Sample on Overcoming Opioid Addiction among Adults in America

Overcoming Opioid Addiction among Adults in America

Abstract

Opioid addiction is a major problem worldwide. Close to 36 million people abuse opioids worldwide, even as an estimated 2.1 million abuse these drugs in the U.S. Opioids are among the major causes of deaths in the U.S., accounting for more than 72,000 overdose deaths and 13,000 unintentional deaths, ideally making it a bigger killer than hypertension, pneumonia, HIV/AIDs, and cancer combined. Among the drivers of opioid addiction are the ease of access to drugs, aggressive advertisement, and general societal acceptance of medication. Although treatment is available and effective, education on the dangers of opioids offers a better option for overcoming the problem of opioid addiction. Alternative medicine, non-opioid drugs, and control of opioid sales and advertisements by the FDA offer additional measures towards overcoming the opioid crisis currently witnessed in the country.

Keywords: Opioid, addiction

Overcoming Opioid Addiction among Adults in America

Opioid abuse and addiction are grave global and national problems in the U.S. The effects of opioids cut across a wide spectrum of society, including the social, health, and economic wellbeing of any society. Estimates by the Substance Abuse and Mental Health Services Administration indicate that close to 36 million people abuse and are addicted to opioids across the world, even as the U.S. contends with an estimated 2.1 million people who have addiction and substance abuse disorders resulting from opioid prescriptions (Kolodny et al., 2015). Moreover, concern for the numbers emanates from the rising consequences of the abuse. Phillips, Ford, and Bonnie (2017) report that opioid use was responsible for more than 28,000 overdose deaths in 2014 in addition to putting users at risk of catching and spreading infectious diseases such as HIV and Hepatitis. Given these grave concerns for opioid addiction, it is important to find and implement strategies geared towards overcoming opioid action among adults in America. Medication, education, and outreach are among the strategies that offer plausible solutions to overcoming opioid overdose among American adults, which is a problem that is driven by several factors, for instance, aggressive advertising and the general attitude towards medicine.

Current Research on Opioid Addiction

Some gaps in the healthcare system encourage addiction to opioids; thus, sealing these gaps could help to solve the problem. One of the realities of the health care setting is its fragmentation, where diverse health care organizations provide specific care. According to Lipari, Park-Lee, and Horn (2016) in a Substance Abuse and Mental Health Services Administration report, most individuals with substance abuse problems do not seek treatment for the disorders on their own, yet they access the health care system for various other problems. Current research looks at integrating both primary care and other aspects of care (including mental health and substance) within the same care to make it easier and possible to screen for substance misuse and disorder within the varied health care setting.

Screening is a valuable tool for dealing with opioid addiction. Opioid addiction is sometimes so subtle and not easily detected by friends and family members, who have customarily sought help from addicts. Moreover, before the signs are evident to the friends and family members, it may be too late into the addiction. Lander, Howsare, and Byrne (2013), in their study on the impact of substance abuse on families and children, inform that one of the reasons that should encourage screening at primary care facilities is that of the 20.8 million people that needed treatment for addiction, 95% felt they did not need it. Further, of the total of 20.8 million people, the 3.7 percent that felt the need for treatment made no effort to receive it, while 11% that made an effort to receive treatment never received it (Lander, Howsare, & Byrne, 2013). The statistics point to a larger problem within the health care setting due to fragmentation. Integration of the services, therefore, provides hope for overcoming not only opioid but other substance addictions as well, through screening and referrals to specialized care facilities.

Integrating the treatment is especially encouraging as it is effective and offers many benefits. Volkow (2014) states, “Medication-assisted treatment will be most effective when offered within the larger context of a high-quality delivery system that addresses opioid addiction not only with medication but also with behavioral interventions to support treatment participation and progress, infectious disease identification and treatment (especially HIV and HCV), screening and treatment of co-morbid psychiatric diseases, and overdose protection (naloxone).” The idea here is to provide integrated care, which screens for the diverse disorders, within the primary care system, begins treatment, and where appropriate transfer/give referrals for specialized treatment.

