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How Did the Opioid Epidemic Become a Disaster?

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How Did the Opioid Epidemic Become Such a Disaster and How Will We Fix It?

The Opioid Epidemic has been around for a few decades now. There are still so many people who have no clue about the crisis lurking in the shadows. I personally have never heard of this crisis until I started working in the healthcare field. I would think that I’m up to date on current news but there were so many things I didn’t realize was going on within our country. Occasionally we will hear the stories of those who fought and survived the ordeal. Many still wonder how we got to where we are now and how are we going to get through these dark times. The problem doesn’t affect everyone yet but it soon will when the crisis grows. This whole mess will eventually come out of the shadows and it would already be too late. The battle has been going on since the beginning but now it’s up to everyone to contribute to it. Many still ask “how are we going to deal with this problem?”. These three major points is what I believe will benefit the country the most because by understanding how the epidemic started, how does it affect us in these modern times, and how can we find ways to stop the crisis so that this doesn’t happen again. These points will lead us to understand the problem and to overcome it.

First, not many people even know about opioids and where they come from. I believe we can solve any problem if we know it’s origin and the effects. This way we will know how to prevent and move forward. Opioids are used around the world as well but they have not reached a crisis as we have here in the United States. Opioids are potent, addictive drugs that inhibit the transmission of pain signals in the brain. A few common opioid painkillers are called hydrocodone and oxycodone. They are chemically similar to opiates derived directly from the opium poppy like morphine and heroin. Opioids are very powerful drugs. Because the body can very quickly become used to the drug, a person needs more and more of the drug to achieve the same effect. This is also referred to as building tolerance. As a result, when a person stops taking an opioid, they may feel intense pain and suffer the symptoms of withdrawal, which may include nausea, sweating and flu-like symptoms. This makes stopping the drug incredibly difficult. Opioid medications were used specifically for a few reasons as stated by Dr. Sumit Dutta, “Decades ago, opioids were reserved for catastrophic circumstances: patients coming out of major surgery, serious cancer and pain associated with end-of-life circumstances. There was a more balanced understanding within the medical community of the potential risks versus benefits of opioid therapy.” (“Working to end the Epidemic”).

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Since the late 1990s, sales of prescription opioids have quadrupled as drug manufacturers aggressively marketed opioid painkillers. Pharmaceutical companies stated that opioid drugs were not going to be addictive but they were completely wrong. By that time that the addiction was noticed, it was too late. Then doctors wrote more prescriptions for an ever-wider variety of ailments with over 240 million prescriptions in total in 2014. This amount meant there was enough for every adult in the U.S. to have had a bottle of pills. Even though the U.S. only represents 5% of the global population, Americans consume about 80% of all prescription opioids. The Opioid Epidemic continues to spread coast to coast, border to border across the United States. It is now known that those that are addicted to opioid medication are considered to have a chronic medical condition and will be treated like diabetes. Some people believe that we should stop opioid drugs in general. There are always pros and cons to every medication. Opioid drugs do what they’re intended but it all matters about how it’s being used. Besides not everyone gets addicted to the opioid drug. There are just those who are unlucky because we are all the same. So, doctors believe we shouldn’t cut the opioids until there is at least a sufficient treatment and alternatives for pain patients.

Second, the crisis had been going on for so long and now we wonder how does it all affect us this very moment. Things were not comparable as to the past then now because the modern times had caused the problem to explode even more. The crisis had gotten worse every year until it had reached the title of “National Health Crisis”. By the time everyone had realized the problem, it had already been too late for a quick resolution. The number of overdose deaths caused by opioid drugs were increasing massively until it had reached number one top accidental deaths in the US. It wasn’t that long ago that driving was deadlier than drugs in America. That change was driven by prescription opioid abuse. This lead to the high fatality rate of those under the age of 50 as reports stated. Soon, police officers and paramedics were all carrying “Naloxone”. This medication reverses the effects of an overdose and can save lives within an hour. Results from the years have stated that someone dies from an overdose every 13 minutes in the US. That would mean that 4 people die every hour. I believe this is especially hard on those in the medical field because they must find the best way possible to stop this. Every doctor always must put their patients as main priority because they believe every life matters. Time is everyone’s worst enemy and every second must be well spent. Although there are tons of thousands that die each year, a reporter from the New York Times stated, “it is hard to say precisely how many died or in which places drug deaths rose most steeply. Because of the delay associated with toxicology reports and inconsistencies in the reported data” (Katz, “Drug Deaths”). It is known that toxicology reports can take as long as three months or even longer. This causes the huge delay and that makes researchers make a very well-informed estimation of the total deaths.

