Literature Review On Opioids

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.

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

In America, the use of opioids is at an all time high, it has became such an issue nationwide, that it has became an epidemic. Because of the opioid epidemic, America is tearing apart, children all across the country are dying everyday, these children are dying from overdoses due to poisoning. The opioid problem is not just because of a person's decision to pick up a needle or a pill bottle, but it is because in the 1990’s doctors gave up on trying to treat patients for their overwhelming pain and discomfort, causing opioids to become over prescribed. Due to the carelessness of America, opioids are being distributed more and more everyday, causing the skyrocketing number of deaths.

Opioid drugs are some of the most widespread pain medications that we have in this country; indeed, the fact is that opioid analgesic prescriptions have increased by over 300% from 1999 to 2010 (Mitch 989). Consequently, the number of deaths from overdose increased from 4000 to 16,600 a year in the same time frame (Mitch 989). This fact becomes even more frightening when you think about today; the annual number of fatal drug overdoses in the Unites States now surpasses that of motor vehicle deaths (Alexander 1865). Even worse, overdose deaths caused by opioids specifically exceed those attributed to both cocaine and heroin combined (Alexander 1865).

The United States of America has had a war against drugs since the 37th president, Richard Nixon, declared more crimination on drug abuse in June 1971. From mid-1990s to today, a crisis challenges the health department and government on opioid regulation, as millions of Americans die due overdoses of painkillers. Opioids are substances used as painkillers, and they range from prescription medications to the illegal drug, heroin. Abusing these substances can cause a dependency or addiction, which can lead to overdoses, physical damages, emotional trauma, and death. To ease the crisis, physicians are asked to depend on alternatives to pain management. Law enforcement cracks down on profiting drug-dealers and heroin abusers. People are warned against misusing opioids. The controversy begins for those who suffer from chronic pain, because they depend on opioids. There’s so a correlation to the 1980s cocaine epidemic, and people are upset over racial discrimination. Nonetheless, the best way to avoid this crisis is to recover the people at risk, reduce inappropriate opioid description, and have a proper response.

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.

Have you ever thought about doing drugs? If so you're not the first, but you probably didn't think about how it could affect you and your life. In 2016 63,600 people didn’t think of the consequences and ended up dying from overdosing in the United States. 42,249 deaths involved an opioid. Opioids are drugs made to replicate opium. They both include legal painkillers like morphine, oxycodone, or hydrocodone prescribed by doctors. The problem with opioids has been growing for years and its growing with each year. The misuse of and addiction of opioids is a serious national crisis. It effects public health as well as social and economic welfare.

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.

Initially opioids are prescribed to relieve pain, however many patients get hooked and addicted to opioids. The risks for addicted patients with chronic pain is yet known, in addition opioids are also more accessible, thus overdose cases have increased, some leading to death. A woman who is addicted to opioids during her pregnancy, has the possibility of leading her child to addiction and causing birth defects. Additionally, the addiction is expensive, thus to get the money it will lead to criminal activity or withdrawal symptoms such as pain, diarrhea, nausea, vomiting, and other symptoms. Needles, and various methods are used to inject opioids, however this will lead to transmission of diseases. Opioids cause damages emotionally, physically, and economically, as an attempt to make others aware of this ordeal, National Institute on Drug Abuse (NIDA) is communicating with teens through an online education program. Overconsumption is hard to ignore, however the prevention message are hard to disregard as

Ouch! The dull, tingle of the pain has gradually escalated to a full on throttle that radiates pain in the lower back. When usually PM over the counter pills would easily make the pain disappear has been replaced by a small dosage of hydrocodone pill. Yet taking the opioid pill at nighttime can be easy for a good, restful sleep and just worry about the pain later the next day. A single dosage at night can be easily manage, for at least many people. A doctor’s advice and prescription to help chronic pain should be a patient’s responsibility, yet there are doctors who have been at fault for overdose deaths.

According to Hanson, Venturelli, and Fleckenstein (2015) opioids are described as the “nation’s fastest-growing drug problem” (p. 276) and are also known as narcotics. Opioids originated from the opium poppy and have been chemically altered throughout the years in order to create more potent drugs such as hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), and codeine. Known for analgesic properties, opioids are seen to be the most commonly used drugs among clinicians. Although these narcotics are legally prescribed to patients, there are many, even adolescents, that not only abuse prescribed narcotics, but also abuse another form of opioid, heroin. In adolescence, the structures of the brain are not fully developed and are therefore more likely to acquire severe consequences for abusing opioids. There are many ways to use and administer narcotics, but misusing opioids may lead to signs and symptoms of drug abuse, annoying side effects, dependency, abuse, and in worse case situations, death.

With every five first time heroin users, four of them will have started out by using prescription painkillers (ASAM). According to the Journal of Addiction Medicine, the years 2010 to 2013 showed an increase of heroin-overdose deaths by 37% (NIDA). Until recently, opioid addiction, related criminal activity and death have been deeply casted into the shadows of important issues in our societies at a global level. Care for this particular area of substance abuse is urgent and crucial, one dosage having the capability to kill a person instantly. Before people can rid themselves of the poisons, the human body reacts to the absence of opioids in a powerful cycle of withdrawal. Decades filled with little to no research surrounding the rehabilitation of this common but life threatening illness has unfortunately resulted in few options for people to turn to. Medical experts, politicians and even passionate citizens are beginning to point attention towards this progressively large margin of individuals that are becoming addicted, desperate for treatment, and ending up with results of complete failure. The one-size-fits-all approach to opioid treatment needs to be abolished and replaced with a method of accountability and strict individual progress.

The figure is startling: A 96.6 percent increase in drug-related deaths in a five-year period (Hanson, 2010). According to Brown University Pharmacology Update (2009), since the period of increases in opioid misuse in the 1990s, data over the last three-to-four years indicate a high, steady prevalence of opioid prescription misuse in the United States. According to the 2007 National Survey on Drug Use and Health, about 5.2 million people ages 12 and older were current nonmedical users of prescription pain relievers in 2006, comprising 2.1% of the population. This rate has remained statistically unchanged since 2002. Survey data from 2002 to 2005 found that 4.8% of persons ages 12 and older (11.4 million people) used a prescription pain reliever nonmedically in the 12 months prior to the survey. This data also indicated that an annual average of 57.7% of people who used prescription pain medication nonmedically in the past year used hydrocodone products, and 21.7% used oxycodone products. Recent male users were more likely to use hydrocodone products nonmedically compared to recent female users (61.4% compared to 54.9%). Young

For some people, drugs are a part of everyday life. Drugs are what allow them to be able to walk around in the mornings with no ache, or comfort the pain of a recent surgery, or help and individual cope with anxiety or stress; however, the same drugs that are used to bring enjoyment into one persons life can bring destruction into another. This has become a major problem in the U.S. and all over the world as well. In a recent survey, thirty different clinics, spread out over five urban areas, reported that thirty-six percent of admitted patients has admitted to the nonmedical use of prescription drugs over the past year (Brown, Chaitkin, 1981); consequently, prescription pain killers have lead to more deaths that than heroin and cocaine combined (CDC, 2013).

A review of thepublished data focusing on the pharmacokinetics of opioids brought forth pertinent variations that is critical in making optimal analgesic choice.