Opioids are strong painkillers that include, amongst others, oxycodone, hydrocodone, and morphine. Opioids offer several positive effects, but they also have the potential for some very significant adverse effects. Opioids are medications used to treat various medical conditions, including pain, diarrhea, and coughing. They are naturally occurring chemical compounds derived from the opium poppy plant. Nevertheless, an alarming number of Americans have been adversely affected by the substantial risks linked with these prescriptions, and the scale of the opioid problem continues to expand despite the efforts that are being made currently. Since opioid drug use is a major cause of mortality, there is a pressing need for restrictions imposed and alternative approaches to addressing this epidemic.
Opioids are increasingly claiming lives at an alarming rate, and overdoses from prescription are lowering life expectancy, especially in the United States. The opioid crisis in the United States is characterized by medical practitioners’ proactive prescribing practices, pervasive opioid abuse, and rising prescription and illegal opioid-related overdose mortality rates. Americans experience greater difficulty than any other population in the world, and nearly 80% of the globe’s supply of opioids is taken in the United States (Gusovsky).
About 99 percent of the world’s hydrocodone is consumed in the United States (Gusovsky). As a result of its significant tendency for abuse, hydrocodone was rescheduled from Schedule III to Schedule II in 2014. Perhaps, therefore, there is no better nation to use to support the claim that the opioid overdose and misuse crises may be nearly entirely attributable to the rising prescription and access of these drugs.
In the 1990s, the United States opioid epidemic began to escalate. Initially, the opioid crisis was caused by increased opioid prescription drugs, but it has now expanded to include strong heroin and illegal fentanyl. However, reducing the availability of prescribed opioids should mitigate this trend. In the United States, 91 individuals each day die from an opioid overdose, with roughly 50 percent of these deaths not attributable to prescribed opioid medication (Shipton et al. 2). It has been estimated that the annual economic cost of opioid abuse in the United States exceeds $78 billion (Shipton et al. 2). This does not entail the cost to diminished quality of life, dysfunctional family connections, psychological distress, and societal dysfunction.
The implementation of regulations meant to encourage doctors and healthcare facilities to prioritize pain reduction also contributed to the rise in opioid usage. These policies entail The Joint Commission’s Pain Management Standards, which helped foster the concept of pain as the “fifth vital sign” (Fiore). Irrespective of the precise cause of the significant increase in opioid usage, it is evident that the healthcare system fostered the growing use of opioids and ignored the danger of abuse. In this regard, the opioid crisis is iatrogenic and comes under patient safety. Given that the majority of opioids abused by patients are derived from prescription prescriptions, it is crucial, as part of a comprehensive safety approach, to at least educate and supervise patients about opioids.
Opioid usage has increased in the United States due to the increasing use of prescription opioids by the elderly, the increasing rates of addiction, the attempts to combat the under-treatment of chronic pain, and the industry’s marketing of the use of prescription opioids. A nationwide study conducted in the United States in 2013 revealed that 74% of opioid addicts obtained their opioids primarily from a single doctor, acquaintance, or family (Shipton et al. 4).
In turn, these friends and family members acquired opioids from a clinician. The majority of opiate addicts initially encountered opiates via a valid pain prescription. Up to 40% of chronic opioid treatment patients in the United States often have prescription opioid use disorder (Shipton et al. 4). Opioid abuse increases proportionally to the usage of prescribed opioids for pain management. Multiple physicians frequently prescribe opioids concurrently to Medicare beneficiaries, according to research (Shipton et al. 4). It has been claimed that this is connected with increased rates of use-related hospital admissions.
By desensitizing antinociceptive channels to opioids, chronic opioid usage may lead to resistance. Long-term opioid usage may build physical dependency, resulting in withdrawal symptoms if the drugs are abruptly discontinued (Shipton et al. 7). Opioids can activate Mμ opioid receptors in the brain’s reward centers. This leads to addiction (with severe urges for opioids) when higher dosages of opioids are used for longer durations. Opioid-induced hyperalgesia (OIH) is the stimulation of nociceptive pathways through which opioids conversely enhance pain hypersensitivity and susceptibility to pain (Shipton et al. 2). Overdose, sleep apnea, myocardial infarction (MI) driving impairment, and indications of sexual and other endocrine complications are among the dangers associated with long-term opiate usage.
The cautious use of opioids is paramount, and pain management does not supersede safety. Before administering opioids, a thorough evaluation with documentation should be conducted. Such activities involve documenting a thorough history, medical history, a psychosocial history that addresses mental state, and a drug use history (Shipton et al. 5). Before initiating opioid medication, if possible, the relevant medical and psychiatric diagnoses should be established. All clients should consider attainable treatment objectives regarding pain alleviation and function improvement. Due to its harmful consequences, opioid usage should be minimized in the elderly and limited in children.
