At the center of the opioid addiction epidemic are real people facing real challenges. And we’re looking for solutions.
Serious, chronic health conditions such as diabetes, heart disease and cancer, represent just a few of the staple diagnoses in developed countries, but few are as stigmatized as addiction. The opioid epidemic is at the forefront of public health issues capturing national attention in the United States, affecting communities from Hollywood to small town USA. Former U.S. Surgeon General Vivek Murthy wrote, “Above all, we can never forget that the faces of substance use disorders are real people. They are a beloved family member, a friend, a colleague, and ourselves.” With nearly 100 people dying every day from an opioid overdose, broken families, medical professionals, law enforcement and politicians have rallied together to make public calls to action.
Understanding the Appeal of Opioids
The term opiate is a classification for a drug that contains the highly addictive drug opium, a narcotic derived from the Papaver somniferum poppy plant. Opioids are appealing because the user feels a great sense of euphoria, followed by both decreased pain and increased drowsiness. The problem is that users develop a tolerance to these effects, so if they want to continue to experience that same euphoria and reduction in pain, they need to take higher doses of the drugs, increasing the likelihood of overdose.
Adding to the complexity of this epidemic is the availability of similar, and often illicit, drugs that produce the same euphoric feelings of prescription pain medications. The abuse of, and addiction to, illicit versions of opiates, such as heroin, is growing as regulations and costs make it more difficult to obtain legally prescribed opiates. Heroin, which is derived from morphine, is known by a variety of street names, including dope, smack, H, junk, skag and China white. Like legal opiates, heroin is derived from the same poppy plants, which explains why individuals who are addicted to opiates turn to heroin when they cannot legally obtain their prescribed pain pills.
A Prescription for Disaster: Trends in the Opioid Epidemic
Trends in prescription drugs sales, including opiates, have risen sharply, quadrupling in less than two decades. Unfortunately, so has the number of opioid addictions, overdoses and subsequent deaths. More than 500,000 people have died from drug overdoses from 2000 to 2015, and many more are suffering from opioid addiction, with more than two million Americans either abusing opiates or suffering from opioid dependence in 2014 alone. It makes sense, then, that the United States consumes 80% of the global opioid supply. Individuals hit hardest by this epidemic are between the ages of 25 to 54, with higher overdose rates seen in non-Hispanic whites and Native Americans or Alaskan natives. Men die from overdoses at higher rates than women, but that gap is said to be closing.
Turning the Tide: Revisiting Treatment Recommendations for Chronic Pain
Despite their highly addictive nature, opiates such as morphine, oxycodone, hydrocodone and codeine are still regularly prescribed by medical professionals in the United States, leading to a significant number of Americans suffering from opioid addiction and giving rise to the phrase “prescription drug epidemic.” In fact, more than 210 million opiate prescriptions were distributed in 2010 alone. Once the leading treatment option for chronic pain, opioids are no longer viewed as a first line of defense for all pain cases. Opioids are still appropriate in certain short-term treatment regimes, as well as for patients suffering from cancer, undergoing active cancer treatment, or undergoing end-of-life care. Newly released prescribing guidelines from the Centers for Disease Control recommend that physicians discontinue the use of opioids as a treatment for chronic pain (pain lasting longer than three months) due to the lack of supporting evidence that it improves quality of life, decreases reports of chronic pain or improves the patient’s ability to function.
Dr. Monique Tello, an MD with a public health background, was no stranger to the realities of opiate addiction, having long walked the halls of major hospitals filled with patients battling this disease. Then her nephew died of a heroin overdose in 2013. This tragic loss, combined with former U.S. Surgeon General Vivek Murthy’s call to action for health care professionals, catalyzed her journey to become an active part of the solution. Now she fights to prevent another family from experiencing her grief: “In my 16 years of clinical training and practice, I have witnessed all of this firsthand: the blatant, medically rationalized overprescription of pain meds, the stigma and undertreatment of opioid use disorder, and the unnecessary, premature death of a really good kid. I’m just starting off on this, and I’m still learning, but my hope is to keep another family from experiencing unnecessary loss.” She has since become certified to administer lifesaving drugs like Suboxone, and she advocates for the use of medication-assisted treatments to promote successful recovery. Fortunately, physicians like Dr. Tello are rallying together to practice safe treatment practices and to provide the safest treatment measures for those currently addicted.
A Dose of Hope: Alternatives to the Opioid Epidemic
Given the rate at which Americans are being prescribed and becoming addicted to opiates and/or illicit drugs like heroin, it’s likely you or someone you know is affected. National, accredited organizations like SAMHSA and the National Institute on Drug Abuse are great starting places for those wanting to learn more about this epidemic or find additional resources. Additionally, TurntheTideRx includes an easy-to-understand guide to opioids, providing prescribing information for providers as well as alternative treatments for certain pain disorders.
If you are suffering from chronic pain and have yet to be prescribed opioids and are concerned about the risks, talk to your health care professional. Ask your health care professional what alternatives are recommended for the treatment of chronic pain, whether that’s physical therapy, meditation or yoga or seeking counseling from a mental health professional. You have a right to advocate for yourself and your health care.