Name: Shay Roth
From: Johnstown, PA
The Opioid Epidemic: From Havoc to Hope
The Opioid Epidemic: From Havoc to Hope
The year is 1995. A young mother gives birth to a beautiful child– her first born. Years pass, as she watched her adolescent son blossom into an accomplished young man ready to take the world by storm. However, one day her beloved child would not answer her calls. Frantic, she rushed to his apartment in an utmost panic to see if something was wrong. The mother opened the door and immediately fell to the ground at the sight of her beautiful, innocent child lying dead on the floor with a needle in their arm and an empty prescription bottle at their side. The year was 2019. Now, more than ever, thousands of civilians fall victim to the opioid epidemic each day, claiming copious amounts of innocent lives. Possibly one of the greatest rising problems in today’s world, the opioid epidemic poses a major threat to pharmaceutical industries and citizens alike and must be terminated by appropriate means before more Americans fall victim to the ghastly effects of drug abuse.
The opioid epidemic stands as perhaps one of the most fatal and rising dilemmas in today’s world, demanding a resolution before the crisis potentially claims even more lives. Unfortunately, many Americans believe the opioid crisis stems from the nation’s healthcare centers, such as hospitals, pharmacies, and clinics, since ultimately, addictive substances are most often distributed at such places (“Combating,” 2018, p. 12). The opioid epidemic began in the late 1990s, when physicians were improperly informed and guilted by researchers into prescribing powerfully addictive medications to their patients in an effort to suppress their patients’ chronic pain. Opioids are often used to suppress pain in treating both acute and chronic cancer pain but are also commonly used in cancer free patients (Cobaugh, et al 2014).
Opioids release Dopamine– a highly addictive, pain relieving chemical in the brain. When ingested in excess, dopamine could potentially spark an addiction in a patient. Researchers, neglecting the alarming possible side effects, expressed to physicians that it would be selfish to not prescribe opioids to their patients, as they saw little risk and a great reward by utilizing the pain suppressing prescriptions. Fearing ridicule from the public and with numerous research groups pressuring the healthcare industry to prescribe opioids to their patients, physicians apprehensively complied, thus beginning the era of the epidemic (Glauser, 2018).
Consequently, research shows that addiction most commonly stems from a minor dosage of an opioid from a physician to counter a patient’s chronic pain (Sutherland, 2017). However, Dr. Holly Boisen argues that though many health officials feel as though prescribing opioids benefits the patient, this solution actually harms the victim even more, as their body begins to crave the addictive drugs (Stempniak, 2016). Overtime, the patient becomes increasingly immune to the opioid, requiring stronger doses, and ultimately resulting in a full-blown addiction. The patients’ cell receptors are inversely downgraded as the amount of substance throughout the body is increased, thus making the possibility of an addiction or overdose highly likely (Sutherland, 2017). This phenomenon is seen in all human beings—regardless of what they are treated for.
In addition to dealing with the problematic issue of addiction, the opioid epidemic adversely affects innocent members of the nation. Patients who show no inkling of addiction, but merely require the prescribed medications as a means of lessening their pain, are negatively impacted by the epidemic. Sober, sickly patients reap the consequences of the epidemic as access to necessary prescriptions slowly becomes more and more difficult to obtain in an effort to isolate addicts from powerful opioids. Through required insurance prior authorizations or holds placed on prescriptions of controlled substances, it can take weeks until a patient can possibly obtain their medication at an affordable price through their insurance (Glauser, 2018). With the risk of the health of innocent citizens and predicaments in the healthcare industry, the opioid epidemic continues to prove to be a serious issue demanding quick and effective reformation.
Besides the turmoil amongst physicians the epidemic has created, the opioid crisis has also claimed copious amounts of lives in recent years, with the number of fatalities growing each day. Over the past forty years, opioid overdoses have grown at an alarming rate, with nearly 150 Americans dying of overdoses each day (Feldman, Frank, & Spera, 2017, p. 2). Since the turn of the century, the opioid epidemic has taken over 200,000 lives, drawing the attention of the nation and demanding reform (Glauser, 2018). In fact, as of 2016, abuse of opioids caused 116 overdoses in America each and every day (Compton et al, 2019, p. 12).
According to the CDC, the number of fatalities as a result of poisoning from the beginning of the twenty-first century to nearly ten years later almost doubled. Researchers blame this sudden increase on the opioid epidemic, as deaths directly linking to opioid abuse nearly quadrupled in the same amount of time (Cobaugh, et al 2014, p. 1545).
