Dr. Leah M. Baecht, DNP, CRNA, APRN Contributing Columnist June 27, 2021
Updated: June 28, 2021 12:03 a.m.
Source: The Intelligencer
Unsplash, Ellie Pourreza
Americans are more likely to die from a drug overdose than a motor vehicle accident. The United States represents less than 5% of the world’s population yet consumes over 80% of the world’s prescription opioids. Six out of the top 10 medications responsible for fatal overdoses are classified as opioids. In 2017, opioid drug use was responsible for almost 400,000 deaths worldwide. According to the Centers for Disease Control and Prevention (CDC) there have been nearly 500,000 deaths in the United States involving opioids over the last ten years. The National Institute of Drug Abuse (NIDA) reported Illinois deaths caused by opioid overdose dramatically increased by 86% between 2013 and 2016; the equivalent of five deaths per day due to opioid overdose alone. While most of the opioids in use are prescribed medications, they are either misused or obtained illegally. Opioid over-prescribing is a growing global health problem leading to diversion, misuse, addiction, overdose, and even death.
Opioids are often prescribed to reduce pain. They have been around for centuries, originating from opium, a natural substance found in the juice of the poppy plant. The term “opioid” is an umbrella term used to describe legally prescribed medications, illicitly manufactured opioids, and illegal street drugs all containing some form of opioid. Opioid misuse occurs when opioids are consumed by individuals without a prescription or when taken for reasons other than what they are prescribed for, for longer periods of time, or in doses greater than prescribed.
Opioids work throughout the body and the brain. The science behind the development of cravings involves research using functional Magnetic Resonance Imaging (fMRI) and positron emission tomography (PET) scans to study the response within the human brain to addictive substances. Opioid exposure activates pleasure areas within the human brain. Humans enjoy this pleasurable feeling and desire more of it, resulting in a craving. A vicious cycle occurs as we feed the craving with another dose of opioid, and the craving morphs into an addiction. Nora Volkow, the Director of the National Institute on Drug Abuse (NIDA), points out, “Almost anything deeply enjoyable has the potential to be addictive.” In 2017, the United Nations Office of Drug and Crime (UNODC) reported 16 million people suffered from Opioid Use Disorder (OUD) globally. OUD describes opioid dependence on a spectrum from opioid tolerance to addiction. One may be diagnosed with OUD after attempts to reduce or manage use are unsuccessful or when the desire to obtain opioids is prioritized over social, work or school obligations. In 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported 16 million people worldwide suffering from OUD. In 2018, SAMHSA reported 2.1 million people in the United States ages 12 and older, suffered from OUD.
Many of the individuals misusing prescription opioids for non-medicinal use or purposes other than intended, have obtained them from family or friends. Numerous studies have found that the number of opioids prescribed far exceeds the number of opioids needed for pain management. Moreover, excess opioids are not properly discarded or are stored for later use. Prescribed opioid medications that are not disposed of properly or not stored securely too often fall into the wrong hands, increasing the risk for dependence and addiction. Persons of all ages are at risk for consuming medications inappropriately. In 2020, the CDC reported almost 200 young children are brought to emergency rooms across the US every day for treatment of accidental ingestion or overdose of an unprescribed medication left within their reach.
July is Opioid Awareness Month. This is a great time to properly store currently prescribed medications or discard any unused medications no longer needed for indications as prescribed. Please remember and remind friends and family to keep all medicine, prescribed and over the counter, stored securely, up high, and away from the reach of children. For more tools and information, please visit the Centers for Disease Control and Prevention PROTECT initiative at UpandAway.org
Opioids were prescribed to patients as medication / drugs? How did a medication prescribed to patients become a drug epidemic? How is it that we have an opioid epidemic and health care professionals who deny overdosing patients and aiding in drug addiction? How is it that the same medical marketing firms, such as McKinsey (who was just envolved in a law suit settlement for its role in the opioid epidemic), who aided the creation of the opioid epidemic are now profiting from the recovery of opioids, which includes different drugs not no drugs? What are the similarities between the opioid epidemic and the Chinese Opium Wars?
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