The United States is currently facing an unprecedented opioid addiction crisis. The facts are grim, and the numbers reflect a painful reality. More than 130 people a day die from opioid-related drug overdoses, according to the Health Resources and Services Administration (HRSA).
The Centers for Disease Control and Prevention (CDC) reports that the number of people who died from a drug overdose in 2021 was over six times the number in 1999. Of the nearly 107,000 drug overdose deaths, over 75% involved an opioid. But unlike Covid-19, the Opioid crisis never waned.
The epidemic is so pervasive, the U.S. Supreme Court, two weeks ago, agreed to hear a 6-billion-dollar settlement case involving Purdue Pharma, maker of the powerful and highly addictive pain medication OxyContin that played a key role in the country’s opioid epidemic. In this MedDigest edition, we shed light on the facets of this crisis, its origins, and the devastating emotional, economic, and health tolls in its wake.
What are Opioids?
🩹Opioids are a class of drugs derived from, or mimic, natural substances found in opium poppy plant.
🩹Opioids work in the brain to produce a variety of effects, including pain relief.
🩹Opioids are commonly used for the treatment of pain, and include medicines such as morphine, fentanyl, and tramadol. Heroin is a frequently misused opioid.
🩹Opioid drugs include both prescription pain medicine and illegal drugs.
🩹After intake, opioids can cause euphoria, which is one of the main reasons why they are taken for non-medical reasons.
🩹Due to their pharmacological effects, they can cause difficulties with breathing, and opioid overdose can lead to death.
🩹Dependence is a major problem with opioid intake from prolonged use, misuse, and use without medical supervision.
🩹Opioid drugs can cause an addiction known as Opioid Use Disorder (OUD).
Opioid Drug Overdose
Opioid use can lead to death due to the effects of opioids on the part of the brain which regulates breathing. An opioid overdose can be identified by a combination of three signs and symptoms:
- Pinpoint pupils
- Unconsciousness
- Difficulties with breathing
Worldwide, about 600 000 deaths were attributable to drug use in 2019. Close to 80% of these deaths are related to opioids, with about 25% of those deaths caused by opioid overdose, according to the World Health Organization (WHO).
According to the Centers for Disease Control and Prevention (CDC), the rate of drug overdose death in 2020, increased by 31% compared to 2019. Adults 35 – 44 experienced the highest rate of drug overdose death. These numbers are alarming and should serve as a wake call to the ravaging course of the opioid epidemic.
Further, the number of opioid overdoses has increased in recent years in several countries, in part due to the increased availability of opioids used in the management of chronic pain, and due to increasing use of highly potent opioids appearing on the illicit drug market.
Fentanyl is a potent synthetic opioid that is used as a pain reliever and as an anesthetic. It is approximately 50–100 times more potent than morphine. Fentanyl has been associated with a spike in deaths from opioid overdose.
Who is Affected?
The percentage in male overdose death is higher than females and continue to increase every year. The rate increased from 8.2% in 1999 to 29.1% in 2017. The rate in females increased from 3.9% in 1999 to 14.4% in 2017, according to data from the Centers for Disease Control and Prevention (CDC).
Did You Know?
About 75% of people that became addicted to street opioids such as heroin during the 2000s report that they started out taking prescription opioid drugs, according to data from the Johns Hopkins Medicine.
Availability plays a big part in fueling this epidemic as fentanyl is cheaper and easier to access in most parts of the United States than prescription opioid.
Opioid Use Disorder is both progressive and fatal, resulting in the rise of opioid deaths in the United States.
Effects of Opioid Intake
Sleepiness, relaxation, euphoria, vomiting, nausea, constipation, and slow breathing which can result in decreased oxygen level in the body (hypoxia), are some of the adverse effects of opioids.
How to Prevent Opioid Overdose
Beyond approaches to reducing drug use in general in the community, there are specific measures to prevent opioid overdose. These include:
- Increasing the availability of opioid dependence treatment, including for those dependent on prescription opioids.
- Reducing and preventing irrational or inappropriate opioid prescribing.
- Monitoring opioid prescribing and dispensing; and
- Limiting inappropriate over-the-counter sales of opioids.
The gap between recommendations and practice is significant. To drive that point, only half of countries provide access to effective treatment options for opioid dependence, and less than 10% of people worldwide in need of such treatment are receiving it, according to the WHO.
How is Opioid Overdose Treated
Death following opioid overdose is preventable if the person receives basic life support and the timely administration of the drug Naloxone.
Naloxone is an antidote to opioids that will reverse the effects of an opioid overdose if administered in time.
Naloxone has virtually no effect in people who have not taken opioids.
Access to naloxone is generally limited to health professionals.
What Role Did the Sackler Family Play in the Opioid Crisis?
Lawsuits against Purdue and Sackler family members accuse them of fueling the opioid epidemic through deceptive marketing of its pain medication. The company pleaded guilty to misbranding and fraud charges related to its marketing of OxyContin in 2007 and 2020.
The Sacklers’ conduct is alleged to have “contributed to the massive overuse of OxyContin and other opioids in this country,” according to law professor Joshua Silverstein of the University of Arkansas at Little Rock.
Members of the Sackler family have denied wrongdoing but expressed regret that OxyContin “unexpectedly became part of an opioid crisis.” They said in May that the bankruptcy settlement would provide “substantial resources for people and communities in need.”
Bottom Line
As stewards of public health, healthcare providers play a pivotal role in addressing the opioid crisis. By fostering a proactive and compassionate approach, we can collectively work towards a future where individuals receive the care they need, and communities thrive free from the grips of opioid addiction.
