Drivers of opioid epidemic in United States

Drivers of opioid epidemic in United States

The entire United States is suffering from a severe opioid epidemic. President Barack Obama has tried to address America’s one of the biggest crises from various public platforms, the most recent being an official statement wherein the federal government proposes nearly $1.1 billion fund to deal with the prescription opioid abuse and heroin use epidemic. Even in his last State of the Union address in January 2016, Obama had pledged to bring reforms in the lives of the people battling prescription drug and heroin abuse.

According to the Morbidity and Mortality Weekly Report (MMWR) 2000-2014, prepared by Centers for Disease Control and Prevention (CDC), the rate of drug overdose deaths has increased 137 percent since 2000. There has also been a 200 percent increase in the deaths caused by opioids, which includes pain relievers and heroin. There were 47,055 drug overdose deaths which occurred in 2014, representing an annual increase of 6.5 percent, or 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014.

Opioids: An insight to the cause

Opioids seem to be one of the main causes of drug overdose deaths. There are multiple drivers to the problem – over-prescribing of clinical drugs, lack of oversight towards inappropriate prescriptions, insurance benefits and a mass belief that prescription drugs are harmless.

Prescribing trends: One of the biggest causes for opioid mortality is the increase in opioid analgesic prescribing, especially as pain relievers. Apart from increase in opioid prescriptions, the day’s supply of the opioid, the cumulative doses to be consumed and amount of opioid to be taken has also increased. A study highlighted in the 2012 report “Addressing Prescription Drug Abuse in the United States” by the U.S. Department of Health and Human Services (HSS) examined that the average amount of opioid per prescription, in morphine milligram equivalents, increased 69.7 percent for oxycodone, 69.4 percent for hydrocodone, and 20.9 percent for fentanyl nationally between 2000 and 2009.

Prescribing in high volumes:  There have been multiple studies that show that a high volume of prescriptions are given suggesting opioids, actually by a small percentage of prescribers. The report stated above also highlighted that in 2009, it was the top 20 percent prescribers who were responsible for 82 percent of controlled substance prescriptions in Kentucky.

General prescriptions of opioids: The majority of opioid pain relievers in the U.S. are in fact prescribed by general physicians and interns who do not have specific training in pain management and addiction. Moreover, new formulations, information and guidelines for opioid management and doses structure have only emerged in the last few years. However, some physicians do not follow risk mitigation strategies even if they are aware of the risks involved with high dosage of opioids.

Pain clinics: Pain clinics or ‘pill mills’ are one of the cohesive contributors of opioid prescribers. These pain clinics conduct only cursory examination of patients, thus prescribing large quantities of opioids. They were more of cash establishments rather than an effective treatment center.

Emergency wards of hospitals: The HSS report states that around 10 percent of opioid analgesic prescriptions are written in the emergency departments of the hospitals for patients in 20-39 age group. In fact, the report also confirmed that 13 percent of patients entering treatment for opioid abuse have cited emergency departments as the source of drugs.

Pharmacies: Prescription drugs have been frequently taken by patients at a later stage without prescriptions. Some pharmacies do not dispense it to the patients, but most of them do. Moreover, there have been instances where many pharmacies have been involved in illegal opioids distribution. The majorities of pharmacists, however, are attempting to practice appropriately, but may not have complete information to identify illegal or problem prescribing a medicine or a certified doctor or a clinic.

Insurance: Some insurance policies cover opioids like methadone, and do not cover non-opioid medicines. Some do not even reimburse for undergoing screenings and risk mitigation activities or for that matter, non-pharmacological therapies. Such policies also provide a window for increasing opioid abuse.

The problem of opioid abuse and overdose is complex. On the one hand, the unchecked issuance of prescriptions should be mitigated, on the other hand, there should be alternate medicines which work to relieve pain. An effective strategy that addresses all the drivers of the problem should be underlined with the combined effort of public health, clinical medicine, public safety, and other stakeholders. There should be a balance between patients’ needs, medicines prescribed, treatment provided accounting the risks involved as well.

If you or your loved one is undergoing an opioid abuse, seek the help of an expert medical practitioner immediately. Florida Prescription Drug Addiction Helpline can help you find the best and most effective treatment depending on what suits you best. You can call anytime at 866-292-3211 to take the first step towards a brighter, abuse-free future.

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