Opioid abuse is emerging as a serious public health issue of modern times. The current opioid epidemic is the worst drug crisis in american history. In 2015 alone, over 50,000 people died of drug overdose, almost equivalent to the number of deaths in road traffic accidents. Drugs were made ‘cool’ in the 80s and 90s by rockstars, and despite adverse outcomes of so many prominent public figures at the hands of substance abuse, there is still no stopping the large number of deaths that result from misuse/overuse of drugs in general, and opioids in particular. Surprisingly, opioid abuse is not as much of a problem elsewhere in the world as it is in the USA.
The U.S. Surgeon General has listed some statistics which describe the extent of the problem:
- 78 Americans die every day from an opioid overdose.
- In 2014, more than 10 million people in the United States reported using prescription opioids for nonmedical reasons, and close to 2 million people older than 12 years met diagnostic criteria for a substance use disorder involving prescription opioids.
- There has been a quadrupling of prescriptions for opioids since 1999, but there has not been an overall change in the amount of pain that Americans report.
- As many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with addiction.
The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin. The consequences of this abuse have been devastating and are on the rise. For example, the number of unintentional overdose deaths from prescription pain relievers has soared in the United States, more than quadrupling since 1999. There is also growing evidence to suggest a relationship between increased non-medical use of opioid analgesics and heroin abuse in the United States.
Prescription opioids act on the same receptors in the brain that heroin and morphine act on, and so they have intrinsic abuse and addiction potential, especially if used for non-medical purposes. Opioids receptors are present in the same center of the brain which moderates rewards; hence, the pleasure and euphoria.
They are most dangerous when when taken via methods not generally recommended, such as snorting, injecting, or taking with alcohol. Opioids are generally prescribed for control of moderate to severe pain, because of their property of changing the perception of pain by binding to specific receptors. With repeated administration of opioids, the body’s own opioid production is reduced, which leads to the discomfort observed in patients dependent on exogenous opioids.
The public health consequences of opioid pain relievers abuse are broad and disturbing. The CDC has laid out guidelines to combat this growing epidemic, which enlists the help of family, community and social set-up. The greater “social acceptance” for using these medications (versus illegal substances) and the misconception that they are “safe” may be contributing factors to their misuse. Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments. Equally important is the improved training of medical practitioners and their staff to better recognize patients at potential risk of developing non-medical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients.