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Prescription Opioids Can Be Addictive and Dangerous It only takes a Little to Lose A Lot

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the straff of the Ridgewood blog

Ridgewood NJ, The Ridgewood Health Department warns you that he misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. According to the US Department of Health & Human Services (HHS), more than 130 people in the United States died every day from opioid-related drug overdoses in 2016 and 2017. In 2016, more Americans died due to opioid overdoses than car crashes. The Centers for Disease Control and Prevention (CDC) estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. From cities and suburbs to rural America, opioid addiction and overdose is “the crisis next door”. The United States is in the throes of an opioid epidemic, as more than two million Americans have become dependent on or abused prescription pain pills and street drugs. In October 2017, the President of the United States declared the opioid crisis a national public health emergency.

Opioids are natural or synthetic chemicals or drugs formulated to replicate the pain-reducing properties of opium. Opioids bind to receptors in the brain and spinal cord, disrupting pain signals. They also activate the reward areas of the brain by releasing the hormone dopamine, creating a feeling of euphoria or a “high.” Opioids are a class of drugs that include pain relievers available legally by prescription such as oxycodone, hydrocodone (Vicodin), codeine and morphine for acute or chronic pain, as well as illegal drugs like heroin and synthetic opioids such as illicitly made fentanyl. The word “opioid” is derived from the word “opium.”

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness. Taking too many prescription opioids can stop a person’s breathing—leading to death.

In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of the following side effects, even when taken as directed:
Tolerance—meaning the individual might need to take more of the medication for the same pain relief.
Physical dependence—meaning the individual has symptoms of withdrawal when the medication is stopped.
Increased sensitivity to pain
Constipation
Nausea, vomiting, and dry mouth
Sleepiness and dizziness
Confusion
Depression
Low levels of testosterone that can result in lower sex drive, energy, and strength
Itching and sweating

The following individuals are at most at risk of heroin addiction:
Ø People who are addicted to prescription opioid pain relievers
Ø People who are addicted to cocaine
Ø People without insurance or enrolled in Medicaid
Ø Non-Hispanic whites
Ø Males
Ø People who are addicted to marijuana and alcohol
Ø People living in a large metropolitan area
Ø 18 to 25 year olds

Research shows that some of the following risk factors make individuals particularly vulnerable to prescription opioid abuse and overdose:
ü Obtaining overlapping prescriptions from multiple providers and pharmacies.
ü Taking high daily dosages of prescription pain relievers.
ü Having mental illness or a history of alcohol or other substance abuse.
ü Living in rural areas and having low income.
ü Inappropriate prescribing practices and opioid prescribing rates are substantially higher among Medicaid patients than among privately insured patients.
ü In one study based on 2010 data, 40% of Medicaid enrollees with prescriptions for pain relievers had at least one indicator of potentially inappropriate use or prescribing.
ü Overlapping prescriptions for pain relievers,
ü Overlapping pain reliever and benzodiazepine prescriptions, long-acting or extended release prescription pain relievers for acute pain, and high daily doses.

Recognizing an opioid overdose can be difficult. If an individual isn’t sure it is an overdose, it is best to treat the situation like an overdose and a life could be saved. It is important not to leave the person alone and make sure to call 911 or seek medical care for the individual. Signs of an opioid overdose may include small, constricted “pinpoint pupils, ” falling asleep or loss of consciousness, slow, shallow breathing, choking or gurgling sounds, limp body, and pale, blue, or cold skin.

A drug called naloxone (Narcan) is available as an injection or a nasal spray, and is used as a treatment for opioid overdoses. It blocks or reverses the effects of opioids and is often carried by first responders. Individuals can take a training program on how to use this drug.

There are a variety of ways to help reduce exposure to opioids and prevent opioid use disorder, such as:
v Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the risk of opioid use disorder, overdose, and death. More than 11.5 million Americans, aged 12 or older, reported misusing prescription opioids in 2016.
v Prescription drug monitoring programs—A prescription drug monitoring program (PDMP) is an electronic database that tracks controlled substance prescriptions. PDMPs can help identify patients who may be misusing prescription opioids or other prescription drugs and who may be at risk for overdose.
v State prescription drug laws—A variety of promising legal and regulatory strategies are available to states to address prescription drug misuse, abuse, and overdose.
o The 21st Century Cures Act, passed in 2016, allocated $1 billion over two years in opioid crisis grants to states, providing funding for expanded treatment and prevention programs. In April 2017, Health and Human Services Secretary Tom Price announced the distribution of the first round of $485 million in grants to all 50 states and US territories.
o State legislatures are also introducing measures to regulate pain clinics and limit the quantity of opioids that doctors can dispense.
o The United States has launched an Opioid Fraud and Abuse Detection Unit within the Department of Justice. The unit’s mission is to prosecute individuals who commit opioid-related health care fraud. The United States Department of Justice (DOJ) is also appointing US attorneys who will specialize in opioid health care fraud cases as part of a three-year pilot program in 12 jurisdictions nationwide.
v Formulary management strategies in insurance programs, such as prior authorization, quantity limits, and drug utilization review.
v Academic detailing to educate providers about opioid prescribing guidelines and facilitating conversations with patients about the risks and benefits of pain treatment options
v Quality improvement programs in health care systems to increase implementation of recommended prescribing practices
v Patient education on the safe storage and disposal of prescription opioids
v Improve awareness and share resources about the risks of prescription opioids, and the cost of overdose on patients and families.
v Expand access to and use of naloxone – a non-addictive, life-saving drug that can reverse the effects of an opioid overdose when administered in time.
For more information on opioids and the opioid crisis/epidemic, visit the CDC websites at www.cdc.gov/drugoverdose/opioids/index.html, www.cdc.gov/drugoverdose/prevention/index.html; the National Institute on Drug Abuse at www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis; and the U.S. Department of Health and Human Services at www.hhs.gov/opioids/about-the-epidemic/index.html.
Opioid dependence and associated drug-related overdoses and deaths are serious public health issues that have reached crisis proportions in our communities, state of New Jersey, and throughout our nation. To address this epidemic, education and awareness can play a major role.

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