Addiction Awareness Scholarship Campaign 2020 - Opioid Epidemic

Name: Victoria...
From: Tempe, AZ
School: Arizona State University
Votes: 0 Addiction Awareness Scholarship Campaign 2020 - Opioid Epidemic

Opioid Epidemic

Tipescu
16


Opioid
Epidemic

Victoria
Tipescu

Opioids
kill individuals at an alarming rate. In 2017, someone in the United
States died from an opioid overdose every eleven minutes (Hedegaard
et al. n.p.). The onset of opioid use began in the late 1800s;
Mothers used opioids as an ailment to treat “themselves and their
children,” soldiers took opioids during the war, and people used
them to ease hangovers (Kolodny et al. 561). As time goes on,
opioids, both illicit and non-illicit, have become more prevalent.
When visiting the doctor for pain, an individual can expect to
receive some type of opioid, even when it may not be necessary.
Recently, news reporters have been talking about the staggering rates
of individuals overdosing on fentanyl and the dangers of this drug.
Heroin is also heard of as a common highly addictive illegal drug.
With more Americans being aware of opioid addiction through the use
of media, there is something that can be done to help combat opioid
addiction. In order to prevent opioid overdose fatalities in the
United States’ rural areas, there needs to be an increase in access
to medication-assisted treatment (MAT) in rural communities.

There
are many contributing factors that have caused addiction and overdose
of opioid drugs to become an epidemic in the United States. The
addiction to opioids can be primarily linked back to physicians not
being able to treat pain. Andrew Kolodny et al. explain that from the
1800-1900s, medical professionals did not know much about how to
treat or the cause of diseases or pain; however, they discovered that
morphine mitigated pain, making everyone happy, but often left
patients and sometimes physicians addicted (561). Because there was
no well-known solution for pain and illness, physicians prescribed
opioids to patients to make them happy. Giving patients opioids, like
morphine, came at a cost because it sometimes made doctors and
patients addicted. Physicians desire to keep their patients
satisfied. If they did not know how to cure the pain or illness, but
prescribing medication would relieve the symptoms, this would allow
them to feel like they succeeded in curing the problem. Prescribing
opioids to patients, because physicians did not know how to cure
pain, was one of the first major contributing factors of the opioid
epidemic. Furthermore, overprescribing prescription opioids have
added to the opioid epidemic. In 1980, a one-paragraph study found
that only four of 11,882 patients who were prescribed prescription
opioids became addicted; therefore, it is uncommon to become addicted
to opioids (Porter and Jick 123). Physicians relied on this study’s
inaccurate evidence to excessively prescribe opioids because they
considered it uncommon for patients to get addicted. The increase in
physicians promoting opioids increased the number of individuals
getting hooked. Nowadays, more people know the dangers of taking
opioids, but in the 1980s physicians had no idea. Physicians
practiced faulty techniques because they cited the wrong evidence.
This study caused many physicians to over-prescribe opioid
medications thinking that it would not harm patients.

The
final factor of the increased use of opioid drugs was the release of
the drug OxyContin. Kolodny et al. discover that the “acceleration
[of opioid use] was fueled in large part by the introduction in 1995
of OxyContin… manufactured by Purdue Pharma” (562). The debut of
OxyContin, a brand name of the drug oxycodone, sparked many doctors
to order these unneeded prescriptions for their patients. The newly
released drug caused an increase of opioid abuse because this drug
was highly advertised to treat illness and pain. The increased
advertisement and marketing of OxyContin are associated with elevated
prescribing rates (Hadland et al. 8). Advertising is very influential
and, in this case, was appealing to consumers and physicians. Just
like anything new, not much is known about the side effects or even
the long term effects of the products on an individual’s body.
Physicians presumably knew little about OxyContin and therefore,
thought it was okay to commonly administer to various individuals.
Overall, many different factors added to the opioid epidemic
including prescription opioids being overprescribed, knowing little
about the cause and treatment of pain, a study stating that opioids
are safe, and a new highly-advertised prescription opioid being
introduced.

