(Tiny Tips) – The country is in the midst of an unprecedented opioid epidemic. According to the Centers for Disease Control and Prevention (CDC), more than 80,000 people died from opioid overdoses in 2021. That’s 220 people per day.
Opioids are a class of drugs that include prescription painkillers such as oxycodone (Oxycontin), hydrocodone, codeine, and morphine (OMS). Heroin; and synthetic opioids such as fentanyl (Actiq).
The crisis began in the 1990s, when pharmaceutical companies widely marketed prescription opioids to doctors to help patients relieve pain associated with surgery, chronic back pain or toothache. Pharmaceutical companies have also assured health care providers that patients will not become addicted to painkillers. This led to widespread use of highly addictive drugs, and statistics show that opioid overdoses began to increase.
The CDC reports that drug overdose deaths have increased more than sixfold since 1999. This is primarily due to opioid use. From 1999 to 2021, nearly 650,000 people died from opioid-related overdoses. Opioids accounted for three-quarters of overdose deaths in 2021.
According to an article published in the American Journal of Public Health, OxyContin’s manufacturer, Purdue Pharma, took an aggressive approach to marketing the drug to doctors, including offering sales representatives a generous bonus system to increase OxyContin’s Kangding sales. Purdue Pharma targeted doctors who prescribed the drug more frequently than others and dramatically misrepresented OxyContin’s addiction risks. Pamphlets and tapes sent to doctors said the risk of addiction was extremely low. Doctors began prescribing opioids more frequently, leading to increased abuse of these highly addictive drugs.
According to the CDC, nearly 280,000 Americans died from prescription opioid overdoses between 1999 and 2021. Research shows that opioid use disorder may lead people to turn to more powerful illicit drugs such as heroin.
As a result, opioid overdoses have risen dramatically in recent years. According to the Centers for Disease Control and Prevention (CDC), 247,000 Americans died from prescription opioid overdoses between 1999 and 2019.
Who is most at risk for opioid use disorder?
Opioid addiction can affect anyone regardless of age, race or socioeconomic background.
However, some groups are at higher risk than others for developing opioid use disorder. This includes people who:
- Younger, especially those in their teens and early twenties
- You have a personal or family history of substance abuse
- You live in a stressful environment, such as because you are unemployed or live below the poverty line
- Have had legal problems in the past
- Regular contact with drug addicts or exposure to drug abuse
- You have a history of mental health problems such as depression, anxiety, or post-traumatic stress disorder (PTSD).
- Prone to risky behavior
- Smoke regularly
Common Questions & Answers
How big is the opioid epidemic?
The opioid epidemic is a national health crisis affecting hundreds of thousands of Americans. Approximately 21% to 29% of patients taking opioids for chronic pain abuse these drugs, and an estimated 4% to 6% of these patients switch to heroin. According to the CDC, nearly 280,000 Americans died from prescription opioid overdoses between 1999 and 2021.
Who is most at risk for opioid use disorder?
Opioid addiction can affect anyone of any age. Still, if someone is in their teens or early twenties, has a history of substance abuse, has legal problems, is unemployed or living in poverty, has a history of severe depression or anxiety, or engages in risky behaviors like excessive smoking.
How can I tell if a loved one is addicted to opioids?
People who are addicted to opioids may feel like they need the medication every day or several times a day. Having a strong urge to use the drug to block other thoughts; taking large amounts of the drug for longer than expected; borrowing drugs from others; and over time, you will need more of the drug to achieve the same effect. Failure to perform work obligations; and engaging in dangerous behavior.
What’s the best way to treat opioid use disorder?
Many health care providers recommend a combination of therapy and medications to treat opioid use disorder. This approach may also include counseling through community support groups and family members, as well as hospitalization or inpatient treatment if necessary. This “whole patient” approach increases the likelihood of successful recovery.
Symptoms of Opioid Use Disorder
It is important to be aware of the signs of opioid addiction in order to identify the problem in yourself or a loved one.
