The Centers for Disease Control and Prevention is a government branch that is responsible for addressing epidemics and other health-related issues. The CDC has provided a collaboration of many real-life stories of people who have struggled with opioid addiction, including Christopher's story. Christopher had an amazing life until he got in a very minor car accident when he was twenty years old. He experienced slight back pain and was prescribed opioids. Christopher quickly became addicted and he sought out any doctor that would prescribe him more opioids. He increased his pill intake from one to twenty-five a day, which completely flipped his life around. He no longer cared about work, he didn’t sleep, and he became very angry towards those that he loved. He was unable to receive help, and within two years of being prescribed opioids, he overdosed at the age of twenty-two. (“Real Stories”) Christopher’s death was a tragedy and emphasizes how fatal opioids can be.
The Addiction Center is an organization that helps patients find the help they need to recover from addiction. They define the Opioid Epidemic as a growing issue that refers to the increasing number of deaths and hospitalizations from opioids. (Smith “The Opioid Epidemic) This crisis is a devastating national issue; for there are over one hundred Americans across the country dying each day due to opioid overdose. Ann Schuchat, CDC acting director, stated, “This fast-moving epidemic does not distinguish age, sex, or state or county lines, and is still increasing in every region of the U.S.” (“Transcript for VitalSigns Teleconference: Opioid Overdoses Treated in Emergency Departments”) Schuchat refers to the Opioid crisis as an epidemic, which is a widespread occurrence of an infectious disease. This outbreak is spreading; there are more and more Americans are falling into this all-encompassing addiction. So far the Opioid crisis is not slowing down, if anything it is accelerating, and no one knows when it will end, or if it will end at all. Soon no one will be able to go untouched by the shattering effects that come from opioid addiction. Because this is such a widespread crisis, many people are passionate about this topic; such as healthcare professionals, writers, reporters researching this national crisis, and personal stories from individuals affected, or from family members of those affected that passed away.
Dangers of opioids
The Opioid Epidemic began in the late 90s when pharmaceutical companies began creating new ways to manage pain. (Smith “The Opioid Epidemic”) These companies promised good results and did not yet know the risks to these opioids which led many doctors to begin prescribing them in large amounts. George Lopez, a writer for VOX since 2014 and a former Cincinnati Newspaper writer, explains, no one knew what future problems opioids could cause so the US was soon flooded with opioid painkillers prescribed by healthcare professionals. Drug dealers then followed by selling heroin and illegal opioids that people could buy when their prescriptions ran out or when they wanted something stronger. ( Lopez “The Opioid Epidemic, Explained.”) Because of opioids’ strong addictive properties when someone becomes addicted they need for something stronger, which often leads to the use of many illegal drugs.
Opioid addictions are proven to lead to other serious addictions. Searching for a stronger high, most opioid addicts eventually move on to other drugs such as heroin and fentanyl. In a 2014 study, in Jama Psychiatry, 75% of heroin users started with pain killers. That’s not a coincidence. In a 2015 analysis, CDC researchers found that people who are addicted to painkillers are forty times more likely to become addicted to heroin. Heroin is illegal in the United States and is more potent, which makes it much more addicting; therefore, it is more likely for someone to overdose. (Lopez “The Opioid Epidemic, Explained.”) Brenda is a perfect example of this claim. At the age of twenty-five, Brenda was in a serious car accident that required her to see multiple doctors, one of whom prescribed her opioids. A single day after she filled her prescription, she doubled the amount she took and from then on, she never took her prescription responsibly. She went from going to many doctors to get more medication to selling it off the streets in her community. Eventually, Brenda became addicted to Heroin and it took a toll on her life. She reached the point she never thought her addiction would get to. Heroin destroyed her relationships with family and her friends. (“Real Stories.”) Basically, this isn’t just a painkiller Opioid Epidemic; it’s a full-on epidemic, involving legal and illegal drugs, and doesn’t seem to be slowing down any time soon.
Once on the path of addiction, it can be very difficult to get off it. After taking opioids for a few weeks, they become essential to feel even a little okay. When someone has stopped taking drugs abruptly, their body will seriously be affected which is called withdrawal. Symptoms of withdrawal include anxiety, goosebumps, restlessness, insomnia, yawning, body aches, sweating, vomiting, diarrhea, fever, shaking, faster-than-normal heartbeat, rapid breathing, high blood pressure, hallucinations, and seizures. Symptoms can appear as soon as twelve hours after the last dose is consumed. The severity of symptoms can vary depending on how long the individual has been using the drug, or whether they are quitting abruptly or taking other drugs to help them stop taking opioids. When someone stops taking opioids, they need to do so slowly over a long period of time and under the supervision of a healthcare professional. (“Symptoms of Opioid Withdrawal.”) Doctors need to be able to supervise their patients so that they are more aware of what their patients are actually doing with their prescriptions, and can assist them when they need to stop taking their medication.
