The United States is currently grappling with a crisis of opioid epidemic. In the the last 15 years alone prescriptions for opioid has quadrupled according to the center for disease control and prevention (CDC). The current statistics in the national institute on drug abuse (NIDA) indicate that 115 people die daily. Over 42, 200 deaths were recorded in 2016 across the country through overdose on opioids begging the question, is the country getting more sicker or the policies around drug prescription has weakened ? In 2016, oversubscription of postsurgical opioid led to over 3.3 billion unused pills finding way to communities enabling diversion and misuse of the drugs. In the same year through 2017 there was a 30% increase on overdose cases across the 45 states (Vivolo, K. et al 2016). Opioid addiction is a great health concern that needs to be addressed by all stakeholders who include policy makers, addicts/patients using pain medication, health workers/professionals, and community members like you and me.
Opioid and side effects : Opioid is a synthetic or natural agent that help stimulate the opioid receptors in the brain with an aim to achieve either or all the three effects
Increased feelings of pleasure and relaxation.
Decreased automatic processes such as breathing.
There are legal prescriptions such as oxycodone, hydrocodone, codeine, morphine and many others that can be accessed through medical procedures. On the other hand there are illegal drugs such as heroine that are cheap and easily accessible that serves as a landing pad for those already addicted to opioid and cannot access them through prescriptions. According to American society of addiction (ASA), 4 out of 5 heroin addicts started off with prescription drugs. Most patients using prescription drugs containing opioids, do so in order to reduce pain resulting from medical procedures such as broken bones, and cancer. These processes may come with are several side effects such as
Increased sensitivity to pain.
Decreased levels of testosterone that may drastically lower libido.
Addressing the opioid crisis : There are numerous proposals that have been made by the foods and drugs administration FDA (2016) which include
Balancing the individual and societal risks through developing a regulatory framework to review, approve and monitor an individual need for pain control in relation to the broader public health consequences of abuse and misuse.
Re-examination on labelling and post market research to ensure strict detailed instructions description on their associated risks, and emphasis on limiting the quantity.
Deterring of abuse and developing a countermeasure such as naloxone that can help reverse overdose.
Developing addiction and overdose-reversal tools may be the most ambitious solution for this crisis but one psychology professor alludes that if people can be scared enough about the crisis and be convinced that drugs cause addiction we may begin to register fundamental changes on drugs intake attitude.
Addiction does not discriminate among socioeconomic and ethnic groups. In some instances, drug use and abuse can be a way to fit in or bond with. However this does not justify addiction. We all must embrace a concerted efforts in reshaping and changing the cultural norms that have over the years permeated the escalation of drug and alcohol abuse in our societies. There are three factors, namely drug, set and setting according to Zinberg that can be used to explain the patterns and consequences of drug use. According to this framework, drug refers to the pharmacological properties of a drug, set refers to the characteristics of the person using the drug, and setting refers to aspects of the social and physical environment in which the drug is consumed. Through understanding this framework we should be able to safely navigate through this crisis.
What do we do as a community ? Opioid abuse upsurge in the country is perceived to be driven by economic and social despair. We see around our communities over the years how economic opportunities for those with no college degrees have decreased. We have also seen family structures which ought to give social support disintegrate and safety nets for those struggling broken yet the cost of life and economical demands continue to go up. Various social and economical demands have put many people on the crossroads increasing confusion and pain thus underlying the upward trends on opioid abuse. According to CDC, using opioid while taking alcohol and other medication may lead to overdose which is the key contributing factor to the current mortality rates. Solution proposal for the opioid crisis from the community health perspective needs to start with
Identifying the underlying social and economic factors driving the upsurge.
Address them on three levels (1). Though strengthening social family support so as to reduce stigma and promote strong link with the law enforcement and health providers, (2). Ensure that both the manufacturers and distributors who include those healthcare workers giving descriptions follow the laid down procedures through the chain, and (3) Improve access on both prevention, treatment and support system levels.
Increase primary prevention through education as well as providing more economical opportunities and safety nets to those on the low end of education.
Increase well informed social service providers.
Strengthen and update social and economic policies.
We all must be on board for any meaningful change to take place.
Califf, Robert M., et al. “A Proactive Response to Prescription Opioid Abuse.” New England Journal of Medicine, vol. 374, no. 15, 2016, pp. 1480–1485., doi:10.1056/nejmsr1601307.
Vivolo-Kantor, Alana M., et al. “Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 2017.” MMWR. Morbidity and Mortality Weekly Report, vol. 67, no. 9, Sept. 2018, pp. 279–285., doi:10.15585/mmwr.mm6709e1.