People addicted to drugs can:
- They feel they need to take medication regularly, daily or even several times a day
- Having a strong craving for the drug that blocks all other thoughts
- Take medications “just in case” even if there is no medical need
- Taking large amounts of medication and taking it for a longer period of time than expected
- Borrowing medication from others or “losing” medication, requiring more prescriptions to be filled
- Get prescriptions from multiple doctors to get a “backup supply.”
- Even if you can’t afford it, you still have to spend a lot of money to buy medicine.
- To achieve the same effect over time, a larger amount of drug is needed
- Failure to fulfill work obligations
- Reduce social or recreational activities related to drug use
- Experience changes in sleep patterns
- Continue using drugs even if it causes life problems or physical or psychological harm
- To get drugs, they will do things they wouldn’t normally do, like steal
- Driving or engaging in other dangerous behavior while under the influence of drugs
- Failed attempts to stop taking drugs
Treatment options for opioid use disorder
There are many options for treating opioid use disorder. According to the American Society of Addiction Medicine (ASAM), a combination of medication, counseling, and behavioral therapy is the best strategy for most people. This is called medication-assisted treatment (MAT).
Medications include methadone (Dolophin) and buprenorphine (Subutex), which can relieve withdrawal symptoms and food cravings. They act on the same targets in the brain as other opioids, but don’t make people who take them feel high. Naltrexone (Vivitrol) is another option that works differently than methadone and buprenorphine. It does not help with withdrawal symptoms and cravings, but it can relieve the rush you often feel when taking opioids.
According to ASAM, MAT has no fixed duration. Everyone reacts differently, but these medications can be taken safely for many years.
ASAM cites research showing that medications to treat opioid use disorder can reduce the risk of overdose and death. But not everyone who could benefit from MAT can get it. The use of these drugs must be closely monitored and only certain doctors can prescribe them. Some people also have the misconception that taking these drugs is simply exchanging one addictive substance for another. According to the National Institute on Drug Abuse, this is not the case.
Counseling Discussing addiction issues with a qualified professional can be very helpful in the treatment process. Counseling can include individual, group, and family counseling and often includes a combination of these interventions and medications. In more severe cases, outpatient/hospital treatment is recommended.
Cognitive Behavioral Therapy Cognitive behavioral therapy, also known as CBT, is an example of an individual talk therapy that helps patients identify and stop negative thoughts and behavior patterns that may lead to opioid use.
Peer Support Groups For example, community groups that meet regularly, such as Narcotics Anonymous or 12-step programs like Drug-Assisted Recovery Anonymous. The SMART Recovery (Self-Management and Recovery Training) program also allows for in-person and online group sessions.
Family therapy This includes partners or spouses and other family members close to the patient. It can help repair and improve family relationships that often lead to addiction problems.
Residential and Hospital Treatment Residential programs combine residential and hospital treatment services. Inpatient hospital programs combine health and addiction treatment services to serve people with medical problems, and some programs offer intensive outpatient treatment to relieve less severe problems or ease the transition to hospitalization. All of these types of treatment are very structured and often include several different types of counseling and behavioral therapy. This often includes medications and medical care to help you quit prescription or illegal opioids.
Damage limit
One element of the public health response to the opioid crisis is harm reduction. This means that even if people with opioid use disorder are unable to stop using the drugs, overdoses can be prevented and their quality of life improved. The Substance Abuse and Mental Health Services Administration supports many programs that are administered at the local level. Strategies include:
- Clean needle programs stop the spread of infectious diseases like HIV and hepatitis.
- Outreach activities that connect people to treatment and social services.
- Education and distribution of naloxone for overdose reversal.
- Plan to provide fentanyl test strips so drug users can check for contamination.
Opioid use during the COVID-19 pandemic
In 2022, the CDC recorded more than 103,000 drug overdose deaths, the highest number in 12 months. A 2020 report found that deaths related to opioid use increased 38.4% compared to the previous year.