As of February 2018, drug overdoses now prevail as a leading cause of death in the United States, totaling more fatalities than both car accidents and shootings alike, with two-thirds of overdoses directly linking to opioids (“Combating,” 2018). While the pain reported in Americans has remained relatively stagnant over the past several decades, prescription painkiller sales have recently multiplied. In fact, the amount of controlled substances prescribed by healthcare professionals has reached four times the amount of medication once prescribed (Connolly, 2018). Consequently, the opioid epidemic has gained national attention in recent light as the rising issue has drawn the attention of legislative authorities.
In October 2017, President Donald Trump declared the opioid epidemic a national emergency after drug overdoses were deemed the leading cause of death among young citizens in the United States (Talbot, 2017, p. 50). Reported overdoses in emergency rooms range from adolescents to adults, with a wide variety of American citizens from various backgrounds falling victim to the rising epidemic (Stempniak, 2016). In recent years especially, the opioid crisis has reached intolerable heights, requiring a powerful solution to end a groundbreaking crisis present in our nation today. This solution, I believe requires stronger and stricter legislation regarding the production and distribution of controlled substances among American citizens.
Though the solution to an epidemic of such magnitude may seem somewhat out of reach, improvements in government legislation can bring America closer to suppressing the opioid crisis. If stricter laws were passed limiting the amount of a substance doctors can prescribe, the risk of exposure to highly addictive opioids is lessened greatly. With the passing of new, stronger legislation requiring greater regulation of controlled substances, patients can be required to meet with their doctor before receiving a prescription refill. By meeting with a physician regularly, unnecessary extra highs that result from excessive intake of painkillers can be prevented as less opioids are in the hands of the patient. Therefore, in order for a patient to be prescribed a substantially addictive opioid, they must meet with their physician who could advise against the prescription or lower the patient’s dose if deemed uncalled-for or unnecessary (“End,” 2016).
A way this theory could potentially be put into practice throughout the entire nation is through Lock-In Programs. In some regions, Lock-In Programs have been active since 1970, proving functional in restricting the number of refills a person may obtain to prevent the start of an addiction to a controlled substance such as a painkiller. With the end goal of suppressing drug abuse among community members, North Carolina residents have utilized the Lock-In Programs, combatting and decreasing opioid abuse in their region (Roberts, Gellad, & Skinner, 2016). With the formation of Lock-In Programs throughout the country, similar positive results could leave a lasting impact on the nation.
Another state that has taken efforts to combat the epidemic is Ohio. Overdoses relating to opioids prevailed as the number one cause of death in the state, making Ohio the fifth highest rate of deathly overdoses in the entirety of the United States. In an effort to surprise the ghastly amount of deaths within the state, the Governor’s Cabinet Opiate Action Team was developed in an effort to halt the growing epidemic. (Penm et al, 2017, p. 152).
The Team developed ways to aid in stopping the epidemic, including educating the public on the risk of opioid abuse, as well as setting legal standards and monitoring prescription drug distribution. Since placed into action, Ohio has seen nearly half the the amount of opioid related overdose deaths and has distributed 81 million fewer prescriptions for controlled drugs. Since this plan was so effective in the state of Ohio, it, too, can be effective across the United States if implemented correctly (Penm et al, 2017, p. 152).
However, it is of utmost importance that pharmacists are cognitive of their power to reduce the amount of opioids leaving the doors of the pharmacy. By properly educating patients on the risks of certain medications, the risk of addiction is noted by the patient, thus ultimately reducing abuse of the drug. Additionally, pharmacists can be on the lookout for red flags, such as multiple opioid prescriptions from different prescribers, “pharmacy hopping,” or forged scripts (Compton et al, 2019).
Several authors described that another way to prevent the abuse of opioids is to better educate the physicians prescribing them as well. The author discussed that often times, doctors are not even aware of the long-term detriments that patients may face as a result of being prescribed a controlled substance. By better educating the healthcare providers, the patient’s risk of addiction is significantly decreased (Kolodny et al, 2015).
In addition to revised legislation placing drug caps on the amount of controlled substances entering the hands of patients in the United States, improvements also need to be made on how authorities handle cases of addiction. New community ideals in some towns around the nation do not punish addicts when convicted of abuse, but rather offer alternative options, such as community involvement, as a means to end the epidemic. This approach humanizes addicts and recognizes opioid addiction as a medical issue rather than a crime. This can ultimately prove more impactful when treating a proclaimed addict recover, allowing the addict to develop relationships with people who are going through similar circumstances (“End,” 2016).
