Written by Cristian Gonzalez and Miranda Helus
Opioids have become highly prevalent yet controversial in the field of medicine. Used for pain management, these medications can be not only extracted from the poppy plant but also produced naturally in the body as beta-endorphins. Opioids relieve pain by binding to mu (ยต) receptors in the nervous system and inducing feelings of euphoria. While pain relief is certainly beneficial, opioids and their euphoric effects can pose both physical and psychological risks. For example, opioid interactions with antidepressants can result in excessive, toxic levels of serotonin, which may lead to confusion, increased heart rate, and high blood pressure [1]. Long-term improper opioid use has recently caused major issues in the healthcare system due to widespread incidents of substance misuse (consuming the drug in a non-compliant or unsafe manner) and abuse (overdosing due to drug addiction or dependence). Unfortunately, the birth of the opioid plague has opened up even more complications.
In 2013, about 207 million prescriptions for opioids were administered; during that same year, 14,000 deaths due to opioid overdoses were reported [2]. In the last decade alone, hospitalization due to opioid abuse has risen by 72% (301,707 hospitalized in 2002 to 520,275 in 2012) [3]. Even more shocking is that, as one study demonstrated, 5% of hospitalized patients will presumably die from opioid-related illnesses [3].
Opioids have also placed a huge strain on healthcare finances. In 2012, for cases related to opioid addiction or dependence, total charges per hospitalization were estimated to be more than $28,000 ($107,000 when opioid-induced infections were accounted for) [3]. Between 2002 and 2012, total inpatient fees associated with opioid abuse more than quadrupled to $14.85 billion, and nearly $700 million of that amount was used to pay for opioid-related hospitalizations [3].
In response to the opioid epidemic, federal officials and regulatory organizations have prioritized strategies to combat opioid abuse whilst remaining thoughtful to those who actually require these medications. For example, the Federal Drug Administration has disclosed plans to organize committees that will oversee new drug opioid applications and pediatric opioid administration [4]. In addition, the FDA has advocated for warning labels [1,5] and safety guidelines to prevent patients from resorting to opioid misuse or abuse [4]. The state of New York has implemented an electronic prescribing system to minimize opioid prescription errors, while Massachusetts and Ohio have enforced the prescription limit to a time period of seven days [2]. Early this year, President Barack Obama proposed a supplemental fund of $1.1 billion to reduce prescription opioid abuse [1].
In spite of these admirable efforts, the United States still has to recognize one vital but largely overlooked fact. Contrary to popular belief, the majority of opioid users are currently taking them as advised, yet these people are regrettably inflicted with harmful stigmas regarding opioid abuse [2]. If medical practitioners and government officials wish to achieve more significant progress in managing opioid abuse, they will primarily need to inform the public that those who are taking these medications correctly are not to blame.
References:
1. Eder K, Gilchrist A. 2016. Overdose Death Warnings Added to Opioid Labels. Pharmacy Times
2. Poquette J. 2016. Opioid Nonabusers: An Inconvenient Truth. Pharmacy Times
3. Arlotta CJ. 2016. How Opioid Abuse Contributes to Rising Healthcare Costs. Forbes
4. Ross M. 2016. FDA Rethinks Opioid Approach Amid Drug Abuse Epidemic. Pharmacy Times
5. 2016. FDA Orders Warning Labels on Prescription Narcotic Painkillers: MedlinePlus. U.S National Library of Medicine