Opioids can be a very useful tool in effectively controlling pain if used correctly. There are many people who are in a great deal of pain, whether fighting cancer or some other pain-causing illness or injury. Opioids can be very effective in controlling cancer patient's pain, an article written on cancer pain states, “Not to aggressively attempt to manage pain in ‘malignant’ pain conditions, using any tools available, would be unethical and simply bad practice.” (Foley“The treatment of cancer pain.”) Cancer patients and many others are dealing with tremendous amounts of pain and it would be “unethical” to not do anything possible to control their pain. There are many people who use opioid painkillers to successfully manage pain without falling into addiction.
CDC data show opioid deaths dropped 4.6% overall during a 12-month period that encompassed 2017 and 2018. (“Provisional Drug Overdose Death Counts”) With proper resources and awareness about the risks of opioids, opioid deaths have dropped. Doctors are finding that opioid deaths decreased in the last years. Does this mean the opioid crisis is on the downfall? Will the rise in deaths drop? Unfortunately, this decrease in opioid deaths was paired with an 11.1% opioid death increase due to illicitly manufactured Fentanyl. (“Provisional Drug Overdose Death Counts”) Fentanyl is the strongest pain reliever developed so far, it is 80 to 100 times stronger than morphine and can only be prescribed in the emergency room. It was primarily developed for the treatment of cancer-related pain. But because it is such a strong drug, it is being made illegally and sold in many different ways. Drug dealers are combining it with many different drugs because it takes very little fentanyl to produce a high. This is dangerous because people taking these drugs may be taking much more than their bodies are used to without realizing it, therefore they are at the risk of overdose.
The Opioid Epidemic is not slowing down, those individuals who were given opioids painkillers for minor injuries were not warned of the dangers that opioids can lead to. If doctors and healthcare professionals had been made aware of the dangers and addictive properties of opioids, many opioid addictions and overdoses could have been prevented. Opioids can be effective in treating intense pain and chronic pain, especially in cancer patients. But without strict guidelines on who should be prescribed opioids the number of opioid prescriptions being filled skyrocketed along with the amount of opioid-related deaths. Because not only are people becoming addicted to prescription drugs, they then turn to other drugs to fill their addiction. With stricter guidelines on who should be prescribed opioids, the amount of patients with possibilities of becoming addicted could decrease.
Effects on America and individuals
Opioids have had and continue to have very many effects on America and individuals, ranging from different symptoms, leading to other drug addictions, and driving families and friends apart. The Overdose Lifeline Website was founded and executively produced by a woman whose son died of a heroin overdose, she has been given many awards for working with overdose patients. She wrote, Opioid Overdose has many symptoms and warning signs, these include but are not limited to: very pale face, clammy to touch, lips have a purple hue, vomiting, gurgling noises, unable to be awakened, or cannot speak, or their breathing slows or stops. (“Opioid Overdose: Know Your Options.”) Looking for warning signs and symptoms can save a life.
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The United States is crumbling under the effects of Opioids. America is the world’s leading consumer of these drugs. Stanford Drug Policy expert Keith Humphreys stated: “Consider the amount of standard daily doses of opioids consumed in Japan. And then double it. And then double it again. And then double it again. And then double it again. And then double it a 5th time. That would make Japan Number 2 in the world, behind the United States.” In only ten years, our country is at risk the lose the entire population of Baltimore which is over six hundred thousand people. How did we get here? First of all, pharmaceutical companies market these drugs in a way that will help them make the most money possible, even though the evidence shows that the risks clearly outweigh the benefits. Second, doctors were under a lot of stress at the time to treat pain more seriously, quicker, and more effectively. Doctors weren’t sure how to treat complex pain because treatments required too many resources, so the easiest alternative would simply be to prescribe patients pills. This national crisis has obviously escalated rapidly from there.
CDC statistics show that on average 130 people in the United States die from opioid overdose each day. (“Understanding the Epidemic”) This number is way higher than it should be, this is way too many people dying early due to overdose every day, and the number is not going down, it is increasing every day. In 2017 the opioid-related deaths were 6 times higher than in 1999. (“Understanding the Epidemic”) The National Institute on Drug Abuse is a government-funded organization that does national research on drug abuse. In an article published by them, it states, The total “economic burden” of prescription opioid misuse in the United States alone is $78.5 billion a year. (“Opioid Overdose Crisis”) An economic burden is the amount of money that is required for medical costs, such as physician appointments, ER visits, outpatient visits, and hospital stays. Drug overdose is the leading cause of injury-related deaths; more deaths than car accidents, and homicides. In 2016, 64,000 people died, which is more than from guns, car crashes, HIV/AIDS, and deaths from the Vietnam and Iraq wars combined, and it is a growing issue/ it hasn’t slowed down. Only increased. (“Opioid Overdose: Know Your Options.”)