Pharmaceutical
companies including, Purdue Pharma, are one of many companies
benefiting from individuals getting addicted to opioids. In a court
case, it was found that Purdue made millions off of getting more
patients to use their drug, OxyContin, after they tricked both
patients and physicians to purchase them (United States Superior
Court 2). Purdue is being sued for having known about the harm that
their drug is causing others. Through prescribing this medication and
getting millions addicted, it has allowed for Purdue and their top
officials to make a tremendous profit. Pharmacies and hospitals
charge an enormous amount of money for small amounts of opioids.
OxyContin is not the only opioid prescription drug that patients can
get addicted to. There are many more brands of oxycodone and other
prescription opioids that profit from prescription opioid addiction.
These pharmaceutical companies are fueling and profiting from the
epidemic.

Illicit
and non-illicit opioid drugs are the direct source of opioid
fatalities. In a study, Abby Alpert et al. find that the OxyContin
reformulation created harsher measures on the distribution, so users
switched to other opioids including heroin and fentanyl, which are
easier to overdose on (30-31). Even though a policy like this was
attempting to make it harder to get prescription drugs, addicts
figured out a way to get illegal opioids instead. Illegal opioids,
like fentanyl, are easier to overdose on because when sold on the
streets, individuals who buy them do not know how potent the drug is.
The effort to make prescription opioids tougher to attain and use did
work, but the people who used opioids just moved to other types of
opioids. Restricting prescription drugs was a sensible idea; however,
if individuals are restricted from doing something, they will find a
way to push past the barrier. Just like when a child is told they can
not do something, they find a way to do it. This attempt at combating
opioid overdose fatalities is indirectly contributing to the problem
because individuals using prescription drugs will begin to use
dangerous, illegal opioids.

Opioid
addiction is a major issue that rural communities are facing. Robin
Ghertner and Lincoln Grove point out that “opioid sales per capita
were around 50 percent higher in rural areas than in small and large
metropolitan counties” (5). People purchase illegal and
prescription opioids at a higher rate in rural areas than in urban
areas. This higher amount of opioid access in rural regions can be
attributed to several ideas. Katherine M. Keyes et al. suggested that
the increasing use of opioids per person in rural communities is
because people have closer-knit relationships so opioids are
dispersed more rapidly, opioids are prescribed more, and the
stressful atmosphere and “economic deprivation” puts people at
risk for doing drugs (55). With statistics attesting that there are
more sold opioids in rural areas, it can be attributed to the
accessibility of opioids in these areas. Individuals in rural
communities often know most of the people in their town because there
are fewer people. This enables these individuals to share opioids and
be aware of who has them for sale. Because living in a rural area can
also leave people with lower income in poverty, individuals have
higher stress. Added stress and lower income lead to the use of drugs
in order to take away the pain. Additionally, treatment for addiction
is lacking in rural communities. When looking at how many physicians
are able to administer medication for opioid treatment, there are
few. The data shows 82.5 percent of rural counties have no physician
that is able to administer the medication (Rosenblatt et al. 25).
There is a tremendous need waiting to be met in rural communities.
This factor makes it extremely hard for addicts to get help. If
individuals are unable to get help, there will never be a decline in
opioid use. Since there is a high rate of opioid sales in rural
areas, because of factors caused by living there and a significant
lack of treatment for opioid addicts, the problem remains unchanged.

The
opioid epidemic has an effect on loads of people, which causes the
government to take immediate action. The government has been
attempting to combat this problem before and after it was declared an
epidemic in the United States. The Comprehensive Addiction Recovery
Act (CARA), enacted in 2016, provides various government agencies
with grant money to help with opioid addiction through treatment and
campaigns warning about the harmful side effects of opioids (United
States Congress, 114-198). This act gives proof that there is a
severe need to solve this crisis. It even sets apart money to give to
agencies to take remedial actions. With this act being current, it
explicates to the country the strong need to assist this problem. The
government is attempting to control and decrease opioid addiction and
overdose fatalities because of the massive impact it has on
Americans. Overall, governmental support is a valuable part of
combating the opioid crisis.

