Drug Use And Health During The Civil War

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

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

Drugs first surfaced in the United States in the 1800s. After the Civil War opium become very popular and was used medicinally. Following opium was cocaine which was also used as a health remedy but near the end of the 19th century opium and cocaine abuse peaked and local governments began to prohibit opium dens and importation. In 1914 the first federal drug policy, the Harrison Narcotics act, is passed and drugs are no longer seen as harmless remedies. The act aggressively regulated the manufacturing of marijuana, cocaine, heroin, and morphine. During the 50’s more federal drug policies were passed and drugs began to become more criminalized. The 60’s saw a rise in counter-culture and substances such as marijuana and LSD saw widespread use. The demand for drugs skyrocketed in the 1960s. In 1971 President Nixon declared drug abuse America 's number one enemy and proclaimed that we must wave a all out offensive. After President Nixon declared the War on Drugs in 1971, the United States has spent more than a trillion dollars on this failing policy that not only has had no effect on the amount of drugs being used in the United States and has increased the number of people incarcerated on drug charges from just 50,000 to over half a million, but also has helped fuel drug cartels and foment violence and death through overdoses from uncontrolled drug potency and turf wars between street gangs.

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

Mike Alstott knows first-hand how opioids, when used correctly, can play an important role in managing pain and helping people to function, but he is also keenly aware of the growing crisis of opioid misuse and overdose. More American adults are dying from misusing prescription narcotics than ever before. An estimated 35 people die every day in the U.S. from accidental prescription painkiller overdoses resulting from things like not taking a medication as directed or not understanding how multiple

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

It is important for our culture in western society to educate doctors on how to modify and limit their prescribing behavior so that less people become dependent on opioid medication. Doctors must start limiting and monitoring the number of opioid prescriptions they administer to patients. Limiting the number of prescriptions will lower the chances for potential abuse within patients, as well as lower the ease of access and circulation of opioid medication on the streets.

In fact, there was thought to be more of a need for them. Before the last two decades, opioids were used for cancer related or acute pain. However, in the 1990s chronic non cancer patients got attention because people nationally felt there was a shortage in patients receiving opioids, thus making them deprived of adequate pain management. Because of this, clinicians were encouraged to treat chronic non-cancer pain and patients in hospice care more often than they were used to. It was also encouraged to use high doses of opioids for long periods of time (Cheatle). The idea that providers seemed overly cautious about these medications caused a large increase in opioid prescriptions from health care providers. Threat of tort and litigation for some doctors that were deemed for not prescribing enough to alleviate pain of patients was also a concern for doctors This quickly turned a shortage of prescription opioids into a national prescription opioid abuse epidemic in under twenty years. From 1999 to 2010, the amount of prescription opioids sold to hospitals, pharmacies, and doctors offices quadrupled, and three times the number of people overdosed on painkillers in this time (Garcia). While some patients have benefitted from the increased sales and loose guidelines of prescription opioid analgesics, the increasing in opioid misuse, abuse, and overdose is truly daunting. As a nation, we need to back track, and

During his research, Quinones documents the origin of opiate use within the United States in three areas: drug cartels, overprescription from medical practitioners, and the pharmaceutical companies. He claims that illegal use spurred from drug cartels when he notes, “... heroin in Denver originated in one small town in Mexico… a town called Xalisco” (43). However, even though opioids were common in the black market, the drug cartels were not the sole culprits of increasing the risk of addiction. Many Americans used the drugs for medicinal reasons. In a town named Portsmouth, people grew increasingly dependent on opiates during the 90s: “In this part of the country, anything that relieved pain was welcome. But opiates … quickly led to addiction” (Quinones 26). People that were just looking for some treatment soon had a deadlier problem on their hands— addiction. Since the public was looking for a solution for pain, the pharmaceutical companies were hungry to promote opioids for pain management. The industry, according to Quinones, was just starting to produce the deadly drug, and wanted the public to use its

As we all have researched and found out the devastating numbers to the opioid epidemic “the abuse of prescription and non-prescription opioids is one of the greatest threats facing public health in the United States today. It is estimated that as many as 2.5 million people in the US are suffering from opioid addiction related to prescriptions, and an additional 467,000 are addicted to heroin”(2017).

Doctors and clinical prescribers have discovered their role in curtailing the increased opioid prescriptions in America. It is without a doubt that they play a role in facilitating the opioid misuse endemic in the past by being enablers of the situations. When patients ask for pain medications, they do not take time to analyze the pain complaints or suggest alternative medications other than opioids. Even in instances when one doctor declines to offer a patient an opioid prescription for their pain needs, the patient is likely to find another who will give the prescription. However, there has been wide recognition of the opioid misuse endemic such that clinical prescribers are practicing more vigilant prescribing and are advocating opioid-free

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,

Roughly 100 million Americans suffer from chronic pain with an annual cost of $600 billion dollars in health care and a limited number of pain specialist physicians (Harle, et al., 2015). The conditions require the daily use of opioid medications which are being prescribed by primary care providers and providers in the ED. Along with multiple prescribers of opioid medications, the number of prescriptions for these medications has quadrupled from 1999-2013 in correlation with an increase in deaths related to opioid use (Greenwood-Ericksen, Poon, Nelson, Weiner, & Schuur, 2016). The significant increase of opioid related deaths and complications is commonly being referred to as the prescription opioid epidemic and to blame for the most unintentional deaths in the US (Smith, et al., 2015). Though responsible for administering and prescribing opioids to provide pain management, nurse practitioners in the ED have limited patient history and are placed under time constraints. Improved education regarding pain management, clinical practice guidelines and the use of resource tools like the Prescription Drug Monitoring Programs (PDMP) have been proven effective for reducing opioid related complications (Greenwood-Ericksen et al.,

An epidemic is on the rise and is hitting closer to home than one may expect. From the hospitals to the pharmacies and the medicine cabinets of many Americans, the damage prescription opioids are causing have been detrimental. Prescription opioids being medication that is meant to alleviate extreme pain, has induced more damage into the users life with its controversial side effects, and death in an abundant amount of cases. The issue revolving around prescription opioids does not just stay within the parameters of the dangerous medicine itself, but in addition the expansion of loose laws and corruption within the medical industry. This rise in the prescription opioid epidemic has been created by a contribution of physicians, pharmaceutical industry and a misconception of the medicine in the eye of the public. Even with all these factors in play, there is still hope to bring an end to the prescription opioid drug ring, with the combination of current laws and hopeful laws and restrictions in the future. The epidemic of prescription opioids has gone on for far too long and has caused an obscene amount of critical damage to the lives of many for the issue to be ignored any longer. Usage of prescription opioids must be reduced to ensure the safety of patients and to stop further abuse and death.

According to the Centers of Disease Control and Prevention 44 people die each day in the United States of America due to an overdose of a prescription painkiller (“Joining the Fight”, n.d.). A staggering 2.1 million people in the United States suffer from substance abuse disorders and the number of people using opioids for nonmedical uses is continuing to rise (Volkow, 2014). Who is to blame for these outrageous numbers? I believe that the patient and the pharmaceutical companies are to blame for this on-growing problem. Some of the largest contributing factors to these growing statistics is that the pharmaceutical companies have very aggressive marketing of the medicines, which in turn leads to a rising number of prescriptions written for