Opiate Overdose Research Paper

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

There is no question that the alarming rate of deaths related to opioid overdose needs to be addressed in this county, but the way to solve the problem seems to remain a trial and error approach at this point. A patient is injured, undergoes surgery, experiences normal wear and tear on a hip, knee or back and has to live with that pain for the rest of their life or take a narcotic pain medication in order to improve their quality of life and at least be able to move. The above patients are what narcotic pain medications were created for, a population of people that use narcotic pain medications for fun is what is creating a problem. Narcotics are addictive to both populations, however taking the narcotic for euphoric reasons is not the intention of the prescription that the physician is writing. The healthcare system needs to find a way to continue to provide patients that experience chronic pain with the narcotics that work for them while attempting to ensure the Drug Enforcement Agency (DEA) doesn’t have to worry about a flood of pain pills hitting the streets by granting access to the population with a substance abuse problem.

As we learned in class last week, victimless crime can be one of many things. Victimless crime is defined as a crime taking place where there are no harmful injuries done from one person to another. Instead, the damage being done is committed by the individual who is committing the crime. Some examples of a victimless crime are, Drug use, prostitution, gambling, suicide, traffic citations and trespassing.

Opioid abuse has become so widespread in Baltimore that on March 1, 2017, the governor of Maryland, Larry Hogan, declared a state of emergency. The rise in the number of opioid-related overdoses in the Baltimore have skyrocketed in the past few years. According to the Maryland Department of Health and Mental Hygiene, 1089 people, a majority from Baltimore, died of a fentanyl overdose in 2015. In 2016, the number rose to 1856 deaths. (Maryland Department of Health and Mental Hygiene 14). The spike in overdose deaths can be contributed to the increased use of Fentanyl. Fentanyl is 50 times more potent and costs less than a third of heroin (Adwanikar; Duncan). Drug dealers mix fentanyl with heroin to make their product less expensive to produce

Milwaukee is currently facing an epidemic. This epidemic is the usage of opioids. Every year, the death toll grows from opioids usage. Opioid overdoses are America's leading killer. People are becoming more and more addicted to them and it is causing the user to overdose on the drugs. There are many types of opioids with different usages. This causes short and long term effects which can later lead the body to experience withdrawal from the drugs.

If you have been working in EMS for longer than a week you will probably already know the epidemic that America is facing. The epidemic that I am referring to has no discrimination and anyone can fall victim to it. If it hasn't already destroyed your family in some way then you are one of the lucky few.

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

According to NIH, millions of people suffer from opioid use disorder throughout the United States. This epidemic has continued to spread and the numbers of people who are becoming addicted is on the rise so much that the total burden of cost is at 78.5 billion dollars per year for prescription opioid misuse, this includes the cost of addiction treatment, criminal justice services, and health care (NIH, 2017. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis) Unfortunately there does not seem to be an end to this epidemic anytime soon. The numbers are unremarkable; natural and semi-synthetic opioids peeked at 14,427, heroin at 15,446 and synthetic opioids other than methadone at 20,145. That is a total of 50,018 deaths for some type

Rates of opioid-related overdose have been rapidly increasing in the United States. From 2010-2015, overdose deaths attributed to the use of illicit opioids has increased by over 200% (1). In 2016, the number of opioid-related deaths reached 64,070, the highest number ever recorded in the nation’s history and anticipated to increase (2). While opioid-related overdose had been largely caused by prescription opioid misuse, the problem is increasingly due to heroin and other illicit opioid use (3, 4). Increasingly, illicitly-manufactured fentanyl (IMF), an opioid much stronger than heroin, has become an increasingly common additive pervasive in the supply in the United States and has contributed to the steep rise in opioid-related overdose (5-8).