COVID-19 lockdowns have disrupted treatment for many people, while social isolation and economic uncertainty have curbed drug addiction that may have worsened. Being home alone with nothing to do but worry about what’s going on in the world causes many people to relapse.
Rehabilitation centers are also unprepared for the challenges of social distancing. According to a study released in 2020, at the beginning of the pandemic, only 27% of drug rehab facilities in the United States offered telemedicine options.
However, the federal government has taken steps to expand telemedicine options for treating opioid use disorder during the pandemic by relaxing guidelines limiting remote appointments and prescriptions as well as take-home medications. A study published in 2022 found positive results. During the pandemic, more Medicare beneficiaries were able to use telemedicine to treat opioid use disorder than before the pandemic began, and those who did were more likely to remain in treatment and less likely to take excess.
How to Prevent Opioid Abuse
To combat the opioid epidemic, many in the scientific community are looking for ways to prevent addiction before it spreads.
Physicians play an important role in stemming the opioid epidemic by prescribing opioids more safely and responsibly and screening patients for opioid abuse during routine visits.
Most states have established prescription drug monitoring programs, which are electronic databases that track prescriptions for controlled substances. These programs can help identify patients who may be abusing prescription opioids and who are at risk for overdose. Doctors can then use this information to assess a patient’s history of controlled substance use before prescribing the medication.
Patients can also play a role in addiction prevention: Patients should never disclose their prescription medications and should not stop or change their medication regimen without discussing it with their doctor.
Patients should also be careful to handle their medications responsibly, as research shows that most people get the opioids they use for free from friends or family.
The U.S. Department of Justice’s Drug Enforcement Administration (DEA) hosts National Prescription Drug Take Back Days twice a year to provide the public with safe ways to dispose of opioids. If you miss these days, the DEA also offers locations to drop off controlled substances year-round.
Finally, researchers are investigating new strategies to prevent opioid abuse and overdose, including opioid-blocking vaccines and Food and Drug Administration (FDA)-approved opioid alternatives.
Can CBT treat chronic pain?
Cognitive behavioral therapy (CBT) is a form of psychotherapy designed to increase mindfulness, change destructive thought patterns, and help patients develop a rational mindset for coping with life’s challenges.
It is most commonly used to treat mood disorders such as anxiety or depression. However, some researchers believe it may also play a role in relieving chronic pain without the harmful effects that opioids sometimes have.
Experts say patients’ thoughts and beliefs play a crucial role in how they experience pain and how it affects their lives. For example, patients may avoid activities they enjoy because they fear the pain will worsen. Adults with chronic pain often take opioids to control pain. However, cognitive behavioral therapy can provide patients with strategies to address some of the psychological complications of chronic pain.
However, doctors stress that CBT does not cure the underlying pain pathology and may not work for everyone.
There is growing evidence that trauma (e.g. physical, psychological or sexual), particularly in childhood, and the resulting PTSD can lead to someone developing addiction problems later in life, e.g. : B. Opiate and other drug abuse; Therapies such as CBT and other trauma-based approaches may be able to address some of the underlying causes of addictive conditions.
Helpful Resources
ASAM’s Pocket Guideline and Patient Guide
The American Society of Addiction Medicine publishes a guide for people with opioid use disorder, plus their families and friends. It explains the assessment process and available treatments, including medications. The organization also has links to find a provider and support groups on its website.
SAMHSA Opioid Treatment Program Directory
The Substance Abuse and Mental Health Services Administration has a number of resources on its website, including a database of treatment programs.
SAMHSA Buprenorphine Practitioner Locator
You can also search for a doctor in your area who prescribes buprenorphine through this tool on the SAMHSA website.
This nonprofit hotline and online chat service allows someone using drugs alone to connect with a volunteer. That person is trained to listen for signs of an overdose and can alert first responders.
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