The opioid epidemic that has reached crisis proportions in the United States was caused by an unprecedented rise in the misuse of prescription opioid painkillers. But what constitutes misuse? How did we get to the point where legally-prescribed medications caused an epidemic of addition and overdoses? And how do we stop the public health crisis of opioid painkillers? In honor of Drug & Alcohol Facts Week, we look at all these issues below.
What are Prescription Opioids?
Opioids are a class of drugs that relax the body and relieve pain. They're naturally found in the opium poppy plant, but some prescription opioids are made from the chemical structure of the plant without using the plant itself. Prescription opioids are used mostly to manage moderate to severe pain, but are extremely addictive.
One of the main reasons for this addiction is that dopamine is released during opioid use: this hormone helps regulate reward-motivated behavior, the part of us that creates motivation by determining the desirability of a action's outcome. So opioids not only increase pleasure and relaxation, they also release the hormone that motivates you to keep trying to achieve that same pleasurable outcome.
While all forms of opioid abuse have risen in the past two decades, of concern in this article is largely the misuse of prescription opioids and their addictive qualities. Heroin, derived from opium, is also incredibly dangerous and addictive, and its rise in prominence is heavily connected to escalation from prescription opioid addictions, but it's also highly illegal. The opioids we're discussing are legally prescribed, and addictions to them often begin while people are recovering from injury or surgery, as well as suffering from chronic pain. They're even prescribed in long-term care settings like nursing homes.
Prescription opioids include:
- Hydrocodone (Vicodin)
- OxyCodone (OxyContin, Percoset)
- Morphine (Kadian, Avinza)
Opioids can make you feel relaxed and happy, but come with a host of potential, short-term side effects too, such as drowsiness, confusion, nausea, constipation, and slowed breathing. The effects of slowed breathing are particularly worrying, as this can cause hypoxia, a condition in which too little oxygen reaches the brain, possibly leading to comas, permanent brain damage, and death. This is one of the primary reasons for opioid-based overdose.
You can also easily build up a tolerance to prescription opioids, leading to requiring more of them for the same amount of pain relief, as well as misusing them for increased effect. This can also dovetail with withdrawal symptoms as an addiction forms, and these uncomfortable, painful symptoms are one of the reasons people find it difficult to stop opioid use.
What is Opioid Misuse?
Opioid misuse isn't just taking a prescription opioid for the high it provides. That's a common reason, but it also might involve taking someone else's prescription medication, or taking the medication in a way or dose other than prescribed. Sometimes this means altering the format or delivery of the medication, and sometimes it means taking more than prescribed.
Opioid Misuse: The Statistics
The numbers surrounded the opioid epidemic display an unprecedented rise in the use of opioids as well as deaths from them:
- 10.3 million people misused prescription opioids in 2018.
- 2 million of these people misused them for the first time.
- 2 million people had an opioid use disorder in 2018.
- Over 130 people died every day during 2018 and 2019 from opioid-related drug overdoses.
The most concerning statistic might be a comparison over a longer timeline: the number of drug overdose deaths was four times higher in 2018 than in 1999, and nearly 70 percent of overdose deaths each year now involve opioids.
How Did This Happen?
The opioid epidemic is a problem that has been building since increased prescribing of opioids in the late 1990s, spurred by new developments in opioid pain relievers, particularly the approval of OxyContin in 1995. Since 1999, the quantity of prescription painkillers sold in the United States has nearly quadrupled as well as the quantity of prescriptions written, with a corresponding increase in addiction rates.
It's important to recognize that addiction to opioid pain relievers can happen to anyone who uses them, even in a medical setting. As many as 1 in 4 (25 percent) patients receiving long-term opioid therapy in a primary care setting struggles with addiction.
Naloxone to Reverse Overdoses
Many police forces, EMTs, and other emergency responders now regularly carry naloxone kits to refuse opioid overdoses. A medication that blocks the effects of opioids, naloxone may be delivered via nasal spray in humans and even police dogs. It is a non-selective, competitive antagonist to opioids, meaning that it attaches to multiple opioid receptors in the brain, which blocks them from accepting opioids. It often goes by the brand name Narcan, and can also be injected intravenously or into a muscle. Its effects begin within 2 to 5 minutes, and last between 30 and 60 minutes.
Overcoming the Opioid Epidemic
There's no easy way to combat drugs as addictive and widespread as opioids, which do have legitimate uses in pain management. At its base level it requires serious rethinking of how we manage pain in a medical setting. This work is already underway, especially since the United States Department of Health and Human Services (HHS) declared the opioid epidemic a public health emergency in 2017. By 2018, prescription opioid-related deaths had fallen 13.5 percent.
Pain management is a complicated and often gradual process that should not be left solely to medications as addictive and powerful as opioid pain relievers. Non-habit forming analgesics are potentially a key component in pain management's future, and our own Mountain Ice Pain Relief Gel could be crucial for many people suffering from pain.
Trials in nursing home settings have shown Mountain Ice has a 50 percent effectiveness rate in helping to transition chronic pain patients off opioid analgesics. Its unique blend of rich ingredients is formulated to relieve pain, reduce inflammation, improve circulation and promote better muscle and joint healing. Mountain Ice is safe, effective, and non-habit forming. For relief of chronic pain from inflammatory, autoimmune, or nervous system disorders, consider Mountain Ice!