The escalating number of prescription drug overdose deaths nationwide warranted a recent White House Summit. The abuse of opioids, a class of drugs which includes heroin and prescription painkillers, continues to takes its toll on our nation’s resources, both human and economic. To this end, the Acting Director of the Office of National Drug Contol Policy, the Attorney General of the United States, the Governor of Vermont, the Director of National Institute on Drug Abuse as well as some others regarded as experts on the issue of opioid abuse, came together in June of this year to address the problem.
An epidemic is defined as a sudden increase in something unpleasant or bad, affecting many people. And the current escalating abuse of prescription opiates certainly qualifies as a national epidemic.
In the past twenty years, it seems that an issue of chronic pain has become prevalent in our society, fueling an opioid epidemic and driving escalating health care costs which together have burdened our nation with seemingly insurmountable and adverse consequences.
According to a 2012 online PubMed article, an NCBI (National Center for Biotechnology Information) resource, the concerted efforts to increase the use of opioids in concert with a campaign touting an alleged under-treatment of pain continue as significant factors in fueling the escalation.
The article points out that many of the arguments made in favor of opioid use are based only on anecdotal observation, tradition of their use, practical experience and opinion.
Additionally, laws governing the prescribing of opioids have been liberalized by state medical boards over the past two decades to include treatment of chronic pain other than that caused by cancer; leading to a dramatic increase in the use of opioids.
The Current Scene
In addition to the above-identified changes as regards opioids and their use, there are more changes which have contributed to the prescription drug epidemic we now face as a nation.
The JCAHO (Joint Commission on Accreditation of Healthcare Organizations) introduced new pain management standards in 2000. There has been an change in attitudes as regards the right to pain relief with various organizations supporting large-dose opioid use, and probably the largest contributing factor—the aggressive marketing of opioids by the pharmaceutical industry.
According to the PubMed article, the above-taken stances on opioid use are not based on sound science, and on the contrary, are based on “blatant misinformation”. Exacerbating the situation is the dangerous assumptions made by the public and others that opioids are safe, highly effective and without adverse effects when prescribed by a physician.
The Results and Consequences
The 2010 NSDUH (National Survey on Drug Use and Health) shows that approximately 22.6 million Americans 12-years and older, used an illicit drug within the month prior to the survey.
That number translates to 8.9 percent of all Americans.
Again according to the NSHUH, the opioid painkiller hydrocodone topped all others with 136.7 million prescriptions in 2011. Total narcotic analgesic (painkiller) prescriptions exceeded 238 million in that year alone.
Opioid analgesics are now the cause of more deaths than the number of deaths from either motor vehicle crashes or suicides; and cause for more deaths than heroin and cocaine combined.
A significant correlation exists between death and the sales of opioid pain relievers, with 60% of the deaths occurring in patients who are prescribed the drugs according to medical board prescribing guidelines. As a point of comparison, 40% of deaths occur in those who are abusing the opioids gotten from doctor shopping, multiple prescriptions and drug diversion.
It was also noted in the article that its purpose was to describe the different aspects of the opioid crisis in our nation, and to point out the obstacles that must be overcome—most importatnly the inappropriate prescribing patterns which are based primarily on a perceived safety of the drugs, on a lack of knowledge about the drugs, and an on inaccurate belief of an existing under-treatment of pain.
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