Recent research has attempted to find the relationship between pain medication and opioid addiction. Volkow (2014) informs that opioids have traditionally been used to treat acute pain and relieve chronic pain in patients. However, their use for such treatment presents a dilemma for health care providers, who have to balance between the risk of patients abusing and developing an addiction and relieving their patients’ suffering. Research in this end, according to Volkow (2014), looks into the development of novel ways of pain treatment. Part of the initiative includes developing pain relievers with decreased levels of abuse, dependence risk, and tolerance. Furthermore, the initiative looks to develop substitute delivery systems and combinations for existing opioids with the aim of reducing diversion and abuse, as well as the risk of overdose deaths (Volkow, 2014). Of particular interest in the ongoing research is the development of new compounds “that exhibit novel properties as a result of their combined activity on two different opioid receptors (i.e., mu and delta).  Preclinical studies show that these compounds can induce strong analgesia but fail to produce tolerance or dependence” (Volkow, 2014). The idea here is to develop drugs with non-opioid-based drugs for pain, which divert from the brain’s reward pathways, thereby reducing the potential for abuse and addiction.

Drivers of Opioid Misuse and Addiction among Adults in the U.S. and Mitigation

The increase in opioid misuse and addiction among U.S. adults stems from several factors. One such driver is the increase in the number of prescriptions written. Volkow (2014) informs that the number of opioid prescriptions has increased drastically from about 76 million in 1991 to 207 million in 2013. The number of prescriptions peaked in 2011 when there were 219 million opioid prescriptions and dispensation (Volkow, 2014). Reynolds et al. (2017) believe that pharmacists have fueled the crisis as they state, “Pharmacists are clearly stakeholders in the opioid crisis across the pharmacy practice continuum” (p. 203). To illustrate the role of pharmacists, Phillips, Ford, and Bonnie (2017) inform that individuals with opioid prescriptions and an opioid use disorder easily escalate their opioid misuse in the event that the opioids are easily accessible. The increased prescription rate means that individuals can easily access drugs, whenever and where they want. Moreover, some pharmacies easily dispense drugs without a prescription, further increasing the chances of misuse and addiction.

Another driving factor is the increased societal acceptability for the use of medication. Compared to decades ago, society today easily accepts the use of medication for different purposes (Volkow, 2014). Taking antidepressants, antiallergics, and analgesics, among other medications without a prescription, has become a norm within society. Moreover, many in society do not take a keen interest in the regularity and amount of medication adults take. Given this wide acceptance of medication, few people are alarmed at the use of opioids. The acceptance and absence of any reprimand over the use of medication easily leads to opioid addiction,

Pharmaceutical companies are another driver to the increased use of opioids and eventual addiction. Volkow (2014) informs that Pharmaceutical companies in the U.S. aggressively advertise drugs to consumers, who then ask for specific drugs’ prescriptions whenever they see a physician. The drugs advertised as pain relievers, among other “miracle” working properties, push adults to use the drugs despite other non-medication approaches to managing their conditions being available. OxyContin by Purdue Pharma is an example of a drug introduced and highly marketed by its manufacturer. Van Zee (2009) informs that Purdue Pharma aggressively marketed and promoted OxyContin, thus growing its sales from $48 million in 1996 to almost $1.1 billion in 2000. The intense advertisement led to people purchasing and taking the drug, which led to a lot of abuse, diversion, and addiction to the drug. So aggressive was the marketing and consequent consumption of OxyContin that the drug became the most abused drug in the U.S. by 2004 (Van Zee, 2009). Thus, the advertisement of opioids is a significant driver of addiction to them,

