Opioids: A Summary

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.

Opioid abuse, misuse and overdose is a problem in The United States. You can’t turn on the TV or read a newspaper without some mention of the epidemic. This issue has caused the practice of prescribing or taking narcotic pain medication to be looked at under a microscope. Patients are fearful to use some necessary pain medication, because they may become addicted. Other patients who genuinely do have pain and need medication are having a tougher time obtaining the help they need. The problem of abuse and addiction is tough to solve since for some people the medications are the only way they can function and live a semi-normal life. A patient with pain may be hesitant to visit the doctor and

Jamison RN, Serraillier J, Michna E. Assessment and treatment of abuse risk in Opioid prescribing for chronic pain. Pain Res Cl. 2011;2011:1-12. doi:10.1155/2011/941808.

What is the number of lives that need to be taken before a problem is acknowledged as a pressing issue? Elijah Cummings, a US politician, states “More than 26,000 lives may be lost to the effects of drug abuse this year. This tragic impact is felt in communities across this great nation,” many of whom are not trying enough to attempt to alleviate this problem. Opioids are, throughout the US, consistently over prescribed and ineffectively regulated, leading to overuse and abuse of opioids becoming a pandemic in the United States.

Opioids, otherwise known as prescription pain medication, are used to treat acute and chronic pain. They are the most powerful pain relievers known. When taken as directed they can be safe and effective at managing pain, however, opioids can be highly addictive. Ease of access helps people get pain medications through their physician or by having friends and family get the medication for them. With their ease of access and being highly addictive the use and misuse of opioids have become a growing epidemic. Patients should be well educated on the affects opioid use can have. More importantly instead of the use of opioids, physicians should look into alternative solutions for pain management. While pain medication is helpful with chronic pain, it is also highly addictive, doctors should be more stringent to whom and how often they prescribe pain medication.

SOURCE: “F.D.A. to Expand Medication-Assisted Therapy for Opioid Addicts,” Sheila Kaplan, The New York Times Company, February 25, 2018.

Opioid abuse is a growing epidemic within the United States. Not only are people abusing the prescription forms of opioids (such as oxycodone - OxyContin, hydrocodone - Vicodin, codeine, and morphine) by taking more than they are supposed to, but they are also being bought, sold, and used on the streets illegally; such as heroin. Opioids are highly addicting because of the high they can induce in a person, causing a dependence and yearning for continued use (NIDA, n.d.) In 2007, the United States was responsible for over 99 percent of the global consumption of hydrocodone and 83 percent of the global consumption of oxycodone (United Nations Publications, 2009).

McCoy K.’s article Opioid Addiction starts off by explaining what opioids are and its different forms. Then explaining how these medications are extremely addictive and how it causes the brain to crave the drug. She then goes over causes of addiction, risk factors and the symptoms that a person who addicted to opioids will have. Lastly, she goes over extensively on psychological treatment given to an individual who is suffering from opioid addiction, including counseling and support, treatment for other psychological conditions (such as depression, or any other mental disorders they may have), and behavioral therapy headed by a trained psychologist.

The effects of opioid overdose are traumatic, devastating, and preventable. It is estimated that there are 128,000 people addicted to opioids in New Jersey (Stirling, 2015). Furthermore, many of those addicted to the drug heroin became so after being prescribed narcotic pain killers. This is because when the prescription runs out the addiction is still in place. Those addicted can find pills being sold illegally but they can cost up to 30 dollars a pill. Heroin, costing only 5 dollars a bag according to law enforcement officials, is a much better deal (Stirling, 2015).

Modern day America is plagued by a surplus of tragedy, most may have seen viral videos of these “zombies” slumped in cars or streets and yet it continues. In fact, this terrifying epidemic was created by drugs that were intended for pain relief, Opioids. This includes prescription pain relievers like oxycodone, morphine, methadone, and hydrocodone. Ironically, the well-known street drug, Heroin, is one of the most serious offenders of the Opioid crisis (Anderson). With each day, more mothers, fathers, sisters, and brothers are witnessing and losing loved ones from overdoses, which is why the focus of society absolutely needs to be on a path of action towards the rising deaths, excessive prescriptions and governmental influences in opioid addiction.

For my research, I would like to make an impact on the number of opioids prescribed at in the Emergency Department at Houston Medical Center. The United States has an opioid crisis and uses more opioids than all other countries in the world combined (Cassidy, Dasmahapatra, Black, Wieman, & Butler, 2014) . This usage of opioids leads to abuse, dependence and hyperanalgesia. The over prescribing of opioids became dramatically increased following pharmaceutical companies downplaying side effects related to their medications. With the addition of pain as a 5th vital signs and pain becoming a question on the HCAHPS, there has been a rapidly progressing sector of narcotic prescriptions.

Summary: The video and associated article are primarily the first-hand account of an opioid addict who had attempted to detox alone unsuccessfully and then found medical assistance. Aside from the first-hand account the information mentioned in the video and article is insinuated to be from University of Kansas Health System Addiction Center and their staff. The link to the addiction center is provided and for further resources the audience is directed to another webpage on KMBC for other withdrawal and treatment centers. The audience of this news segment is those suffering from opioid addiction and their family members. The segment is also targeted in combination with a series other articles sharing the same overall title “State of Addiction” at the local community to create awareness of opioid addiction. The video expressed a tone of hope

Pain is a common symptom that is associated with numerous medical issues, including musculoskeletal problems that physical therapist see on a day to day basis. There are several different ways to treat pain and one of them is to provide a means of releasing opioids in the body to alter the pain experience. In fact, there are three different types of opioids: naturally occurring (endogenous or exogenous substances such as natural endorphins or poppy), semisynthetic (exogenous substances that contain both natural and synthetic agents), and synthetic agents (man-made substances used to mimic the effect of natural substances) used to decrease the symptom of pain.1

UCF’s College of Medicine was recently recognized by the White House as one of 60 medical schools across the country to pledge to teach students about the dangers of prescribing opioids to patients for pain. The pledge follows President Obama’s public-private efforts to fight the nations epidemic of prescription opioid and heroin abuse, according to a press release from UCF.

To minimize harming patients and to optimize the quality of life for people that are taking opioids, doctors should consider the following strategies; symptomatic management of adverse effects, altering the route of administration, opioid rotation, and dose reduction. Symptomatic management entails treating opioid-induced side effects with a medication that targets that specific symptom. Altering the route of administration might include a switch to a medication that can be administered transdermally, such as fentanyl. Opioid rotation is when you switch out one opioid for another and it’s normally done to improve pain control and/or reduce any adverse effects. Dose reduction is exactly what it says, reducing the dose to minimize drowsiness,