For thousands of years, opiates have been used in the treatment of pain. Opium is believed to have been discovered 6000 BC, and since then, it has had a huge impact on both medicine and the recreations of those seeking euphoria. More recent than the ancient discovery of natural opium are the derivatives of opium, such as the alkaloids morphine, codeine, and thebaine. From these alkaloids, semi-synthetic opiates can by synthesized, such as hydrocodone, and oxycodone. Synthetic opioids are also quite prevalent, which include fentanyl and tramadol. Opium can also be processed into heroin, a morphine derivative. As advancements were made in science and engineering to allow for a wider distribution and usage of opiates, the problems of dependence and overdose also increased drastically. According to Hart and Ksir (2013, p. 302), the invention of the hypodermic needle for intravenous administration of morphine and other drugs allowed for a much faster and more potent dose of the drug. With this increased potency came an increase in the possibility of a recreational intravenous user to overdose. Hart also mentions that some of the wars surrounding the era of the synthesis of morphine may have contributed to the rise of morphine, seeing as a medic soldier’s motto was always “first provide relief” (2013). This relief-driven attitude and extensive use of opioid analgesics in medicine during the time, in addition to the large amount of patent medicines and remedies on the market may

On June 6, 2017 Arizona Governor Doug Ducey declared the opioid epidemic a public health emergency in the state of Arizona (Vestal, C. 2017, June 6). Since 2012 there has been a 74% increase in opioid overdoses and deaths; this equals about 2 opioid overdose deaths per day in Arizona (Vestal, C. 2017, June 6). 431 million opioid pills were prescribed in Arizona in 2016 enough for every Arizonan to have a 2.5 week supply of opioid pills (Arizona Department of Health Services, 2017). The “U.S. is only 5% of the world’s population however we consume more than 80% of the worlds opioid supply” (Arizona Department of Health Services, 2017). In 2011 opioids made $11 billion in profits for pharmaceutical businesses (Eban, 2011)

My concerned is the current opioid epidemic in our society. There has been a significant increase in the use of opioid analgesics for pain control. There is a corresponding growth in the rate of abuse, misuse, and overdose of these drugs. As a nurse, I had witnessed and continue to witness patients coming in the emergency room from opioids overdose between the ages of 12 and 25 and this situation continue to increase in number. There is a significant increase in number of teenagers using opioid they buy from the street and others the opioid from family member who were given prescription and other situations

Opioids attach themselves to specific proteins called opioid receptors. These opioid receptors are found throughout the body including the brain, spinal cord, and GI tract. When an opioid attaches to a receptor, it can reduce the perception of pain. Through this coupling with receptors, opioids can also produce drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can stop respiration leading to death (overdosing).

The social problem I chose to do something about is opiate abuse/addiction. Opiates are naturally occurring narcotics, such as opium and opium derivatives, including morphine, codeine, and heroin. Prescription painkillers are opioid analgesics. Opiates are highly addictive and dangerous when misused. This social problem matters to me because I am a recovering opiate addict. I have been clean for four months and my new found passion is educating people about the dangers of opiates. People assume because doctors prescribe opioid analgesics, they must be safe. Opiate abuse matters to society because when opiates are misused, lives are taken. People die from overdose, abusers’ worlds fall apart because of their addiction, and loved ones of the abusers are left grieving and feeling helpless.

Heroin use and overdose related deaths have increased considerably in the United States in recent years (Jones, Logan, Gladden, & Bohm, 2015). The results of the National Survey on Drug Use and Health [NSDUH] (2014), showed in the year 2013, approximately 517,000 Americans abused heroin, which was almost a 150 percent increase since 2007 (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). According to the National Institute on Drug Abuse [NIDA] (2014), in the year 2011, 4.2 million people who were twelve years of age or older said they used heroin at least once in their lifetime. Furthermore, data from NSDUH showed approximately 460 people, twelve years of age or older, used heroin each day in 2013 (Lipari and Hughes, 2015). An even more frightening statistic is death rates doubled for people who were twelve years of age or older as a result of heroin overdose in the years 2010 through 2012 (Hedegaard, Chen, and Warner, 2015).