This
problem affects many aspects of the United States; one of the biggest
aspects is the economy. There is a remarkable amount of money being
spent in regard to all parts of the opioid epidemic. Curtis S.
Florence et al. identify the expense “for opioid-related overdose,
abuse and dependence was over $78.5 ($70.1-87.3) billion” being
spent on criminal justice, treatment, healthcare, and more related to
opioids (6). The addiction to opioids in America affects not only
people financially but also health care, treatment, and law
facilities. Addicted individuals, and even loved ones, are
financially burdened by the costs of opioids and everything involved
with the addiction and recovery process. Family members can be
burdened financially by the stress of wanting to help their addicted
family member get treatment. Addiction to opioids comes with a hefty
price tag. Through decreasing fatality and addiction rates of
opioids, it will positively impact people’s finances and the economy.

Addiction
to opioids can have many harmful effects on a person. Opioid addicts
are harming their bodies when they partake in the usage of drugs. The
National Institute of Drug Abuse explains that the short-term effects
of prescription opioids have on the body include drowsiness and
slowed breathing (“Prescription” 2), and when an individual
becomes addicted, they can go through withdrawals and have severe
painful symptoms (“Prescription” 4). Opioids have horrible
effects on anyone’s body. These prescription opioids depress the
body’s normal functioning and must be taken carefully in order to
avoid getting hooked on them. Illegal opioid drugs are even easier to
get addicted to. As a user continues to take these highly addictive
drugs, they build up a tolerance. Having a tolerance to a drug makes
it so that every time the individual takes the drug, they need a
little more to experience the same high. After a while, using the
drug excessively can cause the body to shut down and result in an
overdose. The body also creates a dependency on the drug. If
individuals attempt to stop using the drug, they will go through
withdrawal. Symptoms can be agonizing and make the person feel as
though they are dying. Opioids have extremely negative short-term
effects on a person’s body. In the long run, opioid addiction
impacts society. Ghertner and Grove claim that counties with “higher
poverty and unemployment rates generally had higher rates of retail
opioid sales… as well as drug overdose deaths” (5). If opioid
fatalities and sales keep increasing, there could potentially be an
elevated poverty and unemployment rate. Generally, once individuals
become addicted to drugs, they will do anything to get the drugs
again. Consequently, they may deplete their savings because they are
spending a large portion of their money on drugs. Addicts will have a
difficult time maintaining a job and keeping up with the demands of
their job because soon they only will care about the next time they
can intake the drug. Addiction to opioids has both short-term and
long-term effects on many areas of the individual’s life.

In
the past, the government has tried to step in and put a halt to the
rising opioid addiction and overdose rates. The Drug Addiction
Treatment Act of 2000 (DATA 2000) was put into effect to attempt to
give more addicts access to MAT by allowing physicians to become
waived and administer the treatment medication (United States
Congress 106-441). This act seeks to give physicians the ability to
provide the medication that opioid addicts could use to get off of
the drugs. This act is feasible because there does not have to be a
set medical facility for opioid addicts to get treatment. Addicts
could potentially be treated through a family doctor. This would
allow them more accessible treatment options by not having to go to a
specific facility. While this act had very good intentions, there was
a lack of physicians who became DATA waived, making it unsuccessful.
C. Holly A. Andrilla et al. report from a study that the barriers for
physicians not utilizing the DATA 2000 are not having enough time in
the office, being unsure about managing opioid addicts, facing
obstacles with the setup and support of the program, and not wanting
to draw addicts to their business (361). These barriers make
physicians not want to participate in becoming a waivered facility
that can administer treatment medication because it is extra work.
Many physicians do not feel the need to go out of their way to help
addicted people. Although this act was not as successful as the
government hoped, it is still a proficient option that, with the
right support, would be able to be successfully added to medical
facilities.

