Drug-Related ED Report

Most people are familiar with prescription medications; almost everyone has taken them at one point or another during their lifetime. Not all prescription drugs are addicting, but a large number of them are. Prescription drug abuse is a disease that has become a major problem in the United States, which affects over six-million Americans. Prescription drug abuse not only affects the individual, but can additionally have far-reaching consequences that affect family, personal health, employment, communities and society as a whole. Research has shown that at least 10% of people prescribed an addictive medication will become dependent on the medicine. Due to prescription drug abuse, states are beginning to monitor doctors who prescribe certain medications, more closely, which may scare some physicians away from prescribing helpful medications to people who truly need them.

Opioid use in the US has increased over the years, and this has led to an increase in substance abuse. Substance abuse is not only associated with use of illicit drugs but also prescription drugs. In 2015, of the 20.5 million reported cases of substance abuse, 2 million had an abuse disorder related to prescription pain relievers and 591,000 associated with heroin.1 The increase in substance abuse disorder has led to an increase in opioid related death. In 2015 drug overdose was the leading cause of accidental death in the US with 52, 404 lethal drug overdoses.2

“Substance use disorders” or “substance-related disorders” are intended synonymously and are used interchangeably when referring to the broad category of addiction to psychoactive substances. Additionally, the word “drug” should be considered in the context in which it appears and can refer to alcohol specifically and/or other psychoactive substances such as cocaine or heroin etc. Again, this is because of the large overlap within the broader category of substance use and the high prevalence of polysubstance use. For the sake of clarity, “drug” as used in North America to generally refer to any illicit or controlled substance has been avoided. Instead, “medication” will be used to denote a prescribed substance used to treat physical symptoms. However, many legally prescribed medications (such as morphine) can and are abused and have addictive quality, making them just as devastating as “street drugs” or alcohol (Compton & Volkow, 2006).

The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.

It is no secret that the United States is currently experiencing a shortage of nurses . “The U.S. Department of Labor, Bureau of Labor Statistics ( 2009 ) estimated that more than one million new and replacement nurses will be needed by 2018 to meet the increased demands of the health care workforce” (). The stressful conditions under which nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses’ abuse of illicit drugs and alcohol. Nurses are unique in that they work in an environment where they not only have access to controlled substances, but also are exposed to critically ill patients, traumatic situations, death and dying, the stress of which can increase the risk of substance abuse. (Epstein, Burns, & Conlon, 2010). Unfortunately, it is the patient that suffers the most.

Almost one hundred years ago, prescription drugs like morphine were available at almost any general store. Women carried bottles of very addictive potent opiate based pain killers in their purse. Many individuals like Edgar Allen Poe died from such addictions. Since that time through various federal, state and local laws, drugs like morphine are now prescription drugs; however, this has not stopped the addiction to opiate based pain killers. Today’s society combats an ever increasing number of very deadly addictive drugs from designer drugs to narcotics to the less potent but equally destructive alcohol and marijuana. With all of these new and old drugs going in and out of vogue with addicts, it appears that the increase of misuse and

) Discuss the public health impact of opioid misuse and abuse, including costs related to healthcare and criminal justice costs. Opioid drugs are valuable medications in treating acute and chronic pain that cannot be managed with nonopioid therapy, but inappropriate prescribing can cause serious harm. Taking higher doses or a combination of short-acting and long-acting opioids are likely to be abused and can also cause serious dose-related adverse effects that can include death. Opioid abuse affects the community and families in some way. It can lead missed work and sometimes it can be a problem keeping a job. Therefore, it is important that we obtain medication history to give us a picture of the patient pain medication history. While opioid

Prescription opioid abuse is the intentional use of prescribed pain medication, or analgesics, for uses other than or beyond the time limits of, what the prescription is written for. It has become a widespread problem in the United States and is growing quickly. Unfortunately, most of the blame falls on our healthcare system, which tends to take the “band aid” approach to health issues. Oftentimes, pain medications are overprescribed and undermanaged without addressing the origin of the medical ailment that is causing the pain. Due to the misconception that taking these FDA prescribed drugs are safe, rates of abuse with these drugs is on the rise. Accidental deaths due to prescription opioid overdose have increased dramatically since 1999, and surpass those caused by cocaine and heroin. Prescription opioid abuse has a tremendous negative impact on the individual, the healthcare system, and society in general. This paper will explore the trends, history, mechanisms, individual impact, societal costs, and the management and treatment of prescription opioid use and abuse.