It didn’t take to long for the new synthetic opioid drugs to cause problems. These new synthetic drugs were produced for specific purposes but as always will be used the wrong way by some. They are called Fentanyl (50 times stronger than morphine) and Carfentanil (100 times stronger than Fentanyl). These synthetic opioid drugs could cause an overdose immediately if overused by the slightest. The next problem is that these synthetic opioid drugs are now being brought into the streets and sold illegally. The drug Fentanyl is commonly only used for those with cancer pain. Fentanyl is more common in the streets as they are mixed in cocaine and heroin. The reason for so many people overdosing from the drug is because they don’t know how much to use when they buy it. The buyers are clueless that Fentanyl is even there because why would they bother when they only want it for the one reason. The reason to get high and feel excited. It was found that most people resorted to heroin when they can’t get any more opioid medications because the illegal drug has almost the same effect. Heroin is easier for someone to get because they are being sold on the streets. The sad truth is that these illegal drugs are never going to be off the streets. There is just no way to track and even catch everyone who is selling them. I believe that we as the people are the only way to stop it because they are only being sold because of the potential high profits. If that demand was down then there wouldn’t really be much illegal drugs on our streets anymore. They are only on our streets because the need for them is so high in the whole country.

Third, there are many ways to help prevent misuse and rehabilitate those already with the disorder. Although most of these methods are still in the works, they are showing great results in studies. I believe we need to spend more time on researching more methods or by improving what we already know. You would think that there would be a permanent solution as of now since the crisis has been here for so long. Although many people don’t seek help because they don’t want anyone to worry about them. Most people see addiction as sort of a weakness and everyone wants to seem strong. One method is called the MAT (Medication Assisted Treatment). Medical Assisted Treatment include buprenorphine, methadone or naltrexone. Buprenorphine is the main treatment drug and is approved by the FDA. FDA-approved medicines do include buprenorphine products and methadone. They are meant to block the effects of opioids, relieve cravings and reduce withdrawal symptoms so the person can focus on treatment. This method is calculated to be 50% successful and like most treatments depends all about how the patient wants to overcome it.

There were reports being shared and they proved that “Studies have shown that outcomes are much better when you are on medication-assisted therapy. For one, it decreases risk of relapse — significantly. Second, MAT has also been shown to be effective in preventing infectious diseases like HIV. Medication-assisted therapy has been shown to be effective in preventing overdoses” (Sheridan, “How Effective is”). Even though there are many places that provide this service, not many are using it. I suppose nobody would believe that this method would work because you’re using another drug to cancel out each other. Another downfall is the lack of doctor training and certification. Doctors must be MAT certified before they can oversee treatment with buprenorphine, and they must attend extra training to prescribe other MAT medicines. The worst con of all for the MAT is that some insurance providers will not cover the medication buprenorphine. That makes it hard to get the medication needed and to begin the program. I believe that if all or at least most of the health insurance providers had covered these medication costs, that this method would be used more. The last part of the MAT program is talk therapy. This is to help understand the patient’s life problems and how to best assist them in solving those problems.

