Prescription Opioid Abuse And Its Effects On The Individual, The Healthcare System, And Society

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

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 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.

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

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

Prescription opioid misuse has emerged as a significant public health issue in the United States. Since the late 1990s, nationwide sales of prescription opioids have risen 4-fold, and with this, the rate of admissions for substance use treatment and the rate of death from opioid overdose have grown proportionately.1

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.

In the United States, opioids have become a major component in healthcare because they are an exceptional method of relieving pain. For those who are recovering from a recent inpatient surgery or those with cancer who are in a great deal of pain, it is a necessity. A known problem with opioids is that they are addictive, which leads to overuse of the medication by the patient. Opioids are also highly sought after as a street drug, this leads to patients exaggerating their pain level in order to receive more pills and selling their excess medication to others. Doctors will often prescribe opioids to patients who do not need such an aggressive form of pain relief, for example, people with arthritis or who have gone through a minor outpatient surgery. This can lead to a long-term use of these pain relieving drugs and possible addiction, which goes against the original purpose of opioids. In order to solve America’s dependence on opioids, medical professionals must go back to the original method of prescribing them, that is, only short-term use for people recovering from surgeries or in pain due to cancer, instead of a long-term solution for acute pain.

The issue of pain management has been an ongoing crisis for ages. The need for solutions and methods of avoiding pain is natural, however, as time has passed, misuse of these solutions has gotten out of hand. The abuse of prescription opioids, in particular, must be acknowledged. By prescribing opioids to patients, doctors are inadvertently creating drug addicts and fueling the heroin epidemic. As patients grow tolerant to opioids, they are forced to search for stronger drugs, commit crimes, and ultimately die. Alternate solutions for pain management and regulation of opiates must be implemented in order to prevent the meaningless loss of lives.

Doctors and other medical professional specialize in providing quality medical care for their patients, are now fighting to control pain without the risk of misuse and abuse of prescribed medications by their patients. One disadvantage of quality care is providing opioid medications to help control extreme pain for some patients. Many patients have become dependent on opioid—highly addicted painkillers such as fentanyl, hydrocodone, morphine, oxycodone, propoxyphene, and methadone. According to 21 Health Organizations and the Drug Enforcement Agency (DEA) cited by ACPM, “effective pain management is an integral and important aspect of quality medical care, and pain should be treated aggressively” (the American College of Preventive Medicine, 2011). Aggressively fighting patients’ pain with opioid medications have led to an increase rate of addictions to the level in which it is known as uncontrollable epidemic in today’s society.

Since the 19th century the United States has struggled with the control of opioids and how to properly treat the people who become dependent on them. By the 1980s studied revealed that the potential of drug dependence, also known as iatrogenic addiction, was relatively low for patients who were prescribed opiates for treatment (Beauchamp, 2014, p. 2023) - In the mid 1990s, Perdue Pharma introduced OxyContin, a Schedule II prescription opioid analgesic, to the pharmaceutical market (Boerner, 2016, p. 20). Since the release of OxyContin, a substantial number of Americans have been prescribed opiates for medical treatment. Society’s view on prescription opiate use has slowly shifted from being a normative treatment method recommended by healthcare professionals, to being viewed as deviant. Prescription opioids have played a large role in increased rates of incarceration, fatal and non-fatal opiate overdose, transitions to illicit drugs and HIV infection in the United States (Boerner, 2016, p. 21). Prescription opiate use is seen as deviant when the drug is misused for non-medical purposes.

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).

Chronic non-cancer pain is a condition that need different alternatives in order to be treated while some patients could respond efficiently to some medications some others not. Nevertheless, in the market there are available enough options that offer a variety of strategies to treat pain, including opioids. Conversely, in the last years an increase in the abuse of pain reliever drugs containing opioids has increased alarmingly some specialist have termed it as “opioid abuse epidemic”.

Is the misuse of painkillers worth losing a life? A study was performed in West Virginia looking at 295 accidental deaths from pain killers and found nearly 2 out of 3 of those who died overdosed on pain-killers, did not have a prescription (Shmerling, 2008). Today in society, there are many prescription pain killers physicians can choose from to administer to patients. However, statistics show that the most common narcotic painkillers used are Oxycodone, Percocet, and Vicodin. The number of people abusing prescription drugs, including opioids, more than doubled, from 7.8 million in 1992 to 15.1 million in 2003 (Gupta & Christo, 2009). The misuse of prescription painkillers among the general population in the United States is quickly rising to a state of an epidemic.