There
are several solutions that are being introduced to help fight the
opioid crisis in rural communities; one option is expanding access to
MAT. According to the National Institute on Drug Abuse, MAT treats
opioid addiction with medication, Methadone and Buprenorphine, that
will help to lessen or cease withdrawal symptoms when the addict is
attempting to stop using opioids (“Medications” 5). If there is
gained access to treatment for addicted individuals in rural areas,
they will more likely seek treatment. Individuals generally are
unable to get off of drugs by themselves because of the tormenting
withdrawal symptoms. The medication given to the patient during
treatment will block the receptors that make the individual feel like
he or she needs the drugs. Alleviating these symptoms will aid
individuals in not having a desire to take the drug anymore. Ending
opioid addiction will assist in lessening the number of people that
overdose. Overdosing can be put to a stop if there are more treatment
facilities that can end individuals’ opioid addiction.

Another
highly talked about solution to help solve the opioid crisis is the
distribution of Naloxone. The Overdose Education and Naloxone
Distribution (OEND) aids addicts and others around them on how “to
prevent, recognize, and [respond] to overdoses” (Walley et al. 4).
Through the OEND program, individuals can be rescued through a nasal
spray once they have overdosed. This program distributes Naloxone,
trains people on how to use it, and educates individuals on how to
prevent opioid addiction. Through these steps, this program can
reduce the number of deaths that opioid addiction brings because it
rescues people who have already overdosed through raising the
overdosers respiratory function. Naloxone is essentially a reversal
medication for after an opioid overdose; it counteracts the chemicals
from opioids. Alexander Y. Walley et al. find that the
“implementation of OEND [is] associated with lower rates of opioid
related deaths from overdose” (4). Naloxone is proven to save
individuals lives and decrease overdose fatalities. Although Naloxone
saves lives, it still does not deal with the root of the problem.
Once someone overdoses they can be saved by Naloxone; however, they
still may continue using opioids. Increasing access to MAT will
change people’s paths of using opioids and aid them in coming
clean. Increasing distribution of Naloxone will help decrease deaths,
but it will not help the problem at hand, which is opioid addiction.

Another
solution that has been proposed to combat the opioid epidemic is to
stop overprescription through the implementation of prescription drug
monitoring programs. These programs decrease opioid prescription by
30 percent (Bao et al. 6). By putting these programs into action, it
will be easier to catch individuals who are getting over prescribed
opioids or have an addiction. Prescription drug monitoring programs
track medications that have been prescribed any time by any
physician. It can flag individuals who have been prescribed opioids
from other medical facilities and show individuals who are jumping
from doctor to doctor to get more prescription opioids. This program
is a great way to stop overprescribing and addiction to prescription
opioids. However, using a prescription drug monitoring program only
decreases the addiction to prescription drugs, while increasing MAT
will help addicts addicted to any type of opioid. Prescription drugs
do not kill as many people as do other types of opioids. The study
finds that heroin and synthetic opioids, including fentanyl, kill
approximately 14 people per 100,000 while prescription drugs kill
about four people per 100,000 (Hedegaard et al. 4). Implementing
prescription drug monitoring programs is a valid solution that will
help to control the opioid crisis, but a better solution would be one
that helps all aspects of addiction to opioids. Expanding access to
treatment of opioid addiction will be a better use of resources than
an idea that only prevents prescription drug addiction. Prescription
drug monitoring programs do not help the majority of people;
therefore, a solution that does will be more effective.

