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Opioid Crisis | The Foremost Public Health Concern of the Decade?

By December 6, 2018 No Comments
The Opioid Crisis has escalated with more OUD's and overdoses than ever before.

Although the 2010’s have faced numerous public health and safety concerns such as the rising number mental health issues, mass shootings, and new disease outbreaks, these concerns pale in comparison to the rising opioid crisis. It’s time to raise awareness about the opioid crisis that has been developing in the U.S. since the ‘90’s. This article will explain the opioid crisis and what is being done about it.

The Mounting Opioid Crisis

In the late 1990’s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers. Because of that reassurance, healthcare providers began prescribing opioids at a significantly increased rate. Between 1999 and 2013, overdose deaths involving opioids quadrupled, with 8,200 people dying from an overdose in 2013. By 2015, the annual death toll from overdoses rose to 38,329, with over 30,000 of them being unintentional.1 In 2015 alone, 11.5 million people self-reported that they had personally misused opioid prescriptions, mostly to relieve physical pain.

Easy access to opioids exacerbates the opioid addiction problem as over 90% of opioids are obtained either through a friend or relative, or through prescriptions from a healthcare provider.2 As a result, nationwide opioid overdoses increased an average of 30% between July 2016 and September 2017. The Midwestern region saw opioid overdoses increase by 70% during the same time period.3

As the ever-rising opioid crisis escalates, the National Institute on Drug Abuse reports that in 2018, more than 115 Americans die from opioid overdose every day. The CDC’s estimates raise that number to as many as 142 deaths per day from overdose.4 That means 2018 could see as many as 51,000 deaths from overdose in one year. Yet doctors continue to prescribe opioids for chronic pain, even though 21-29% of patients misuse them.3

Opioid Crisis Solution

In response to the growing opioid crisis, the Department of Health and Human Services (HHS) recently awarded over $1 billion in grants to fight the crisis.5 The largest portion of this grant money was over $930 million, which the Substance Abuse and Mental Health Services Administration (SAMHSA) is distributing in opioid response grants to expand access to treatment for Opioid Use Disorder6 and fund recovery support services.

States that receive grant money (grantees) will be required to identify critical gaps in available treatment for people with Opioid Use Disorder (OUD). Grantees will then be required to utilize evidence-based strategies that will “rapidly and adequately address the gaps in their systems of care.” These adjustments are intended to help grantees deliver better medication-assisted treatment for people with OUD. The increased availability of medication-assisted treatment will help reduce opioid-related addiction and overdose deaths.7

3 Priorities to Combat Opioid Addiction Crisis

The HHS has outlined 3 essential tasks that will reduce opioid-related addiction and overdose deaths.8

1.) Improve Opioid Prescribing Practices

By improving opioid prescribing practices, healthcare providers may be able to reduce opioid use disorders (OUD) and overdose. Amid this opioid crisis, we shouldn’t forget that opioid pain relievers may still be beneficial for some patients. However, opioid prescribing practices need to be improved to avoid unnecessary prescriptions and addiction.

2.) Expanded Use of Naxolone

According to the CDC, Naxolone is a non-addictive, life-saving drug that can reverse the effects of an opioid overdose when administered in time.9 People will usually die with 1-3 hours of an opioid overdose.10 By equipping all first responders with Naxolone, we may be able to stop opioid-overdose deaths. Naxolone reversed at least 26,500 overdoses between 1996 and 2014 because it was administered quickly.11

3.) Expand Availability of Medication-Assisted Treatment

Medication-assisted treatments reduce OUD and help people recover from addiction before they accidentally overdose. Once people are relieved from their addiction, their decision-making ability improves, and they can seek better methods of pain relief.

With the new grants in place to fight the opioid crisis and support these three primary tasks, we should see improved healthcare in terms of opioid prescribing practices and emergency Naxolone treatments in overdose situations within the next couple years.

