Opioid Abuse: Case Study

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

I can’t count the number of prescriptions I get from the same doctor for the same medication same quantity on a daily basis. I feel that some doctors are simply writing scripts to make the patient happy when in reality their feeding the addiction. I have seen patients jump form pharmacy to pharmacy in order to fill multiple scripts for the same medication on the same day. There is a system that collects and keeps track of the what types of controlled and narcotic medications people received, however the system takes days to update, so it almost impossible to know right away when the last time a patient received a particular opioid medication. Another issue that I believe is feeding the addiction for drugs abusers is the sale of needles. Depending on the state, people who do not have a prescription for needles or a medication that requires the use of needles, can simply walk into a pharmacy and buy a box of needles. Anyone with commons sense would see that if you don’t have a prescription that requires needles your most likely using it for illegal reasons. Pharmacy regulations make it to easy for people to get what they need in order to “get

Millions of people throughout the world are taking drugs on a daily basis. If you were to ask someone why they take prescription drugs, most people would be taking them for the right reason. However, it’s estimated that twenty percent of people in the United States alone have used prescription drugs for non-medical reasons.1 Prescription drug abuse is a serious and growing problem that often goes unnoticed. Abusing these drugs can often lead to addiction and even death. You can develop an addiction to certain drugs that may include: narcotic painkillers, sedatives, tranquilizers, and stimulants.1 Prescription drugs are the most common abused category of drugs, right next to marijuana, cocaine, heroin, and

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.

Through my observations of the Narcotics Anonymous meeting I believe that my analysis could be beneficial to the realm of medicine. Centers for Disease Control and Prevention (2014) released a study that displayed, “health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.” Considering the mass amount of prescriptions being written nationwide, it is not surprising that one of the members in the NA meeting I attended was able to easily obtain painkillers from her doctor. The specific interaction I encountered during the Narcotics Anonymous meeting where the woman described that her addiction was being supported by the constant prescriptions written by her doctor

* An estimated 48 million people according to the National Institute on Drug Abuse, have used prescription drugs for nonmedical reasons in their lifetime. According to

Abuse is a pattern of substance use that results in negative consequences and impairment (Bukstein and Nquyen). Misuse is the use for a purpose not consistent with medical guidelines or without a prescription for the individual using the medication (Bukstein and Nquyen). Abuse of prescription opioids has been cited as the fastest growing drug problem in the United States, and has surpassed the use of cocaine and heroin combined as a cause of mortality (Singhal ). In 2013 alone, nearly two million Americans abused prescription opioids and 16,235 deaths were caused by prescription opioids representing almost a fourfold increase since 1999 (Singhal ). Two million people reported using

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

Although addiction and overdose of opioids was not declared an epidemic by the Center for Disease Control and Prevention (CDC) until 2011, the beginning of the epidemic can be traced back as early as the 1980’s when attention in medical care began to turn toward pain management. By the early 2000’s the Joint Commission on Accreditation of Healthcare Organizations named pain “the fifth vital sign,” implying that pain is as important clinically as pulse rate, temperature, respiration rate, and blood pressure (Wilson, 2016). At the same time, there has been an emphasis change from patient wellness to patient satisfaction metrics. Non-steroidal anti-inflammatory drugs such as Advil, Aleve, or aspirin have raised safety their own safety concerns, contributing to increased use of opioids. The lack of patient access to and insurance coverage for chronic pain management specialists or alternative healing therapies also contributes to the opioid epidemic (Hawk,

The Opioid Crisis has grown tremendously throughout the years, the number of opioid prescriptions dispensed by doctors steadily increased from 112 million prescriptions in 1992 to a peak of 282 million in 2012, according to the market research firm IMS Health. The number of prescriptions dispensed has since declined, falling to 236 million in 2016.(CNN, Opioid Crisis Fun Facts, 2018, P6.). In 2016 there was 63,600 overdoses and 42,249 came from opioids, these drugs are getting easier to buy off the streets, so more people buy them because they are cheaper than some but get you the same high that they want from the other drugs. People get prescription drugs from either stealing them, or other people sell them to them, or they can even get them from their family, but they end up selling

The misuse of opioids has been around for over 20 years in the United States. In a 2017 article “Opioid Crisis”, it states that in the late 1990s, pharmaceutical companies misled healthcare providers by informing them that patients would not become addicted to opioid painkillers. As a result, healthcare providers too liberally prescribed opioid pain relievers. Opioid abuse rates started to climb and it was clear that these medications were highly addictive. According to Volkow, Frieden, Hyde, and Cha (2014), between 1990 and 2010 death rates from prescription opioid overdose quadrupled in the United States. This surpassed the death rates from cocaine and heroin overdoses combined. Furthermore, they state that the epidemic is a result

Opioid use disorders are directly linked to major consequences for individuals as well as society. Opioids include drugs such as Vicodin, oxycodone, morphine, and heroin among others (CITE). Currently, estimates show there are about 20 million people abusing or addicted to opioids countrywide (Bell, 2014). Opioid use can cause decrease quality of life as it is a common cause of familial conflict, homelessness, incarceration, life threatening illness, and death by overdose.

Opioid overuse, is one of the major overuse of analgesic problem that is addressed by the CMS in the part D drug benefit program. This is an example of unnecessary drug use and its financial impact on health economy. Opioids are considered the top most highly used therapeutic class of drug among part D beneficiaries that accounts for 5 percent of total spending and quantity covered under Medicare part D program (Medicare Payment Advisory Commission). It is estimated that in 2012, nearly 12.3 million or 36 percent of part D enrollees were asked to prescribe opioid in at least one prescription. Therefore spending on abused opioids rise from $1.5 billion to $3.9 billion from 2006 to 2014, showing 156 percent of increase in the spending (HHS Office

Over the past 10 years we have seen prescribed opioid narcotics being abused more often than before. In our society doctors prescribe different types of drugs to control a certain pain or for medical reasons. Most narcotics have the potential to numb pain, relieve stress and overall have the feeling of pleasure. The rates for addictiveness is very high therefore physicians under-prescribe narcotics. Narcotics have been present ever since time was recorded so we can't really say our narcotic problem just came up. For example, narcotics like morphine were commercially available to purchase during the 19th century. In our history narcotics were not something classified as dangerous or bad therefore it was never viewed that way. Whenever narcotics

Since the usual use for the “drug” is to kill pain after operations or surgeries, it is hard to tell whether the recipient will use the painkillers correctly or abuse them. The question is: Will there ever be a time when a doctor will be able to tell whether the patient will abuse the prescription? A study performed by the CDC claimed that “40% of Medicaid enrollees with painkiller prescriptions had at least one indicator of potentially inappropriate use or prescribing” (CDC). Two of the requirements for this data are “overlapping painkiller prescriptions” and “long-acting or extended release prescription painkillers for acute pain and high daily doses” ("Risk Factors"). The majority of the patients who require the medicine are using it for the intended purpose, which is a step in the right direction. The only obvious solution to this situation of overdosing is to attempt to make a drug that cannot be abused to the point where a fatality occurs. If the invention of a drug that could prevent the ability to overdose was present, all of the deaths caused by opioid painkillers would be close to nothing, if it wouldn't be zero. On the other hand of that case, the creation of a non-abusive drug has the potential to stop the economic gains that people have gained through drug prevention. The creation of a non-abusive drug in this sense could also enhance the economy, but the only difference between the two is