Another great strategy many health providers are using is called the “Whole Person Approach”. This approach is mostly used for those with mental illnesses. This consists of 8 priorities that a patient needs to successfully recover. The 8 main priorities are accommodation, education, social, money, caring relationships, occupation, physical wellbeing, and medical treatment. These are just the 8 main points to keep anyone satisfied with their life and to want to make a change for the better. I believe that if we didn’t have these 8 necessities, that we would give up on wanting to get any better. It’s kind of like having your basic freedom with this plan because you’re in charge. This method has caregivers focusing on these main priorities to maintain the well-being of the patient. The caregivers will be experienced as to the situation because they either have been through this themselves or know someone that has. The main issue before was that care providers were still providing the needed care but not with the effort that was needed for successful recovery. This approach helps the patient take charge in managing their illness.

This brings us to the next problem of mismanagement of opioid prescriptions and fraud. It’s important that we monitor prescriptions to ensure they go to the intended recipient. We can utilize today’s technology to our advantage and track where the opioids are going. It was calculated that 70% of the misuse originated from theft, selling, and obtained from illegal ways. There are those that would sell their prescriptions to others for a money rather than using it for its intended purpose. Then there are potential false medical claims. People can persuade multiple different doctors to make a prescription for the same illness they’re having. Doctors can play a big part in fraud as well because some doctors see vulnerable patients as money signs instead. Doctors should already know better but there are always those that are greedy and only care of themselves. This would cost government health care programs and insurers thousands of dollars or even billions depending on how far they go. Modern technology would be able to help healthcare providers track how many prescriptions and amounts doctors are prescribing to patients. A system I would see would mark a red flag for health companies and then they can investigate it to see if there could possibly be some potential fraud going on.

Another big problem in the health industry is that the patients are being prescribed more pills than they need or even too many refills. The whole crisis in general already tells us that there really is no regulation in place. Maybe most doctors are not well informed on how opioids truly are. This would show the lack of training on prescription. Training in place will give reminders to doctors and to better prescribe what is needed. The CDC made guidelines to best prevent misuse of the drug. The guideline is to help Healthcare providers assist in finding ways to track prescription opioids so that they meet the guidelines on dosage, length of prescription, and chronic use. This will help prevent those prescribed from accumulating more than needed. With this training the doctors would be able to prescribe the correct and safe amount. A study stated that just taking opioid pain relief for 3 days in a row will most likely cause you to have opioid dependency. This alone already shows us how strong the pain reliever is. Before all the regulations, doctors were prescribing amounts and refills that were never following guidelines so that patients don’t grow dependency for the drug. There may be many solutions but, “Experts agree fixing the opioid epidemic will take a combination of solutions. But it’s a question of priorities: Which approaches will be most effective and most efficient? What is the best use of resources?” (Katz, “Short Answers”). This statement makes sense because we all want to explore and see what all our options are before we agree that a method is the best. The money that is provided is limited and therefore we can only do so much.

The best way for knowledge is always by hearing those who have fought and survived the addiction. Even though not everyone gets a happy ending, we can still learn from what they’ve gone though. By humanizing the unimaginable numbers with the personal stories of those that have experienced the impact opioids have, this is offering hope across the healthcare landscape with data-driven insights to bring meaningful change by focusing on prevention, treatment, and support. When we learn about how others overcame their struggles, it makes us want to do the same. This helps healthcare providers know that they’re making a difference and that they are doing things correctly. I believe hard work is contagious and we all need help to get better. Fighting alone without any support will most definitely make you fail. Through the education of this matter, we could prevent this problem from getting any worse. Like other chronic medical conditions, opioid abuse is treatable, with a better chance for recovery if effective therapy and long-term support are put in place and tailored to the individual’s needs.

Some ask if there are any alternatives that we can use instead of opioids. There was a recent study that had patients use both Tylenol and ibuprofen and another group using opioid prescribed pain-killers. It was then found out that they all had the same amount of pain relief from the medication. There was not much of a difference between pain relief from them all. The only big difference was that opioids can get out of control while non-opioid alternatives were completely safe from addiction. These alternatives would be best used with those with chronic pain. These basic pain relief medications are easy to get because they are not over the counter so therefore won’t require a prescription. Most doctors would recommend just going into physical therapy or exercising. Pain relief medications are only used for a quick response so that we can forget about it until it comes back.

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