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Ultimate Guide to Ending America’s Opiate Crisis

The current opiate crisis in America is extremely shocking. It is known as the deadliest drug overdose epidemic in history. Only in 2016, there were up to 63,600 deaths caused by overdoses, more than the whole Vietnam War, gun violence, HIV/AIDS, and vehicle crashes in a single year [1].

But up to now, there hasn’t been enough policy action from the government to end this crisis.

Most preventive measures focused on keeping fentanyl and heroin from coming into the country and lowering the consumption of prescription painkillers.

The most important bill introduced by Congress during this time saved around $1 billion in drug treatments. However, this number was far from the economic burden of the opioid epidemic, which would be up to $80 billion [2].

If the opiate crisis keeps growing quickly at the current rate, it is estimated that up to 650,000 people will die of overdoses in the next decade [3].

So what should we do to deal with this stubborn and complicated crisis?

How can we end the existing epidemic and prevent the occurrence of another one in the future?

Read on to find the answers.

OVERVIEW OF AMERICA’S OPIATE CRISIS

Before deepening into the possible solutions for the epidemic, it’s necessary to take a look at its causes and current problems.

The opiated crisis in the United States started in the 90s when healthcare providers had to deal with many hard-to-treat pain patients.

To make use of this golden opportunity, many pharmaceutical firms attempted to encourage doctors to prescribe opioids for treating all forms of pain through misleading promotion about the efficacy and safety of these drugs [4].

The use of opioids grew exponentially, making the US become the leader in this drug prescription.

There are many factors leading to this crisis.

Firstly, pharmaceutical firms wanted to maximize their profits by promoting these drugs even when studies showed that the risks of opioids for chronic pain outweigh their benefits in most cases [5]. These marketing campaigns convince many healthcare providers and patients.

Due to increasing pressure from medical organizations, government agencies, and advocacy groups, doctors had to treat patients efficiently and quickly.

As a result, they tended to prescribe too many drugs to make sure patients can be out timely. These prescriptions left plenty of extra pills since most doctors wanted to avoid complaints from their patients.

Over time, patients gradually moved to more potent forms of opioids, such as heroin and fentanyl. The mean reason was that they didn’t have access to painkillers from their doctors or just wanted to look for a stronger feeling.

Compared to painkillers, these new drugs posed even more serious risks as they are more potent and addictive.

By that time, the epidemic started to affect various age groups and regions. While prescription opioids mostly hit middle-aged and older people, fentanyl and heroin tended to afflict younger people between 20s and 30s [6].

The crisis also hit the Midwest and Northeast, especially in Pennsylvania, New Hampshire, Ohio, and West Virginia.

The opioid crisis is now a complicated problem for the US. It would lead to many issues than death, from posing huge financial burdens to impeding social functions.

That’s why preventive measures should be taken seriously to stop it.

Here are 4 possible solutions that we might need to stop the existing opioid epidemic.

PREVENT OPIOID AND DRUG MISUSE

In 2015, the number of prescribed opioids was so much that it would be sufficient for every people in the US to take for 3 weeks, according to a report of the CDC [7].

This surge of painkillers is the main cause of the existing drug epidemic, and one of the most important things that the government needs to resolve to stop it from worsening.

While different levels of authority have introduced many new laws and regulations to prevent the over-prescription of opioids, these policies aren’t so effective.

Some states limited the amount of opioids healthcare providers would prescribe [8]. The federal government also put some drugs on a stricter and more restrictive regulatory schedule [9].

The initial results are positive as opioid prescriptions have decreased since 2010 [10]. However, there are still many things to be done.

The amount of drugs prescribed to each person is still high and alarming. Given that, we need even stricter measures to end the misuse of drugs in hospitals and healthcare centres.

A possible solution is that the FDA should implement a comprehensive review of painkillers already on the market and improve the post-approval oversight.

Also, the agency should consider the potential effects of yanking drugs from those who really need them.

Measures to end this crisis include the implementation of Risk Evaluation and Mitigation Strategies [11], regular formal re-evaluation of painkiller approval decisions, close surveillance of the misuse and use of approved drugs, as well as careful regulation of promotion and advertising to reduce their harmful effects.

Of course, healthcare providers should have the right to prescribe opioids to those who truly need them. However, they need to do this after some basic checks to find out if the patients are drug addicts.

The key is to prevent those doctors who ignore these steps from over-prescribe, thus stopping a new generation of people with opioid addiction.

However, there are some limits to this solution. It can be dangerous to prevent those people from getting opioids. These are often the only source of pain relief for many patients.

Thus, a sudden stop from high doses would make them go through painful periods. More dangerously, many of them seek help from other illegal drugs, such as fentanyl and heroin, which are more harmful and would result in worse complications.

That’s why it is a serious mistake to focus only on decrease prescriptions. Instead, we need to find some easier alternatives to help patients relieve and go through pain.

