The Opioid Crisis in America

TW: Drugs

Drug overdose is now the leading cause of death in the United States - opioid addiction is driving these deaths. With the opioid crisis significantly escalating these past few years, I thought it would be a good idea to give you guys some statistics about the opioid crisis, how it intensified, and what the government is doing to prevent more opioid-related deaths.

Background info/statistics about the opioid crisis:

More than 450,000 Americans have died from an opioid overdose since 1999. 2018 data shows that, every day, 128 people die in the United States after overdosing on opioids. Drug overdoses are now the leading cause of death for people under the age of 55. Young adults (ages 18 to 25) are the biggest abusers of prescription opioid pain relievers, ADHD stimulants, and anti-anxiety drugs. One of the reasons for this abuse could be that adolescents are prescribed higher number of opioids, doubling from the 1990's. Women aged 40-59 are prescribed more opioids than any other age group and receive twice as many opioid prescriptions as their male counterparts. Between 2005 and 2014, hospitalizations increased related to opioid pain relievers increased: a 75% increase in women and a 55% increase in men.

How did this happen?

In the late 1990s, pharmaceutical companies and medical societies reassured patients and doctors that that risk of opioid addiction is very low, and more healthcare providers began to prescribe them at greater rates. This mass prescription led to the widespread misuse of these medications before it became clear that they can become highly addictive. Opioid overdose rates began to increase. In fact, in 2017, more than 47,000 Americans died as a result of opioid overdose, including prescription opioids, heroin, and illegally manufactured fentanyl, a powerful synthetic opioid.

Specifically, new prescription opioids were marketed more aggressively in white rural areas, where pain drug prescriptions were already high. According to the Kaiser Family Foundation, in 2018, 35,363 white people had died due to opioid overdoses compared to 6,088 black people and 4,370 hispanic people. Some researchers think African-Americans did not get as affected as the white population did in the initial years of the opioid crisis because they received fewer opioid prescriptions. Doctors believed that black people had a higher pain threshold than white people because they were biologically different. I touch more on this in my article about medical racism, which I will link here: https://sciforthought.blogspot.com/2020/07/medical-racism-history-behind-it-and.html. Because African-Americans were less likely to receive these prescriptions, they were less likely to become addicted.

However, the opioid crisis is getting worse, particularly for African-Americans and Native Americans, as seen in the graph below.

What are people trying to do about this?

In an effort to reduce the risk of opioid addiction and maximize the benefits of additional pain treatment options, the US Centers for Disease Control and Prevention (CDC) have issued a series of comprehensive guidelines for prescribing opioids for chronic pain outside of cancer treatment, palliative care, and end-of-life care. These recommendations say non-opioid treatments are the preferred first step for treatment of chronic pain, and opioid medications should only be added after careful assessment of pain control followed by regular evaluations of need.

Opposition to changing opioid prescribing patterns:

Attempts to change opioid prescribing patterns have been opposed primarily by the pharmaceutical industry through lobbying and advocacy groups. These efforts include not following the CDC's guidelines, attempting to halt measures to restrict opioid overprescribing, and blocking endeavors to hold prescribers and pharmaceutical companies accountable. More than 2,500 physicians have received at least half a million dollars apiece from drugmakers and medical device companies in the last five years. More than half of these doctors received at least 1 million dollars.

What can we as patients do to prevent opioid addiction?

Patients can take steps to ensure that they use prescription medications properly by:

Following the directions as labeled
Being aware of potential interactions with other drugs such as alcohol
Never stopping or changing dosage without consent from a doctor
Never using another person's prescription and never giving your medication to others
Informing healthcare professionals about all the prescriptions and over-the-counter medicines they take before obtaining other medicines

Sources:

1.https://www.cdc.gov/drugoverdose/epidemic/index.html

2. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

3. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented

3. https://www.nytimes.com/2019/11/25/upshot/opioid-epidemic-blacks.html

4. https://www.drugpolicy.org/issues/drug-overdose

5. https://www.drugabuse.gov/drug-topics/trends-statistics/infographics/abuse-prescription-rx-drugs-affects-young-adults-most

6. https://www.cdc.gov/nchs/products/databriefs/db369.htm

7. https://www.womenshealth.gov/files/documents/final-report-opioid-508.pdf

8. https://heal.nih.gov/about/research-plan

9. https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-raceethnicity/?dataView=0&currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

10. https://www.cdc.gov/drugoverdose/prescribing/guideline.html