Research is underway for alternative pain-management medications that can replace opioid prescriptions.12 The goal of that research is to enable people to receive medication-assisted treatment and replace their opioid prescriptions with a non-addictive painkiller. This will also reduce relapse rates and accidental overdoses.

Medication-Assisted Treatment for Opioid Addiction in Washington

As the fight against the opioid crisis marches on, treatment strategies and facilities throughout the country will be improving within the next couple of years due to the additional funding from grants. Luckily, people in the Seattle, Washington area already have the option to receive top-tier medication-assisted treatment from Schick Shadel Hospital.

Schick Shadel Hospital is an addiction recovery hospital that successfully uses aversion therapy to treat addictions for opioids and oxycontin, heroin, alcohol, and other harmful substances. According to an independent study by the University of Washington, 69% of patients from Schick Shadel Hospital are still sober from their addiction 12 months after treatment.13

As we face the looming opioid crisis, we hope that the recent grants from SAMHSA will help the rest of the country catch up to the level of successful care that patients experience at Schick Shadel Hospital. As people understand more about opioids and their propensity to cause addiction, we hope that they will try to avoid using opioids in the first place.

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Citations

1 (2018). Samhsa.gov. Retrieved 5 December 2018, from https://www.samhsa.gov/sites/default/files/programs_campaigns/medication_assisted/mat-pdoa-fact-sheet.pdf

2 Module 5: Assessing and Addressing Opioid Use Disorder (OUD). (2018). Cdc.gov. Retrieved 5 December 2018, from https://www.cdc.gov/drugoverdose/training/oud/accessible/index.html

3 Opioid Overdose Crisis. (2018). Drugabuse.gov. Retrieved 5 December 2018, from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

4 (2018). Whitehouse.gov. Retrieved 5 December 2018, from https://www.whitehouse.gov/sites/whitehouse.gov/files/ondcp/commission-interim-report.pdf

5 HHS Awards Over $1 Billion to Combat the Opioid Crisis. (2018). HHS.gov. Retrieved 5 December 2018, from https://www.hhs.gov/about/news/2018/09/19/hhs-awards-over-1-billion-combat-opioid-crisis.html

6 Treatment of Opioid-Use Disorders | NEJM. (2018). New England Journal of Medicine. Retrieved 5 December 2018, from https://www.nejm.org/doi/full/10.1056/nejmra1604339

7 State Opioid Response Grants | SAMHSA – Substance Abuse and Mental Health Services Administration. (2018). Samhsa.gov. Retrieved 5 December 2018, from https://www.samhsa.gov/grants/grant-announcements/ti-18-015

8 (2018). Aspe.hhs.gov. Retrieved 5 December 2018, from https://aspe.hhs.gov/system/files/pdf/122101/es_OpioidInitiative_0.pdf

9 Reverse Overdose to Prevent Death | Drug Overdose | CDC Injury Center . (2018). Cdc.gov. Retrieved 5 December 2018, from https://www.cdc.gov/drugoverdose/prevention/reverse-od.html

10 Giglio, R., Li, G., & DiMaggio, C. (2015). Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis. Injury Epidemiology, 2(1). doi:10.1186/s40621-015-0041-8

11 Everyone Is Talking About Naloxone—But What Is It, Exactly?. (2018). Women’s Health. Retrieved 5 December 2018, from https://www.womenshealthmag.com/health/a19562876/what-is-naloxone/

12 Service, P. (2018). Nonaddictive drug compound could replace opioids for chronic pain sufferers – News – Purdue University. Purdue.edu. Retrieved 5 December 2018, from https://www.purdue.edu/newsroom/releases/2018/Q3/nonaddictive-drug-compound-could-replace-opioids-for-chronic-pain-sufferers.html

13 Elkins, R., Richards, T., Nielsen, R., Repass, R., Stahlbrandt, H., & Hoffman, H. (2017). The Neurobiological Mechanism of Chemical Aversion (Emetic) Therapy for Alcohol Use Disorder: An fMRI Study. Frontiers In Behavioral Neuroscience, 11. doi:10.3389/fnbeh.2017.00182

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