The
most valid and feasible plan of action to decrease opioid overdose
fatalities is the increased access to MAT. Robert P. Schwartz et al.
discover that the “average annual overdose deaths decreased by 37%
after buprenorphine became available” (919). Because MAT is proven
to save lives, it is a worthwhile solution. MAT has the ability to
stop the root of the opioid addiction problem by preventing
individuals from overdosing. This will make a long-lasting impact on
society. If a lot of addicts are no longer addicted to opioids then
the number of individuals doing drugs will decrease. The demand for
opioids will lessen, which will reduce the overall number of drugs
being sold and the number of people becoming addicts. Improving
access for addicts to get treatment will save countless lives.
Currently, there are not enough licensed facilities that are able to
administer MAT. Christopher M. Jones et al. conducted a study that
suggests while MAT facilities have expanded, there is still a gap of
capacity (61) being estimated at 1.3-1.4 million people who are
unable to receive treatment (57). With the gap being so large, it
shows that not everyone is able to get the treatment he or she needs.
Individuals in rural areas who are unable to receive treatment and
continue to suffer have the option to get clean if there is an
increase in these facilities. Increasing access to MAT will decrease
fatalities from opioid overdosing and is greatly needed throughout
the United States because the capacity of MAT facilities is fewer
than the demand for them.

Increasing
access to MAT facilities is feasible because the government has set
aside a chunk of money, and there are groups that are able to carry
out this solution. The government has set aside a lot of money to
help opioid addiction in the United States. The Substance
Use-Disorder Prevention that Promotes Opioid Recovery and Treatment
(SUPPORT) for Patients and Communities act gives “more than $396
million to 1,232 community health centers, 120 rural community
organizations” (“President Donald”). In order to increase
access to more MAT facilities in rural areas, it needs to be funded
by the government. Money going towards the opioid crisis will be put
to good use by increasing MAT facilities in rural areas. While there
is a need for more medical facilities in rural areas, an increase of
DATA-waived physicians is a feasible way to effectively increase MAT
treatment. To make it even better, “the DATA-waiver course is free
by SAMHSA” (Moran et al. 12); this will allow for more physicians
to become capable of treating patients. Through government funding,
programs will be able to support medical facilities financially and,
additionally, give them rewards for becoming DATA waived, if needed.
To conclude, increased access to MAT facilities is reasonable
because, with financial support from the government, medical
facilities that administer MAT can be added medication.

Universities
and various institutions will be the implementers of a MAT program in
rural areas. The Agency for Healthcare Research Quality reports that
the American Institute of Research, University of Colorado, and other
universities have already been granted money and set up programs
designed to train physicians in rural areas to become MAT certified
and able to administer the medication (“Increasing Access”). This
program can be used widely to help solve the opioid epidemic. With
government funding, more universities and institutions will be able
to carry out the same programs that only a handful of universities
have tested. This solution is sensible because it is proven to work,
specific groups willing to implement it, and it is financially
attainable. The money will be given to universities close to rural
areas and some farther away, too. Universities will train primary
care physicians in rural communities to be MAT certified. They will
also give support to the physicians and enable them to contact other
MAT-certified physicians around them. Overall, the ability to
implement this program will yield faster success in solving the
opioid crisis.

There
is a massive need for a solution to the opioid crisis, especially in
rural areas. MAT is lacking in rural areas and is leaving addicts
with limited to no access to treatment. Increasing access to
treatment can drastically help decrease opioid fatalities. There was
a absence of knowledge about how to treat pain, a push by
pharmaceutical companies to sell opioids, and a large use and access
of illicit opioid drugs, which contributes to the cause of overdose
fatalities. The government has taken a lot of steps to attempt to
solve the growing opioid crisis. The lack of capacity proves there is
a problem, and statistical evidence supports that MAT is a valid and
feasible solution. It can be implemented through a program that
universities have tested before and can use government funding. To
conclude, increasing access to MAT will be successful, as well as,
help individuals who are struggling with opioid addiction in rural
areas. This will decrease the current six deaths per hour that
opioids cause in the United States.

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