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Monday, Oct. 10, 2016

OPIATE ADDICTION

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Overdose deaths on the rise 

Long debated and ever evolving, the issue of opiate abuse and addiction continues to affect millions of Americans and the families, friends and communities around them.

Alarmingly, drug overdoses are the leading cause of accidental deaths, according to the American Society of Addiction Medicine with more than 47,000 overdose deaths in 2014, which was the highest number of deaths than any other year on record. Opiate overdose is a significant factor contributing to these deaths with nearly 19,000 deaths related to prescription pain relievers and more than 10,500 deaths related to heroin overdoses in 2014. Seventy-eight Americans die every day from an opioid overdose, and the U.S. Department of Health and Human Services has issued a public health alert due to the overdose epidemic.

Prescription pain relievers are the leading reason for an increase in opioid overdose deaths over the last 15 years, which nearly quadrupled in a study released by the Centers for Disease Control and Prevention.

The classification of opioids is an umbrella category that includes both illicit and legal drugs; heroin is alongside commonly prescribed medications such as oxycodone, hydrocodone, codeine, morphine, fentanyl and others. Methadone, oxycodone and hydrocodone are the three most associated with overdose death. ASAM reports that in 2012, 259 million prescriptions were written for these types of medication. While there may be some thinking that there is a discrepancy between heroin addiction and prescription pain reliever addiction, the two are related by more than just classification. Four out of five new heroin users began by abusing prescription painkillers. The change in substance use is often reasoned by the expense and difficulty to obtain prescription pills.

Heroin use has been an ongoing issue for Americans for years, but in recent years and even recent months the devastating effects have been a forefront topic for politics and media. In early September of this year, an East Liverpool, Ohio, police officer shared a photo of two individuals unconscious from an opioid overdose with a small child in the backseat. The photo and story received national attention, reinvigorating the conversation of opiate addiction in the country. The EMT’s at the scene administered Narcan, an opioid antagonist medication used to reverse the effects of opioid overdose. Narcan training is now b e i n g pushed as a top priority for first responders and those who deal with individuals struggling with opiate addiction in order to save more lives. While the drug itself, as well as its use, is not a new tool in fighting the effects of opioid overdose, the frequency has increased as overdoses continue to rise.

Between 2002 and 2013, heroin use increased with users aged 18-25, according to the CDC. A number of factors contributed to this trend including the availability and potency. Additionally, there has been an increase in use, as well as in overdoses, in synthetic opioids such as with illegally made fentanyl. It can often be mixed with heroin or cocaine, and even be done so without the consumer’s knowledge. Pharmaceutical fentanyl is 50 to 100 times more potent than morphine, and used for severe pain, more commonly with cancer patients. The danger, however, is with the illegally made and sold fentanyl, which contributed to 5,500 overdose deaths related to synthetic opioids in 2014.

The challenges for fighting opiate addiction in America are complex and multifaceted. As the influx of availability and increased potency for illicit opiates exists, the continued abuse of prescription painkillers remains. There are many clinics and programs that offer treatment with a varying use of medication and therapy. Antagonist medications work to prevent opioids from activating receptors used to treat overdose and addiction, as the National Institute on Drug Abuse explains. Synthetic opioid agonists such as Methadone work to fight withdrawal and cravings, and have been around for more than 40 years used through opioid treatment clinics. The search for solutions continues with harmreduction strategies such as clean needle exchanges and opioid maintenance treatment with the above mentioned medications, but what remains key is prevention.

Educating both the public and, specifically, adolescents and young adults opens the way for communication, awareness and understanding on the devastating effects of opiate addiction. Resources for parents, caregivers, community leaders and school officials are available with many organizations such as the HHS, CDC and ASAM.

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