Several measures must be taken to prevent the availability of these medications, including the Food and drug administration (FDA) forcing containers to have more explicit warning labels and up-scheduling hydrocodone so that it cannot be immediately renewed without an extra prescription order from the physician. These measures to restrict access to opioids are vital, but they may have unintended consequences, such as an increase in heroin use as a result of restricted access to prescription opioids. Certain communities still lack adequate provision for medical pain management and treating opioids responsibly entails giving them to those who need them.
Many may contend that the US mainstream media is eager to criticize opioids and to present them as a drug to be avoided at all costs. While there is cause for worry, certain regions of the US have adopted a more sophisticated strategy that focuses on the social and educational aspects of the opioid issue rather than just restricting access to drugs. Ohio, which recently launched an aggressive, multi-faceted campaign to tackle the opioid crisis its state was facing, is a brilliant example of this strategy. To better comprehend the objectives and outcomes of Ohio’s program, Penm et al. performed a study on it (p.1-6). The efficacy of recent regulations implemented in Ohio state in response to the spreading opioid crisis is examined in this case study.
Ohio has seen an increase in the number of initiatives. Ohio has growing rates of opioid usage, and its incidences of unintended opioid-related drug overdoses rank sixth highest in the United States. In 2011, Ohio governor John Kasich founded the Governor’s Cabinet Opiate Action Team (GCOAT) in an attempt to address this problem. This group has developed several measures to meet three basic goals (Penm et al. 1).
The primary purpose is to promote more responsible use of opioids. Then, the quantity of opioids administered to patients is decreased. The third purpose is to increase access to naloxone. New rules regarding the usage and prescription of opioids seem to have contributed to a decline in opioid overdose rates. According to Penm et al., in 2011, opioid overdose deaths accounted for 45% of all drug-related deaths in Ohio; by 2015, this proportion had decreased to 22% (1). Nonetheless, it is important to note that the general rates of drug overdose deaths in Ohio rose throughout this period, reaching an all-time high in 2015. However, this is believed to be mostly attributable to the increasing distribution of fentanyl at the state level.
Additionally, there appeared to be considerable reluctance to completely adopt the push to improve patient and clinical accessibility to naloxone. Many medical professionals believed that this would act as a “safety net” for those who used opioids or provide them with a phony feeling of assurance. The relatively expensive cost of naloxone was cited as a barrier to extending its circulation by other healthcare practitioners (Penm et al. 5). Moreover, the statistics demonstrate a decline in the percentage of drug overdose fatalities attributable to opioid overdose may be biased. This may be attributable to the fact that the usage of drugs like fentanyl rose during the same period as measures were implemented to tackle the opioid epidemic.
It is indisputable that this study offers solid evidence to reinforce the idea that a combative, multi-faceted legislative strategy to mitigate the opioid crisis can be effective. The approaches that were taken to reduce the number of deaths that were caused by opioids were diversified. These approaches included initiating campaigns to reduce the social stigma associated with allocating naloxone. In addition, it involved the pervasive revocation of medical licenses in cases where the owner was considered to have ignored previous opioid prescription regulations. This program tackled the problem from a social, legislative, and medical perspective, and its nature was fairly comprehensive and well-thought-out in its strategy.
As opioid abuse is a leading cause of death, there is an urgent need for limitations and alternative strategies to combat this pandemic. Opioids are taking lives at an alarming pace, and prescription drug overdoses are decreasing life expectancy, particularly in the United States. Abuse of opioids grows proportionately to the prescribing of opioids for pain treatment. Certain parts of the United States have chosen a more complex approach that concentrates on the social and educational components of the opioid problem rather than just limiting access to medications.
The founding of the Governor’s Cabinet Opiate Action Team (GCOAT) is one example of an effort to combat the opioid usage problem. The major objective is to encourage more responsible opioid usage. Following this, the amount of opioids provided to patients is reduced. Ultimately, the third objective is to expand naloxone accessibility.
Works Cited
Fiore, Kristina. “Opioid Crisis: Scrap Pain as 5th Vital Sign?” Medpagetoday.com, MedpageToday. 2016. Web.
Gusovsky, Dina. “Americans Consume Vast Majority of the World’s Opioids.” CNBC. 2016. Web.
Penm, Jonathan, et al. “Strategies and policies to address the opioid epidemic: A case study of Ohio.” Journal of the American Pharmacists Association, vol. 57, no. 2. 2017, pp. 1–6. Web.
Shipton, Edward A., et al. “A Review of the opioid epidemic: What do we do about it?” Pain and Therapy, vol. 7, no. 1. 2018, pp. 1–14. Web.
