Opioid Epidemic: Exploring the Facts

The personal injury attorneys at McArdle Frost provide detailed, accurate and well-documented information about the dangers of opioid use.

Date: July 14, 2017
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That our nation is in the grips of an opioid epidemic is beyond dispute.[1]  According to the U.S. Department of Health and Human Services, more than 240 million prescriptions were written for prescription opioids in 2014, “enough to give every American adult their own bottle of pills.”[2]  A report published by the Center for Disease Control found that in 2014, over 60%[3] of drug overdose deaths involved opioids.  The statistics show that the problem is continuing to grow – drug overdose deaths increased by 11.4% from 2014 to 2015, and opioid deaths specifically increased by 15.6% during that time.[4]  Additionally, the Department of Health and Human Services reports that “four in five new heroin users started out by misusing prescription opioids.”[5]

In March of 2015, then Secretary of the Department of Health and Human Services, Slyvia Mathews Burwell, announced an initiative targeted at stemming the opioid crisis and saving the lives of opioid users, and specifically sought to improve troubling prescribing practices by physicians, who “are the gatekeepers for preventing inappropriate access and providing appropriate pain treatment.”[6]

What Are Opioids?

But what exactly are these drugs, and why is this problem on the rise?  Prescription opioids usually come in pill form, and are given to treat pain.[7]  They include prescription drugs like oxycodone (Percocet), hydrocodone (Vicodin), codeine, and fentanyl (Duragesic) among others.  Prescription opioids are similar to, and act on the same brain systems affected by, heroin and morphine, and because of this carry an inherent, intrinsic risk for abuse and addiction, even when prescribed by a doctor.[8]  Even patients taking prescription opioids exactly as prescribed can run the risk of developing an addiction.[9]

Opioids act by attaching specific proteins found in the brain, spinal cord and other organs of in the body, called opioid receptors, reducing the perception of pain and producing a sense of well-being.[10]  With repeated use, the body’s natural ability to produce endorphins is inhibited, resulting in withdrawal when the drug is discontinued.

How Strong Are Opioids?

The strength of some forms of these drugs can be startling.  For example, in May of 2017, a police officer in East Liverpool Ohio overdosed on fentanyl, a powerful synthetic opioid which is similar to morphine but between 50 to 100 times more potent,[11] when he “brushed fentanyl residue off his uniform” following a drug bust.[12]  In the wake of growing concern about the opioid epidemic, the New Hampshire State Police Forensic Lab released a photo comparing a lethal dose of heroin to a lethal dose of fentanyl:[13]

Opioid epidemic: deadly doses of heroin and fentanyl

Consider the Medical Use of Opioids

In the case of drug abuse, whether prescription or otherwise, efforts towards curbing the abuse must be tailored towards prevention and education of individuals who are at a risk of becoming addicted.  However, and as the Department of Health and Human Services states, prescribers are the gatekeepers who have the responsibility to ensure that patients are not obtaining inappropriate access to dangerous prescription drugs.[14]  Nonetheless, the CDC estimates that 1 out of every 5 patients with non-cancer pain or pain related diagnoses are prescribed opioids in office-based settings.[15]  While the CDC maintains guidelines for the prescribing of opioids for chronic pain,[16] it is becoming increasingly clear that some doctors are not following those guidelines.  For example, on March 15, 2017 a Boston doctor pled guilty to multiple counts of health care fraud linked to overprescribing opioid pain killers.  According to U.S. News & World Report, at one point the doctor wrote more prescriptions in one month – over 1,100 – than some of the largest hospitals in Massachusetts.[17]

With the severe risks that come with opioid use, even prescription opioid use, doctors must be cautious to ensure that their patients do not develop opioid dependence or addiction.  There in increasing evidence that abusers of prescription opioids are shifting to heroin use, as prescription drugs become less available or harder to use.[18]  This shift carries with it even greater dangers, because unlike prescription opioids, there is a lack of control of the purity of street drugs like heroin and increased risk that it has been contaminated with other drugs – often fentanyl.[19]

Because of the risks that come along with prescription opioid use and its addictive quality, the CDC recommends that health care providers use prescription monitoring programs to identify patients that might be misusing prescription drugs.[20]

Footnotes

[1] https://www.hhs.gov/opioids/about-the-epidemic/
[2] https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
[3] Suggested citation for this article: Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1.
[4] Suggested citation for this article: Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1.
[5] https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
[6] https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
[7] https://teens.drugabuse.gov/drug-facts/prescription-pain-medications-opioids
[8] https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
[9] https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
[10] https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
[11] https://www.drugabuse.gov/drugs-abuse/fentanyl
[12] http://www.cnn.com/2017/05/16/health/police-fentanyl-overdose-trnd/
[13] https://www.statnews.com/2016/09/29/fentanyl-heroin-photo-fatal-doses/
[14] https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf
[15] https://www.cdc.gov/drugoverdose/data/prescribing.html
[16] https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
[17] https://www.usnews.com/news/news/articles/2017-03-15/pain-doctor-expected-to-plead-guilty-to-health-care-fraud
[18] https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
[19] https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
[20] https://www.cdc.gov/vitalsigns/opioid-prescribing/

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