodone and oxycodone (Schuckit, 2016).

Conclusion

Opioid addiction in the US is a real epidemic. Millions of people make up for the addicted populations, which in turn strains resources at the local levels. Emergency Departments have seen a steady increase in patients reporting to these facilities due to overdosing or OUD. Families and communities are affected by OUD as well. Firmer policies should be put in place that discourage the use of prescription opioids, and stricter penalties should be awarded to physicians and pharmacists who abuse their power in unwarranted opioid prescriptions to patients.

References

Ausness, R. C. (2020). Is Litigation the Way to Combat the Opioid Crisis?. The Journal of Law, Medicine & Ethics, 48(2), 293-306.

Barlas, S. (2017). US and states ramp up response to opioid crisis: regulatory, legislative, and legal tools brought to bear. Pharmacy and Therapeutics, 42(9), 569.

Bogdanowicz, K. M., Stewart, R., Broadbent, M., Hatch, S. L., Hotopf, M., Strang, J., & Hayes, R. D. (2015). Double trouble: Psychiatric comorbidity and opioid addiction—All-cause and cause-specific mortality. Drug and alcohol dependence, 148, 85-92.

Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain—United States, 2016. Jama, 315(15), 1624-1645.

Dugosh, K., Abraham, A., Seymour, B., McLoyd, K., Chalk, M., & Festinger, D. (2016). A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. Journal of addiction medicine, 10(2), 91.

Kurland, M. (2018). The opioid epidemic: the crisis that hits home. Professional case management, 23(5), 280-281.

Saitz, R. (2019). Treatment for opioid addiction must be offered in general hospitals: But how?

Schuckit, M. A. (2016). Treatment of opioid-use disorders. New England Journal of Medicine, 375(4), 357-368.

Substance, A., Mental, H. S. A. U., & Office of the Surgeon General (US. (2018). Facing addiction in America: the surgeon general’s spotlight on opioids.

Webster, L. R. (2017). Risk factors for opioid-use disorder and overdose. Anesthesia & Analgesia, 125(5), 1741-1748.

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Opioid Addiction

You will choose a specific addiction and complete a 3–5-page paper about the topic in the current APA format. This is a research paper, so make sure you construct and write it appropriately.

Opioid Addiction

You may choose any addiction discussed in the course material; you should email the instructor if you are unsure of the appropriateness of a chosen topic. The paper must address possible causes of the addiction as well as the prevalence and potential treatments. Include at least 3 outside sources (not including the course textbooks) from current professional journals (published within the last 5 years). Your paper must include a title page and a reference page in addition to the 3–5 pages of text.

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