In 2017, the U.S. Department of Health and Human Services declared a public health emergency to address the opioid crisis. And, for good reason. The HHS reports that more than 130 people die daily from opioid-related drug overdoses, with 11.4 million people misusing prescription opioids. However, the CDC found that in 2017 there were 70,237 drug overdose deaths in the United States - which was the highest number of drug overdose deaths for any single year in the U.S. As a consequence, the opioid crisis has reduced overall life expectancy.
What is the Opioid Crisis?
As explained in a Vox article:
“The opioid epidemic began in the 1990s, when pharmaceutical marketing and lobbying led doctors to prescribe far more opioid painkillers — leading to a first wave of overdose deaths as more people, including both patients and people who stole or bought painkillers from patients, misused the drugs and got addicted.
A second wave of drug overdoses took off in the 2000s when heroin flooded the illicit market, as drug dealers took advantage of a new population of people who used opioids but either lost access to painkillers or simply sought a better, cheaper high. And now the US is in the middle of a third wave, as fentanyls offer an even more potent, cheaper — and deadlier — alternative to heroin.”
One of the most concerning aspects of opioids is how easy it is to develop an addiction. This is because they release endorphins. These are the brain’s neurotransmitters. Endorphins, as noted by the Mayo Clinic, “muffle your perception of pain and boost feelings of pleasure, creating a temporary but powerful sense of well-being. When an opioid dose wears off, you may find yourself wanting those good feelings back, as soon as possible.”
Is There a Solution to the Opioid Crisis?
The easiest solution would be to reduce the number of opioid painkiller prescriptions. Other options could be expanding access to treatment and opioid addiction medications like methadone, buprenorphine, and naltrexone and an increase in public health campaigns.
While these options are effective, they do require the support from medical professionals to lawmakers. Because of this, it could take years for any real solution to become implemented. So, a better alternative may be to take matters into your own hands and protect yourself from opioid addiction.
Know the Risk Factors
“Opioids are most addictive when you take them using methods different from what was prescribed, such as crushing a pill so that it can be snorted or injected. This life-threatening practice is even more dangerous if the pill is a long- or extended-acting formulation,” explains the Mayo Clinic. This is because accidental overdoes are more likely when introducing all the medicine into your body so quickly. Also, consuming more than prescribed can increase the risk of addiction.
Also, how long you’ve been using prescribed opioids is another factor. Research has “found that taking opioid medications for more than a few days increases your risk of long-term use, which increases your risk of addiction. The odds you'll still be on opioids a year after starting a short course increase after only five days on opioids.”
Other possible factors are genetic, psychological, environmental, and the following:
Having a mental illness or a history of alcohol or other substance abuse
Family history of substance abuse
Poverty, low, or unemployment
Risk-taking behavior or history of criminal activity
Residing in a rural area
Frequent contact with high-risk people or environments
Being between the ages of 18 - 25
The Mayo Clinic also adds that “women have a unique set of risk factors for opioid addiction” since they “are more likely than men to have chronic pain.” Women are also more likely to be prescribed opioid medications, given higher doses and, use opioids for longer periods. “Women may also have biological tendencies to become dependent on prescription pain relievers more quickly than are men.”
Ask the Right Questions
Another way to protect yourself is to ask your physician what the best way to treat your pain before being prescribed any type of medication.
“In general, it depends on the type of procedure you're having or the pain you're experiencing,” says Dr. Tim Miller,
“And the plan is really to start slow and use non-opioid substances or drugs, like non-steroidal anti-inflammatories like aspirin or ibuprofen or Tylenol, or other modalities, like massage or other physical therapy efforts.”
“I think we were under the misassumption that opioids treated all types of pain pretty easily as a public, and that's not true,” adds Dr. Miller. “There are many other ways to treat pain,” such as acupuncture, meditation, or yoga.
If you are prescribed pain medicine, discuss with your physician how much you’ll need and for how long. Remember, you don’t want to take a high amount of opioids for an extended length of time.
“So, again, you start with questions,” says Dr. Miller, such:
“What is the best way to treat the pain you might anticipate that I will have?”
“What is your standard of practice?" or "I have this particular pain. What do you think the best way for me to have it treated is?"
“If it starts off with a conversation that seems unclear or moves very quickly to opioid narcotics, then you might want to ask more questions about why are we starting with that particular medication rather than something that's potentially less addictive.”
Take Medication Only as Prescribed
If you must take opioids, make sure that you only take the medication as prescribed. If you no longer need them, do not hold onto them. Destroy them and properly throw them away. “The risk is too great for someone to take this medication when not in pain,” says Sarah Wakeman, M.D., medical director for substance use disorders at the Massachusetts Center for Community Health.
Opioid Addiction Treatment
First, determine whether or not you’re addicted to opioids. “You might be addicted if you crave the drug or if you feel like you can’t control the urge to take the drug,” explains the American Academy of Family Physicians. “You may also be addicted if you keep using the drug without your doctor’s consent, even if the drug is leading to health, financial, legal or relationship problems.
Other signs and symptoms include:
poor coordination
drowsiness
shallow or slow breathing rate
nausea, vomiting
constipation
physical agitation
poor decision making
abandoning responsibilities
slurred speech
sleeping more or less than normal
mood swings
euphoria (feeling high)
irritability
depression
lowered motivation
anxiety attacks
If you notice these symptoms or someone has brought this to your attention, then you will need to speak with your doctor. They can help withdraw symptoms by prescribing methadone, buprenorphine, and naltrexone. You should also talk with a mental health professional and seek support from friends, family, and support groups.
Finally, commit to quitting. There are a number of ways to do this, such as writing down the reasons why you want to end your opioid use, establishing goals, keeping yourself through hobbies, and guarding yourself against temptation like not keeping opioids in your home, learning how to cope with stress, and avoiding people or places that you associate with your past opioid usage.