Among many patients, the effects of opioids are very positive. Unrelieved pain can have just as devastating effects. Unrelieved pain can decrease immune system function, delay the healing process, and decrease the effectiveness of healing. According to R Norman Harden, a healthcare expert from the Rehabilitation Institute of Chicago, trying to recover from an accident without medication is unwise. (“Chronic Pain and Opiates: A Call for Moderation.”) Though effective, the risks of addiction still exist. Opioids can only be given under strict guidelines and only for a set amount of time before physical dependence occurs.
Opioids can be a big help in people recovering from accidents, as they are in an extreme amount of pain. Opioids can also help to keep pain under control while healthcare professionals figure out what the source is or while they attempt to fix the problem. The moral of the story is that opioids can be good if they are used in moderation, the problem is that once physical dependence begins most patients cannot stop themselves from becoming addicted.
Alternate solutions/policies/recovery
MAT stands for medication-assisted treatment, this is a program that uses other medicines to fight cravings. Experts say it is “the gold standard” for opioid addiction treatment, but also be aware that it doesn’t work for everyone. (Lopez “The Opioid Epidemic, Explained.”) MAT is not available to many people because the government has set strong regulations and policies on how many prescriptions doctors can prescribe. Many people are fighting for all funds to go toward MAT because of how effective it has been in helping people overcome opioid addiction.
Opioids can be extremely beneficial when doctors follow the guidelines and prescribe medication in the right way. If this were to happen every time, patients would have more access to safe and effective chronic pain treatment. Doctors first need to determine when to prescribe patients with medication; timing is essential. It is vital that they explain the risks and benefits of the treatment before prescribing medication. Doctors next must decide the dosage, the duration of the prescription, and make sure that the patients have follow-up appointments scheduled. Lastly, they need to address how harmful addiction can be. Once these items have been addressed, the chances of successful treatment are high. (“CDC Guideline for Prescribing Opioids for Chronic Pain.”)
Even if readily available resources became accessible, the reality is that people will still choose to abuse opioids and fall into addiction. Steve’s story emphasizes the power of addiction. Steve was an amazing man and excelled in many aspects of his life. As an adult, he suffered from extreme back pain. That pain led to depression. Steve was prescribed opioids to help with the pain. The medication was the difference between night and day for Steve, but he quickly became addicted to his medication. After a while, Steve realized he had a problem and tried to turn it around by enlisting in rehab facilities, but the gravity of his addiction was too strong and he relapsed and died of an overdose at forty-three years old. (“Real Stories.”) Steve’s story demonstrates how difficult it can be to beat addiction, and even with the help, beating the odds is difficult. If funding was used appropriately for medications like MAT, doctors followed the guidelines presented from CDC, and patients considered other options, opioids would be prescribed correctly, patients could avoid addiction altogether, and fatalities would dramatically decrease.
Increasing readily available resources for those with opioid addiction is a very important part of fighting against the epidemic, but making the right kind of resources available could be the most important part. An article from the yale school of medicine states that admitting people to rehabilitation and expecting patients to retain abstinence-only adds to the problem. As this only heightens cravings and lowers tolerance to the drugs, which leaves a very high risk for overdose and death. ( Hamm“New Strategies for combating the opioid epidemic.”) But a more productive way to treat opioid addiction is with drugs such as Buprenorphine which fulfills cravings but does not have the intense addictive properties of opioids. Patients can eventually taper their dosages down and eventually stop taking it all together. This is a much more successful way of treating opioids because cravings are met so there is no need to take other drugs.
The Opioid Epidemic is affecting millions of Americans both directly and indirectly. If doctors continue to carelessly prescribe these painkillers, hundreds of thousands more people will lose their lives. Lembke, a Stanford addiction specialist, states, “If you see someone who continues to use despite their lives being totally destroyed- losing their jobs, losing loved ones, ending up in jail- nobody would choose that. Nobody anywhere would ever chose that life. So clearly it is beyond the individual’s control on some level.” (Lopez “The Opioid Epidemic, Explained.”) Until we understand this, policies and regulations will remain inadequate and this crisis will continue to spread. When doctors correctly prescribe medication and supervise their patients, patients understand they have alternate options for pain relief, and funding is correctly distributed is when people will be able to take control of their pain, use this medication to benefit their lives, and beat addiction.
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