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Key Facets of Opioid Abuse in the U.S. | Jul 06, 2016

Key Facets of Opioid Abuse in the U.S. Opioid abuse in the U.S. is an increasing concern in the realm of public health. According to the Department of Health and Human Services, 44 people in the country die every day from a prescription drug overdose. More people died in 2014 from an overdose than any previous year on record, and about 60 percent of the incidents involved an opioid, the department reported.

As the government takes increasing action to stem this growing crisis, it is important for those entering the public health field to be familiar with the state of opioid abuse in the U.S.

Opioid abuse and public health

According to the National Institute of Drug Abuse, an opioid is a medication that is intended to relieve pain. This is accomplished by decreasing the effect of the stimulus that is causing the pain through interfering with the pain signals that are sent to the brain. Examples of common opioids include Percocet, Vicodin, OxyContin and other similar prescription medications. These drugs are often prescribed for patients dealing with pain following surgery or an injury.

Another common drug associated with the opioid epidemic is the illegal recreational drug heroin. This opioid, which is synthesized from morphine, is a highly addictive substance which can require increasingly high quantities to achieve the desired state of euphoria. The National Institute on Drug Abuse reported that an estimated 23 percent of those who use heroin become addicted to it.

Although heroin is a part of the opioid problem in the U.S., the high number of opioid overdoses is not purely the result of illegal substances. The Department of Health and Human Services reported that the abuse of prescription opioid pain relievers has in fact been a driving factor in the significant increase in overdoses that has been seen over the last 15 years. While Americans have not reported a significant change in the pain that they are experiencing between 1999 and 2014, the number of prescription opioids sold for pain during this period nearly quadrupled, according to the department. And as the amount of these drugs circulating has increased, so has the amount of abuse.

However, abusing prescription drugs is more than just a problem in and of itself. Often, abuse of these medications can also lead to harder drug use down the road, increasing the risk of overdose. According to the National Institute on Drug Abuse, about 50 percent of young people who inject heroin reported that they first abused prescription opioids.

A growing federal response

To address the growing abuse of opioids in the country, the U.S. government has been increasingly seeking to take legislative measures to both help those in the midst of an addiction and prevent future abuse. In May 2016, the House of Representatives passed a package of 18 bills toward end, including the Comprehensive Opioid Abuse Reduction Act of 2016. The bill, which has yet to be voted on by the Senate, creates a streamlined grant process to provide state, local and tribal governments with funds to combat opioid abuse, through actions such as:

  • Investigating instances of unlawful opioid distribution.
  • Creating, carrying out or increasing programs that prevent, treat or in another way respond to the opioid abuse crisis.
  • Improving collaboration between organizations fighting substance abuse and criminal justice groups.
  • Educating first responders in how to administer reversal drugs for opioid overdoses.

Members of congress acknowledged that the problem is multifaceted, and consequently will require a comprehensive response with many components.

“At its core, this problem is a public health crisis, not a law enforcement-centered issue,” Rep. Darin LaHood wrote in an article for The State Journal-Register. “Every puzzle piece must be in place to terminate this crisis. Treatment and rehabilitation are also essential, and that requires resources.”

Along with increasing funding at the state and local level, there is a strong push to increase patient education efforts to help combat overuse of prescription opioids. In a 2015 report before the House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations, Dr. Nora D. Volkow, the director of the National Institute on Drug Abuse, said that education initiatives, both in the community and school settings, have proven to be effective in decreasing abuse of prescription opioids.

But the patients themselves are not the only ones who can benefit from more education regarding opioid abuse. Increasing the knowledge of doctors and other health care professionals on the topic can also have an impact. Volkow reported that one way the NIDA is advancing these educational efforts is through four Centers of Excellence for Physician Information, which are meant to be national models for future endeavors. The centers seek to equip future physicians – such as residents and medical students – with additional knowledge of drug abuse and addiction that may not be covered in traditional health care curriculum. NIDA has also created two continuing education courses on the topic which can be completed online.

Sources:

https://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-opioids

http://www.hhs.gov/opioids/about-the-epidemic/

https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/what-federal-government-doing-to-combat-opioid-abuse-epidemic

http://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-031914-122957

http://www.sj-r.com/article/20160520/OPINION/160529967

https://www.statnews.com/2016/06/09/opioid-abuse-compassion/http://www.managedcaremag.com/news/new-guidelines-offer-six-ways-hospitals-can-stem-opioid-epidemic

https://www.drugabuse.gov/publications/drugfacts/heroin

https://www.drugabuse.gov/nidamed/centers-excellence/coe-overview