Prescription Opioids: A 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

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.

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.

Opioids are taking over the United States with its addictive composition, once patients are take opioids there is no escaping. The drug directed from opium which is obtained from a plant (Katz). Opioids are most commonly found in prescription pill from making underground sales more common. Since opioids are derived from a plant this makes the reality of home grown drugs more of an issue. American citizens overdosing on opioids is what is sparking the crisis because opioid “overdoses killed more people last year than guns or car accidents” (Katz). Opioids are extremely addictive and that is why so many citizens overdose on these types of drugs. After patients become hooked on opioids their body constantly is needing more and more opium to escape they pain they think they are enduring. The overdosing of Americans is not a small percentage of the population either, it is estimated that “over two million people in America have problem with opioids” proving this growing issue is an ongoing crisis (Katz). The United States government needs to take action immediately to the opioid crisis because doctors are overprescribing patients because they seemingly overreact to pain, and opioids are one of the most addictive drug types in the world.

Last year there were over 64,000 reported opioid-related deaths in the United States – making it the leading cause of accidental death in people under the age of 50 in this country (Katz). Opioids, also referred to as painkillers, have become a growing problem over the past two decades particularly in rural communities all across the country where the death rates are higher per capita compared to the death rate in cities (“America’s Opioid Epidemic is Worsening”). These narcotics, such as codeine, fentanyl, hydrocodone, morphine and oxycodone are extremely addictive and, as a result, this silent killer has quadrupled the overdose death toll since 1999

While our major access to these drugs is doctors, we cannot simply lay blame on them, as there is not enough knowledge about these treatments to correctly appropriate drugs, and therefore extra is given (Hemphill 373). Alexander of the Department of Epidemiology of the Journal of the American Medical Association, states that “There are serious gaps in the knowledge base regarding opioid use for other chronic nonmalignant pain” (Alexander 1865-1866), which leads to the unfortunately large number of leftover drugs. In fact, the main place that people get their drugs are from leftover prescriptions (Hemphill 373).

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.

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.

The rate of death due to prescription drug abuse in the U.S. has escalated 313 percent over the past decade. According to the Congressional Quarterly Transcription’s article "Rep. Joe Pitt Holds a Hearing on Prescription Drug Abuse," opioid prescription drugs were involved in 16,650 overdose-caused deaths in 2010, accounting for more deaths than from overdoses of heroin and cocaine. Prescribed drugs or painkillers sometimes "condemn a patient to lifelong addiction," according to Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. This problem not only affects the lives of those who overdose but it affects the communities as well due to the convenience of being able to find these items in drug stores and such.

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.

If you watch the news it should come as no surprise that drug abuse and overdoses have increased dramatically in the United States. According to the National Institute on Drug Abuse, as many as 36 million people abuse opioids throughout the world with 2.1 million in the U.S. who currently suffer from opioid abuse disorders (National Institute on Drug Abuse, 2014). These astonishing numbers are only marginalized when comparing them to opioid related deaths in the United States. With an increase of 137 percent since 2000, deaths from drug overdoses now occur 1.5 times more often than deaths from motor vehicle accidents (Rudd Aleshire, Zibbell & Gladden, 2016). The opioid epidemic in the

Almost one hundred years ago, prescription drugs like morphine were available at almost any general store. Women carried bottles of very addictive potent opiate based pain killers in their purse. Many individuals like Edgar Allen Poe died from such addictions. Since that time through various federal, state and local laws, drugs like morphine are now prescription drugs; however, this has not stopped the addiction to opiate based pain killers. Today’s society combats an ever increasing number of very deadly addictive drugs from designer drugs to narcotics to the less potent but equally destructive alcohol and marijuana. With all of these new and old drugs going in and out of vogue with addicts, it appears that the increase of misuse and

Roughly 100 million Americans suffer from chronic pain with an annual cost of $600 billion dollars in health care and a limited number of pain specialist physicians (Harle, et al., 2015). The conditions require the daily use of opioid medications which are being prescribed by primary care providers and providers in the ED. Along with multiple prescribers of opioid medications, the number of prescriptions for these medications has quadrupled from 1999-2013 in correlation with an increase in deaths related to opioid use (Greenwood-Ericksen, Poon, Nelson, Weiner, & Schuur, 2016). The significant increase of opioid related deaths and complications is commonly being referred to as the prescription opioid epidemic and to blame for the most unintentional deaths in the US (Smith, et al., 2015). Though responsible for administering and prescribing opioids to provide pain management, nurse practitioners in the ED have limited patient history and are placed under time constraints. Improved education regarding pain management, clinical practice guidelines and the use of resource tools like the Prescription Drug Monitoring Programs (PDMP) have been proven effective for reducing opioid related complications (Greenwood-Ericksen et al.,

As the war on drugs continues, more and more lives are being lost to opiate overdoses. Opiates are drugs that contain or are derived from the opium poppy plant. They can be legally prescribed pain medications such as OxyContin or Vicodin or illegal street drugs such as heroin. Whether these drugs are used legally or illegally, there is always the chance of an overdose if not used correctly. According to a 2014 press release from the Center for Disease Control (CDC), “in 2013 more than 16,000 deaths in the United States involved prescription opioids, and more than 8,000 others were related to heroin.”

In my opinion use of opioids for a short term could have no pain effect. However, once the patient starts taking it over and over again, it becomes difficult for the dose to be effective. Furthermore, when a person uses opioids, they develop tolerance for it. According to a survey by the National Survey on Drug Use and Health (NSDUH), 50.5% people misuse opioids from friends and relatives, while around 22.1% of people are prescribed by their doctor. I also found that opioids has a higher dependence and this could lead someone to start with opioids and then getting used to the harder drugs like heroine. Around 44 people die everyday due to overdose. Overall, the no pain effect depends on the amount of dosage the person is