For instance, Medical-Assisted Treatment, which entailed both medical and behavioral remedies, has proven to be the most effective treatment for opioid abuse in several regions, and therefore should be funded for the rest of the country so all Americans can utilize its methods (Feldman et al, 2017). Through Medical-Assisted Treatment, overdoses and relapses have been drastically suppressed, with a significant amount of recovering addicts residing in retainment programs. Such positive outcomes encourage the program to become a nationwide asset, thus aiding the country’s fight against the epidemic (“Combating,” 2018). Stronger legislation regarding stricter limitations on prescribed medications and new community programs provide an alternative and effective way of suppressing the opioid epidemic through a community approach.
However, perhaps one of the greatest concerns of our nation’s legislatures is the cost of repairing a country stricken by the opioid epidemic. Affordable and feasible proposals such as stronger legislation could certainly lessen the impact of the growing epidemic on future generations, if properly funded and carried out. Additionally, the youth of America deserve to be educated on the topic and warned of what may happen as a consequence of drug abuse.
Democratic representatives in Congress recently proposed a $920 million budget plan to help suppress the epidemic from the legislative perspective. The low cost of the proposed budget would allow immediate action in an effort to halt the rising opioid epidemic before the problem enlarges and more citizens potentially fall victim to the crisis (Schouten, 2016). Proposed grants for smaller regions range from $50,000 to $7 million in an effort to launch the effective, yet affordable Medical-Assisted Treatment discussed earlier, making the approach to repairing our country in reach for legislatures (Feldman et al, 2017, p. 3).
In addition to the affordable cost of solving the nationwide crisis, legislatures of various parties have also expressed an interest and desire to halt the rising epidemic from worsening. From Republicans and Democrats alike, representatives of both parties agree that treating opioid abuse as a medical condition as opposed to a crime can cause more victims of the epidemic to seek help rather than fear prosecution for their actions (“End,” 2016).
In an overwhelming vote in both the House of Representatives and Senate, a bill expressing remedies for opioid treatment, passed in 2016, started the era of drug reformation in the United States. An issue of such magnitude can only be terminated if our nation’s legislatures work in union to defeat the rising problem polluting our nation (“End,” 2016). Such overwhelming support across various political parties and sects of Congress proved that the proposed solutions fare well with the nation’s leaders and would serve effective when put into practice throughout our nation.
Though the vast majority of Americans would agree in saying that stronger legislation regarding drug caps and prosecution would prove most effective, some believe alternative solutions would be the nation’s best option. Many activists believe that addiction can be terminated if the victim seeks religion rather than drugs, encouraging addicts to join community groups and churches as on outlet from their addictive habits as opposed to medical or behavioral treatment.
Though from a religious perspective faith-based healing seems like a strong potential option, excessive funding by the church is required as the staff must work in union with surrounding health clinics and local officials to put the concept into practice. Several non-addicts believe that faith alone can fulfill the hole addiction once inhabited, however, the addict’s emotional and physical withdrawals nearly always require additional medical attention regardless, defeating the low-cost faith based healing entails (“End,” 2016).
Another proposal some activists have encouraged is the development of safe spaces for addicts in some of the nation’s largest cities where the epidemic has peaked. Philadelphia currently leads the United States in deaths related to opioid overdoses with over 1,200 fatalities in the past year, drawing the attention of lawmakers and demanding reform for the city. Philadelphia officials wish to establish safe injection sites, where addicts may “shoot up” with a doctor present in the event an overdose would ensue. With a similar proposal in Seattle to establish a safe injection site, a budget of $1.3 million dollars has been requested to begin the program in the west coast city (De Groot, 2018, p. 3).
However, many critics believe that this not only encourages drug and opioid abuse, but also justifies the deadly problem that lawmakers are working their hardest to end in their city polluted with addiction. In addition to the encouragement of opioid abuse, the proposal is very costly, and ultimately may pose as more of a risk rather than a reward when put into practice in cities across America (De Groot, 2018, p. 3). Though alternative options to the solution of the opioid epidemic are important to consider, legislative reforms can suppress the epidemic in potentially the most cost effective and feasible way.
Though the opioid epidemic has claimed millions of lives and left the United States in a state of devastation, the solution to this crisis can be accomplished through immediate and effective action. With the opioid epidemic drawing recent national attention, a solution to this fatal crisis is not only necessary, but vital to the future of American citizens. Posing a major threat to not only the pharmaceutical industry, but also the entire world of healthcare, the need for reform regarding the opioid epidemic is imperative and greatly desired amongst American citizens in an effort to combat the deadly epidemic that has already claimed the lives of so many. With the passing of stronger legislation regarding prescription restrictions and discouraging prosecution as a means of punishment, the significant drug epidemic in the United States can be resolved, cleansing the nation of the drastic effects of opioids for future generations to come.
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