Possible Treatment and Mitigation of Opioid Addiction

While overcoming opioid addiction with such widespread acceptance of medication may be difficult, it is not impossible; thus, there are various steps that can be taken to avert the crisis. An example is a societal education on drug use and misuse and its dangers. Such an exercise should start in earnest towards overcoming the widespread acceptance. Reynolds et al. (2017) aver that community coalitions that involve a multidisciplinary health care approach can be especially instrumental in creating community awareness and implementation of effective educational interventions. Such initiatives help instill accurate information, such as, while it is acceptable to take medication, abuse presents dangers to the individual and society. Most of the opioid drugs have increasingly and continuously been advertised as offering a reprieve for individuals; messages to the contrary can, therefore, be difficult to convey (Volkow, 2014). Nevertheless, according to Reynolds et al. (2017), educating the community on alternative methods of pain management that do not necessarily rely on opioid medication can help to overcome the addiction, given that patients will have no contact with the opiates. Alternative pain management, in this case, includes physiotherapy, education on correct posture, and alternative medicine that does not contain any opioids. If the members are wary of the effects of the drug and the alternatives, they are likely to avoid the drug.

Education must cover the whole society, including doctors, for it to be effective. The education and outreach herein also cover medical students and resident physicians in primary care specialties (Volkow, 2014). Among the organizations that have been at the forefront of educating the masses is NIDA (National Institute on Drug Abuse). NIDA’s education and outreach target both adults and teens through an initiative known as PEERx (Volkow, 2014). The online program discourages the use of prescription drug abuse among teenagers and adults. Moreover, it presents accurate information on the consequences of opioid addiction to the brain and body. More bodies should join the campaign against the misuse of opioids.

Another way of mitigating opioid addiction is treatment. Drugs such as buprenorphine and methadone (a combination of them) have proven especially effective in treating the disorder. While many have argued that these drugs only replace one drug for another, the supposition is entirely wrong, given that these drugs’ dosage does not give the same “high” effect as opioids do. Ideally, buprenorphine and methadone work by reducing opioid cravings and withdrawal. Additionally, they restore balance to the brain, allowing healing as the individual recovers from the addiction. Once these addicts are treated, then their need for consuming opioids ceases to exist. This approach, together with educating the public on the dangers of the drug and alternatives, could reduce the demand for the drugs, thus taking away the incentive for pharmaceuticals to produce the drugs.

Since pharmacists fueled the Opioid crisis in the nation, they can also avert the problem. Indeed, doctors and pharmacists at the national, state and local levels are well placed to arrest the opioid crisis because they can choose not to prescribe the medicine or avail of the medicine without a prescription. Some of these professionals have already begun taking measures to prevent addiction to these drugs and some issues associated with the habit, such as overdosing. For example, according to Reynolds et al. (2017), North Carolina pharmacists have taken a great step in preventing overdose deaths and arresting the crisis by distributing naloxone and educating the public on the dangers of opioid misuse. Pharmacists have also vowed to dispense drugs with prescription and caution, in addition to counseling patients on the risk factors for opioid overdose.

Conclusion

Opioid abuse and addiction are a huge problem for the world and to the U.S. in particular. Ease of access, aggressive advertisement, and general societal acceptance of medication are among the drivers of opioid addiction in the country. The effects of the addiction are alarming and call for effective strategies to arrest the widespread addiction. Although medication offers effective treatment for opioid addiction, education, and outreach offer a better approach in dealing with the problem. Giving correct information on the effects of opioid addiction to the brain, the body, family, and society at large provide a better approach to overcoming opioid addiction in the nation.

References

Kolodny, A. et al. (2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559-574

Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social work in public health28(3-4), 194–205.

Lipari, R., N., Park-Lee, E., & Horn, S., V. (2016). America’s need for and receipt of substance use treatment in 2015. The CBHSQ Report.

Phillips, J., K, Ford, M., A, & Bonnie, R., J. (2017). Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (DC): National Academies Press.

Reynolds, V. et al. (2017). The role of pharmacists in the opioid epidemic: An examination of pharmacist-focused initiatives across the United States and North Carolina. North Carolina Medical Journal, 78(3), 202-205

Van Zee A. (2009). The promotion and marketing of oxycontin: commercial triumph, public health tragedy. American Journal of Public Health99(2), 221–227. https://doi.org/10.2105/AJPH.2007.131714.

Volkow, N., D. (2014). America’s Addiction to Opioids: Heroin and Prescription Drug Abuse. NIDA