The rate of death due to prescription drug abuse in the U.S. has escalated 313 percent over the past decade. According to the Congressional Quarterly Transcription’s article "Rep. Joe Pitt Holds a Hearing on Prescription Drug Abuse," opioid prescription drugs were involved in 16,650 overdose-caused deaths in 2010, accounting for more deaths than from overdoses of heroin and cocaine. Prescribed drugs or painkillers sometimes "condemn a patient to lifelong addiction," according to Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. This problem not only affects the lives of those who overdose but it affects the communities as well due to the convenience of being able to find these items in drug stores and such.

Prescription drug abuse is an increasingly rampant public health issue. The Centers for Disease Control and Prevention (CDC) has affirmed that the United States is in the midst of an epidemic of prescription drug overdose deaths (2010a). Drug overdose, especially related to the non-sanctioned consumption of prescription opioid analgesic (painkiller) drugs, is the second leading cause of deaths from unintentional injuries in the United States, surpassed only by motor vehicle mortalities (Girion, Glover, & Smith, 2011). In 2005, President Bush signed the National All Schedule Prescription Electronic Reporting Act (NASPER), which amends section 390O of the Public Health

These efforts are focusing little attention on the source of the medications themselves, the access point -- the medical practitioner with a pen. In the current environment, a doctor, dentist, or nurse practitioner can write a prescription to anyone without accountability for the aftermath. In March the CDC convened to put forth guidelines for prescribing opioid medications in cases of chronic pain (Dowell, Haegerich, & Chou, 2016, pp. 1633-1641). The published guideline is a passive 12 point recommendation for prescribing practices without accountability, solutions, or intention to enforce better practice. To date, the national response to the crisis can be described as impotent at best, and the body count rises. “Drug overdose is the leading cause of accidental death in the U.S., with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.” (ASAM,

America is in the midst of yet another drug-related epidemic only this time it is the worst opioid overdose epidemic the world has seen since the late 1990’s. According to the Center for Disease Control and Prevention (CDC 2016), “since 1999, the number of overdose deaths involving opioids has quadrupled.” Opioids (including prescription opioids and heroin) killed more than 33,000 people in 2015, more than any year on record. (Rudd, Seth, David, School, 2015). With overdoses from heroin, prescription drugs, and opioid pain relievers surpassing car accidents as the leading cause of injury-related death in America, it became clear that swift and comprehensive legislation was needed for treatment, recovery support and prevention education in communities

Prescription opioid misuse has emerged as a significant public health issue in the United States. Since the late 1990s, nationwide sales of prescription opioids have risen 4-fold, and with this, the rate of admissions for substance use treatment and the rate of death from opioid overdose have grown proportionately.1

Prescription drug abuse and overdose-related deaths have reached an epidemic level in the United States and are an urgent public health concern. To combat this opioid crisis, in 2016 Comprehensive Addiction and Recovery Act (CARA) was signed into law. CARA authorizes grants to increase access to treatment services and opioid reversal drugs such as Naloxone, strengthen the Prescription Drug Monitoring Program (PDMP), expand prevention and educational efforts. In spite of the extensive range of activities authorized by CARA to control this epidemic, the US has experienced an increase in the number of the opioid overdose-related emergency visit from 2016 to September 2017. Therefore, after considering the policy options to reform this act, the most apropos solution would be the universal mandate of PDMP use. Mandating PDMPs can reduce prescription overdose and misuse of opioids. In order to ensure the impact of this program, PDMPs will have to be implemented on a Federal level. This will essentially make sure that all states taking part in the program are responsible for keeping track of registered physicians and dispensers under the Prescription

The negative outcomes of medication misuse influence people who ill-use medicates as well as their families and companions, different organizations, and government assets (Akindipe, Abiodun, Adebajo, Lawal, & Rataemane, 2014). Albeit huge numbers of these impacts can 't be evaluated, “Office of National Drug Control Policy (ONDCP) as of late in 2002 reported that, the monetary expense of drug abuse within the United States was $180.9 billion” (Akindipe et al., 2014, Pg 250 Para 10). The