FACILITATE ADDICTION TREATMENT

A major issue with the opioid crisis is that getting high is much simpler than getting help. Thus, a possible solution is to make addiction treatment easier to access than heroines or opioids.

Take how New York coped with cigarettes for example. The local government follow a 2-prong approach.

First, it banned smoking in public areas and raised taxes to make tobacco products much costlier. At the same time, the city also opened a phone line to help people get medical support or alternatives to cigarettes [12]. This is what we would do with the current drug crisis.

Until now, the government has attempted to prevent the overuse of opioids. However, it hasn’t done much to introduce accessible alternatives to patients.

According to a report in 2016 by the Surgeon General, only 10% of people in the US with drug addiction obtained speciality treatment [13]. This is mainly caused by a severe lack of healthcare supply in many regions, which results in long waiting periods.

Though Congress has decided to spend $1 billion in the 21st Century Cures Act [14], this amount of money isn’t enough to resolve the crisis fully.

It is estimated that the total economic cost of the epidemic is nearly $80 billion [2]. And around 30% of which comes from drug treatment and health care expenses.

So, the solution here is that the government should spend more on treatment options with strong evidence.

For drug addiction, this means medication-assisted treatment, which use medications, particularly buprenorphine and methadone to deal with opioid addiction.

However, there is still a widespread stigma against this alternative. Many people believe that replacing one opioid for others isn’t so effective. However, they might misunderstand how addictive behaviours work.

The danger doesn’t come from using opioids. Instead, drug use only transforms into addiction when regular use starts hurting your function. Though medication-assisted treatment involves on-going drug use, it would turn that routine into a much safer habit.

Alternative medications would eliminate your opioid cravings and some common withdrawal signs without euphoric high as other painkillers or illegal drugs.

Indeed, many studies have proved the effectiveness of this method in treating drug addiction [15] [16] [17]. Research also suggests that it would reduce mortality rates in drug addiction patients by more than 50%.

Even the World Health Organization and CDC also acknowledge the medical values of medication-assisted treatment [18] [19].

For these reasons, it is necessary to invest more money so that everyone can get easier access to this evidence-based treatment. The key is to attract more experienced doctor and create more facilities for addiction care.

MAKE DRUGS LESS DANGEROUS

An unhappy thing about opioids is that its addiction is stubborn. Even when the government does everything to prevent and treat this condition, patients will still be addicted again.

Thus, in addition to preventing and stopping the use of these harmful drugs, we also need to minimize their dangers.

The prescription of heroin can be a typical example. No matter which treatments are used, addictive people will use heroin for relief.

This, it is better to provide them with a safer source of drugs and safer places to inject them instead of letting them do these things on the street and get overdose with no medical supervision.

To back up this idea, we can see positive results from the prescription heroin campaigns in Europe [20].

These include better health conditions, social functioning improvements, and reduction in drug-related crimes.

Some other trials from other countries, such as Germany, Spain, the Netherlands, the UK, and Switzerland also come to similar conclusions.

There are many things that we can do to minimize the effects of illicit drugs. For instance, a needle exchange program would allow people to change used for new syringes, thus reducing the risks of carrying hepatitis C, HIV, or other infections.

Supervised injection centres should provide a place for these patients to inject illicit drugs, with the supervision of medical employees.

Naloxone, an antidote for opioid overdose, should also be made more accessible to patients, friends, and family [21]. In heavily affected regions, it is a good idea to have them in public streets. With more funding, naloxone would be free or affordable for everyone, thus reducing the number of deaths caused by drug overdoses.

A major concern with this solution is that it would make more people rely on dangerous substances [22]. However, there isn’t so much evidence to back up this claim. Harm reduction programs won’t prevent all overdose deaths. However, they would reduce the risks and harmful effects of these drugs.

To some extent, addiction a terminal disease. Even when it doesn’t result in death, many people won’t get better. So, it is better to help them live more comfortably and longer by alleviating the harmful effects of these drugs.

TACKLING PROBLEMS THAT RESULT IN ADDICTION

When it comes to drug addiction, what we see isn’t always what we get. There are many problems behind drug use that might not seem related, which might be the main causes of the crisis.

Many experts agree that addiction would be triggered by a lot of psychological, environmental, and social issues. Anything in life that makes you feel miserable, anxious, or repressed would increase the risks of addiction for many obvious reasons.

This part of the epidemic requires much more attention to end the crisis completely. In addition to policies that directly deal with drug addiction and prevent opioid misuse, the government and social organizations should also address the underlying causes of these conditions.

From social isolation and economic changes to welfare policies, all of these decisions might play a key role in this process.

We have so many complicated problems in the US. Without really resolving all of these mental, emotional, as well as physical issues, just focusing on dealing with the opiated supply will make no sense at all since patients still experience these issues.

Several countries have introduced new policies based on this idea. For instance, Iceland proposed an anti-drug campaign which mostly focuses on creating after-school activities for children and teenagers [23] [24].

In addition, there were many other approaches to reduce drug addiction, such as limiting smoking and drinking ages, inhibiting cigarette and alcohol advertisements, setting curfews for teens, and encouraging parents to involve in their children’s schools.

All of these policies aimed at discouraging drug use. The results were positive with significant drops in drug consumption.

Approaches can vary. After all, Iceland is a quite homogeneous and small nation. Thus, effective policies there might not work in America. The same thing goes for different areas of the country. But the general idea is sound.

There is a variety of options to resolve the root causes of the opioid crisis. These include creating better job programs, developing better social safety net campaigns, providing better wraparound social policies, integrating mental services with others in the health care system, and more.

The key is to help communities re-establish families and give them meaningful work. Making them happy and relaxed will prevent these people from using drugs at a way of relieving.

In addition to addressing the root causes of opioid addiction, we also need to address chronic pain, which is the main reason why many people turn to painkillers in the first place. Part of this solution is to make some alternative pain treatment options more accessible to millions of people who are suffering from painful conditions.

Currently, there are many non-opioid options to deal with pain, such as meditation, acupuncture, physical exercises, non-opioid drugs, and self-manage techniques.

But to access those options, patients have to see the right doctors or healthcare providers to help them find a suitable treatment plan. Unfortunately, such specialists are too far away or too expensive for many people. This is also a reason why opioids and other painkillers became so popular.

It is much simpler to prescribe someone pills than to design a complex and expensive pain treatment plan. Addressing these issues will help us end the current opioid crisis in America.

If those ideas really work, they would take time and efforts. It requires years or even decades to rebuild communities and restructure the current health care system.

They are not something that we would do overnight. Addressing these root causes would also help us stop other epidemics in the future as well.

CONCLUSION

All of the solutions above are not new. Indeed, there is a lot of research that would back them up. This means that we know what to do to stop this opioid epidemic. However, we have not dedicated the needed resources to achieve this goal yet.

A possible explanation might come from the stigma around drug addiction. Though experts and doctors understand that it can be a serious disease, most people in the general public do not – and regard addiction as moral failures instead.

The best solution for this problem is probably to educate everyone on the basic reality of addiction and the reasons why it needs public attention. People need to know that this is beyond the individual’s control to some degree.

While this is still a long journey, the cooperation between academics, businesses, governments, and citizens will let more Americans have more productive, happier, and freer lives.

REFERENCES:

[1] https://www.cdc.gov/nchs/products/databriefs/db294.htm

[2] https://www.ncbi.nlm.nih.gov/pubmed/27623005

[3] https://www.statnews.com/2017/06/27/opioid-deaths-forecast/

[4] https://www.nytimes.com/2018/01/23/nyregion/nyc-de-blasio-opioid-lawsuit.html

[5] https://www.nejm.org/doi/full/10.1056/NEJMp1515917

[6] https://www.vox.com/science-and-health/2017/4/26/15389644/opioid-heroin-epidemic-startling-age-divide

[7] https://www.cdc.gov/vitalsigns/opioids/index.html

[8] https://www.ajmc.com/newsroom/nj-opioid-treatment-mandate-prescription-limit-heads-to-governor-christie

[9] https://www.dea.gov/press-releases/2014/08/21/dea-publish-final-rule-rescheduling-hydrocodone-combination-products

[10] https://www.cdc.gov/media/dpk/prescription-drug-overdose/opioid-prescribing/index.html

[11] https://www.fda.gov/drugs/drug-safety-and-availability/risk-evaluation-and-mitigation-strategies-rems

[12] https://www.nbcnewyork.com/blogs/go-healthy-ny/Ready-to-Quit-Smoking-NYC-Health-Dept-Is-Giving-Away-Nictoine-Patches-and-Gum-117647758.html

[13] https://addiction.surgeongeneral.gov

[14] https://docs.house.gov/billsthisweek/20161128/CPRT-114-HPRT-RU00-SAHR34.pdf

[15] https://www.ucsf.edu/news/2000/03/5047/methadone-maintenance-found-be-more-effective-treating-heroin-addicti

[16] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(79)91550-2/fulltext

[17] https://www.nih.gov/news-events/news-releases/painkiller-abuse-treated-sustained-buprenorphine/naloxone

[18] https://www.cdc.gov/hiv/risk/idu.html

[19] https://www.who.int/substance_abuse/activities/treatment_opioid_dependence/en/

[20] http://www.emcdda.europa.eu/news/2012_en

[21] https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio

[22] https://www.dfaf.org/international/pdfs/hrstatementbrussels.pdf

[23] https://ec.europa.eu/health/sites/health/files/alcohol/docs/ev_20180320_co08_en.pdf

[24] https://www.landlaeknir.is/servlet/file/store93/item10661/IAE_final2003.pdf

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